Research Findings in Health Inequality Mark R D Johnson
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Transcript Research Findings in Health Inequality Mark R D Johnson
Our Vision Too – Community Views
Mark R D Johnson
Mary Seacole Research Centre
OPSIS Conference: Focus on the Needs of
Vision Impaired People from Black &
Minority Ethnic Groups
(looking forward to World Sight Day 2007)
Research regarding B&ME Groups,
VI and take-up of Services
Composition of ‘English’ Health & Social
Care Users : 2001 13% from a ‘Minority’
group
England - Census 2001
White British
"Minority Groups"
White Irish
White Other
Asian Indian
Asian Pakistani
Asian Bangladeshi
Asian Other
Black Caribbean
Black African
Chinese
Mixed
Black Other
Other
The Population of Birmingham
Birmingham Population: Male %
20.17
69.87
ASIAN
5.88
BLACK
1.21
CHINESE
2.87
MIXED
WHITE
Birmingham Population: Female %
18.9
70.81
ASIAN
6.35
BLACK
1.09
CHINESE
2.85
MIXED
WHITE
The Visual Impairment Register
Birmingham - Males, 2003
5.5
11.7
0.5
Black (groups)
0.8
S Asian (groups)
Chinese/ S-E Asian
59.5
22
Other #
DNA *
White
Birmingham - Females, 2003
3.3
7.5
Black (groups)
0.5
0.2
S Asian (groups)
Chinese/ S-E Asian
23.5
Other #
DNA *
65
White
The Literature Review
Poor quality evidence base
High levels of diabetes lead to an
expectation of worse eye health.
Juvenile inherited eye conditions
Raised levels of glaucoma in African
Caribbean populations,
Keloid scarring – hinders surgery
More cataract among South Asian origins
The Research Base:
The ‘visual impairment’ research
literature tends to ignore issues of
race and ethnicity:
that relating to ‘race relations and
ethnic diversity’, largely excludes
attention to sight loss.
General Consensus
under-use of services by minority
groups
and possibly of under-registration.
low levels of knowledge
failure to recognise needs that can be
addressed.
Many short-term, unreported and
under-evaluated ‘projects’
Factors Affecting Use of
Services
Ethnic Differences in Patterns of Disease
Perceptions of Health, Body and Disease
Cultural and Language differences in Descriptions
Accessibility of Services (time and place)
(Previous experiences of) Encounters with Services
Alternative Treatment Options
Lifestyle, Socio-Economic Status, Religion and Cultural
practices
Racism – direct, personal, indirect or institutional
Language, Education and Availability of Information
Attitude, Awareness and Skill of Clinical staff
Improvement in Service
Uptake Requires
Assertive Outreach,
Cultural Competence,
Partnership with minority ethnic groups
We would add:
Commitment by management
Resources
Persistence
The Aim of the Project
To examine and develop ways of ensuring that
services are more effectively delivered to people
from black and minority ethnic (BME)
communities with visual impairments (VI).
To raise awareness of sight loss issues and
services in black and minority ethnic
communities and voluntary sector groups
working in those communities
To raise the capacity of (VI) service providers to
recognise the specific needs of people from
minority ethnic groups, and establish the best
ways of meeting these.
Some New & Refreshed Insights
a greater level of housing need
culturally specific lifestyle issues
impact on social and religious life
lack of social and family understanding
low expectations – ‘inevitable aging’
stigma or “false” pride
‘learned helplessness’
Responses have to be community-specific
The ‘Good Practice Model’
Stage 1: Project Initiation: The
Conceptualisation and Initial Planning
Stage 2: Recruit Key Worker(s).
Stage 3: Review Local Services
Stage 4: Create Network of Stakeholders
Stage 5: Recruit Community Facilitators
Stage 6: Develop Project Agenda / Topic
Guide
The Model – Part Two
Stage 7: Conduct Interviews
Stage 8: Review, Analyse and Feedback
Stage 9: Devise or Refine Training and/or
Information Packs
Stage 10: Take Appropriate Action – Further
Intervention
Stage 11: Evaluate
Stage 12: (IF Appropriate) Establish and
Integrate Learning into Mainstream Practice
And How do we do that?
Two Checklists
A Checklist of
issues to raise with
and within
communities and
organisations
NB: Disability
Rights are part of
the Law
A Toolkit Checklist
for Service
Providers
NB: Race Equality
Schemes are now
required by Law
Key Recommendations:
Sight Loss support services need to recruit staff from
within minority communities
Information must be translated into minority languages
Information needs to be actively promoted through
community organisations
Sustained effort may be needed to overcome suspicion
based on past experiences
Previous initiatives have foundered because of a lack of
continuity – a longer-term perspective is required to
bring change and create better relationships
The Outcome!
Community Views
Jasbir Behal
Forum – Community, Statutory, VOs &c.
Sight Loss/Eye Health Information Fairs
Lobbying
Publications
More research and development
One new study
Glaucoma awareness and perceptions of
risk among African-Caribbeans in
Birmingham, UK
Vinette Cross, Peter Shah,
Rustom Bativala, Peter Spurgeon
Diversity in Health and Social Care
Volume 2, Number 2, June 2005 , pp. 8190(10)
Further reading (or via WWW)
Our Vision Too: Improving the Access of Ethnic
Minority Visually Impaired People to appropriate
services Seacole Research Paper 4 Leicester:
MSRC with Housing Corporation and Thomas
Pocklington Trust (Asesha Morjaria-Keval and
MRD Johnson), February 2005
‘Ethnicity, Sight Loss and Invisibility’ British
Journal of Visual Impairment Vol 25,1 :23-33
(Johnson MRD, Morjaria-Keval A) 2006
Research Findings & Occasional Papers –
www. pocklington-trust. org. uk
‘Co-ordinates’ or
Contact Details
CEEHD - Mary Seacole Research Centre
De Montfort University
266 London Road, Leicester LE2 1RQ
Tel: 0116 201 3906 (fax: 0116 201 3805)
[email protected]
website: www.dmu.ac.uk/msrc or
www.ethnic-health.org.uk
www.library.nhs.uk/ethnicity
www.pocklington-trust.org.uk
NB: [email protected]