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]