7000PUBHEA: Public Health: Policy And Practice Case Study

7000PUBHEA: Public Health: Policy And Practice

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Introduction: Public Health: Policy And Practice

Health inequality is a term that refers to the differences which is between individuals or groups. The aspect of the heath varies in the aspect of measure between individuals or in the groups that are socially relevant.Supporting the statement, Greenaway et al. (2020) enunciated that some specific factors, such as employment status, education and ethnicity, have played a significant role in creating health inequality. It can be said that health inequalities should be onsidered as unfair to the world and it is responsible to create differences between the groups of society.In the UK, inequalities in the healthcare sector are immensely prevalent, and it is found that compared to men, the life expectancy of women is low. Reports from the GINI coefficient (a measurement of economic inequalities) have revealed that among European countries, health inequalities in the UK are the highest (Statista, 2022a). It is also found that life expectancy in the UK has depended on certain factors, including geographic, gender and sociaoeconomic status. Moreover it can be concuded that in UK medical department ethnicity plays an important role and it has also generate dispairity. Although after evaluating the Office for National Statistics (ONS) report, it is revealed that from 2011 to 2014, the life expectancy at birth of white British people was lower than ethnic minority groups (The King’s Fund, 2022).Another factor that can be disvcussed is BME which refers to black and minority ethnic and the result of BME is that the groups which are included into BME have a worse health condition as compared to the overall population of UK Ethnic health inequality is the reason of so many causes and BME is one of the most important reason (Banerjee, 2021). As an example it can be mentioned that in the last five years approximately 3.9 million people of BME was working in different sections of UK and it wass reported that 21% of them which is equals to 120,000 has quited the job because of getting bullied on a everyday baiss (Newsclick.in, 2022).In the UK, BME is found to be the largest ethnic group and similar to white Britons, the mentioned group has also gained the chance to access primary care services.The bullying of the people have a great effect on the workers as the situation goes very pathetic.. In terms of improving the health condition of a nation, it is inevitable for healthcare professionals to eradicate health inequality. Aiming to reduce health disparities from the BME acronyms, the NHS authority has diversified senior leadership and has hired medical staff from that group.The work process ofr NHS is that they give equal care and treatment toevryone whether they have the ability to pay or not (Annoh et al., 2021). The health ministry of the UK has also invested a lump sum amount of capital in enhancing community engagement activities for providing quality treatment to persons from the selected group. In 2019, NHS created the NHS long-term plan for reducing health inequalities in the UK society (GOV.UK, 2022). The current report aims to identify the severity of health inequality in the BME group of the UK and appropriate strategies to diminish that disparity.

Objectives of the present report include:

• To assess health disparity among the individuals of the BME group and also about the Gypsy and Irish traveller in the UK
• To evaluate strategies for eradicating that health inequity.

What Are Health Inequalities, And What Causes Them?

Based on the experience of Bambra et al. (2020), health disparity has been observed in different health outcomes, from self-assessed mental health to life expectancy. Persons from different cultural backgrounds and social groups have enjoyed various levels of health. However, due to preventable and unjust health disparity, persons from certain socioeconomic backgrounds have failed to acquire the required care. Considering to expand that opinion, Naik et al. (2020) demonstrated that good health is deemed the key aspect of living a quality life. However, due to health inequality, it has been arduous for individuals to maintain a healthy lifestyle. Health inequalitites can be defined as differences that are avoidable in termsof outcome of the health condition between a person and a group.(GOV.UK, 2022). The existence of health disparity has created a negative impact on a specific group of persons who have displayed deteriorated health conditions.There are four theories related to heslth inequality and they are selection. Artefact, cultural and structural and structural theory gives the best explanation. Structural theory describes the inequality between resources, wealth and other resources and the outcome of it, different kind of discrimination can be seen in government, health care, legal and different kind of fields. The structural differences had been seen during the time of covid and the older adults were getting neglected. The understanding the social issue as a in terms of health inequality can be considered as a moral issue (Harris et al., 2020). In the UK, health disparity has not rendered any positive impact on fellow citizens. Instead, the inequality has prevented millions of citizens from obtaining sufficient care, which has decayed their health conditions amid the COVID outbreak. It has been found that the mortality rate due to COVID-19 has remained higher in deprived regions of the UK (Health, 2022). Despite initiating the vaccination program, the presented inequality has hindered frontline workers of the NHS from continuing that program in impoverished regions and ethnic minority groups.

In the UK, the presence of health inequality has created a 19-year gap in healthy life expectancy among individuals who live in developed and deprived neighbourhoods. One report says that the pndamedic has shown a difference between the population who are in working age and with the people who are younger than 65 and also the difference can be shown in between the poor and rich people in terms of wealth as thenumber of the death person of poor people were more than the number of people died becsuse of covid who are rich. In southwest and southeast England, life expectancy at birth for men has fallen. Surprisingly for females, apart from these mentioned regions, life expectancy at birth has remained lower. In the UK, health inequality has arisen due to certain factors such as deprivation and socioeconomic status, vulnerable health groups, characteristics under the Equality Act 2010 and geography.

Figure 1: Factors That Generate Health Inequalities.

Deprivation and socioeconomic status include low income, unemployment and living conditions in impoverished regions. In 2020, the unemployment rate of the UK was 4.1% yet the disrupted financial conditions due to the eruption of the pandemic health increased the rate by 1% in 2021 (Statista, 2022b). A bridge between the health inequality and structural racism can be made as both the topics are parallel with each other. Structural racism is the example of power imbalance where one group of peop,e has set a rule and others are obedient to follow the rules. The person who belongs to the powerful position in terms of political and others take the wrong advantages of their power and exclude that particular human being whom they don not like (Scambler, 2012). The structural inequality is different from inequality as the structural inequality makes an huge difference to the people who are from high class society and the people of low or middle class.

Figure 2: Unemployment Rate In The United Kingdom.

The increasing unemployment rate has significantly reduced the income level of UK households, including all the ethnic groups such as Irish traveller and human from Pakistan and Bangladesh. Reports of 2021 have disclosed that the average income of approximately 45% of UK households was below 600 GBP. Significantly, black minority groups have displayed the lowest income among the other ethnic groups in the UK.

Figure 3: Medical Costs In The Uk Private Hospitals.

A report states that the average cost for one person who may be around 33 years old is monthly £48 and the cost of yearly is average is £576. Any insurance gives the maximu premium of £1,500. In the UK, the health care system for migrants is not appropriate. It is found that despite suffering from chronic conditions such as kidney failure, cancer and heart problems, migrants in England were denied proper treatment for almost 37 weeks (The Guardian, 2020). Reportedly, an anti-FGM campaigner suffering from a brain tumour was charged approximately 8397 GBP as treatment cost (The Guardian,2019). Resulting, a large number of ethnic minority groups who have migrated from other nations have failed to live a healthy lifestyle. On the other hand, reduced health and support services of the NHS has created health-related risk for sex workers (The Guardian, 2016). Maximum individuals in the mentioned profession have experienced gynaecological issues; however, the absence of treatment has severely affected their health conditions. It is reported that specialist NHS-funded health services controlled the outbreak of syphilis, HIV and tuberculosis among punters by initiative hygiene programs. Henceforth, the absence of that service has created challenges for sex workers to maintain proper health conditions. Race and gender are the significant characteristics of the Equality Act 2010, which have remained accountable for creating health disparity. The act has designed to simplify the rules and give strength to the legal work. Racial discrimination is prevalent in the UK medical sector, and apart from patients, healthcare staff have also encountered disparities at workplaces. According to reports, among ethnic minority groups, dark-complexioned citizens of the UK have encountered prejudices from care professionals (Iacobucci, 2022). A maximum of young individuals aged from 18 to 34 have complained of receiving inappropriate care from nurses and other healthcare staff. The Race Relations Act of 1965 in the United Kingdom Outlawed existing discrimination on the grounds of nationality, skin colour and other ethnic origins. However, practices of that law were consciously avoided in every sector, including healthcare. Studies found that in 2017, almost 26% of Britons encountered facial prejudices which hindered them from availing of essential services, including critical care from hospitals (Hackett et al. 2020). The consequence of Brexit has supported migration which has increased the practices of racial discrimination in the UK healthcare industry. A report states that approximately 109,843 cases of racism has been files in the year of 2021-2022. Due to this discrimination, black and other ethnic minority groups have struggled to receive proper care in the NHS and private hospitals.

Figure 4: To What Extent Do You Think Racism Is Present In Uk Society Today.

Conflict theory describes inequality that causes due to the domination of certain groups. According to conflict theorists, inequalities have hindered societal progress that creates challenges for general individuals to maintain the status quo (Cerrato and Cifre, 2018). In the UK, gender discrimination has affected both the business and healthcare sectors. Reports have revealed that compared to men, the number of women citizens suffering from mental health issues such as anxiety has increased during the COVID outbreak ‌ (Finch and Tinson, 2022). This has occurred due to the absence of appropriate treatment for women patients. In 2016, research workers from the University College London covered that women suffering from dementia received less medical treatment compared to men with similar healthcare conditions (Parliament, 2021). . A report published by MBRRACE-UK demonstrated that from 2016 to 2018, approximately 9.7 women/per hundred thousand died during or after childbirth. The maternal mortality rate has also remained higher among ethnic minority groups. It is found that within the mentioned time frame, the number of deaths of black women was 34 while 15 Asian women per hundred thousand passed away during childbirth (Parliament, 2021). Statistics from ONS has revealed that from 2012, the number of suicides among female (aged 10-12) has rocketed in a significant way. Although in 2019, the number of registered suicides among men was 4,303 yet, 3.1 women per hundred thousand successfully committed suicide. These data prove that gender discrimination in provided care has severely affected the health conditions of UK citizens, regardless of their ethnicity and economic condition. Geographic factors such as rural and urban regions have also displayed symbols of health inequality. In the UK, health-related facilities are higher in urban territories than in rural regions, and regarding this, residents of rural areas were unable to obtain emergency care.

Illustrate Health Inequalities

In the UK, health inequality has severely affected ethnic minorities, especially BME groups. A conducted survey has demonstrated that almost 3% of ethnic minority groups belong to BME.

Figure 5: Ethnicity In The United Kingdom As Of 2011.

According to research, the great majority of the individuals from the selected population have failed to collect quality care due to financial deprivation (Robertson et al., 2021). It has been found that persons from the BME group have experienced income inequality which has created challenges for them to avail expensive medical care. According to reports, the median weekly household income of Black/African/ Black British in 2016-17-2018-19 was 408 GBP, and this amount plummeted due to the increased unemployment rate caused by the COVID outbreak (Parliament, 2020).

Although the employment rate of that group was high yet, due to the low income, persons of the BME group suffering have failed to take proper treatment for their prolonged illness. The lack of treatment has enhanced life-threatening diseases such as cardiovascular diseases, cancer and mental health among the concerned group. In the pre-COVID era, the life expectancy rate of the BME group was high however, in the post-COVID, the negligence of the UK healthcare system has escalated the maternal and infant mortality rate of the concerned group (Raleigh and Holmes, 2021). The negligence has also increased the mortality rate from covid-19 in black and minority ethnic groups. The NHS race and health observatory have revealed that healthcare providers have avoided giving proper care, which has led to poor outcomes for different ethnic minority groups. The above mentioned department have stated that the minority people have more chances to get the negligence in medical department more than white people and also there is a huge and considarble difference between various groups and their health condition (Chouhan and Nazroo, 2020).The absence of chances to access healthcare services has rendered issues for COVID patients (BME group) to follow suggestions from doctors. Due to this, the death rate of the selected population from the COVID pandemic was 5.8% (Statista, 2020). Due to the presence of racial inequalities in the UK healthcare system, persons from Black and ethnic minorities have experienced entrenched problems while seeking care services from the NHS and other private healthcare organisations. After evaluating the current condition of the UK healthcare sector, it can be inferred that without proper strategies, it has been difficult for healthcare professionals to provide a healthy lifestyle to the concerned group. Regarding this, the health ministry of the UK has adopted several initiatives so that BME groups might be able to overcome their present health difficulties.

Evaluate Policies Or Strategies

The policies or strategies are essential in inprove the health condition of the community and to reduce the health inequality overall the country. The local and national strategies by NHS have focused on reducing the structural as well as environmental drivers of health discrimination and deprivation among the BME community in the UK (Robertson et al., 2021). During the time of covid the officers of NHS adapted a strong health leadership strategy to change the situation which is going for so much long time.Some individual leaders who were inclusive was appointed and they do not behave in a bad manner to anyone (Kline, 2019). The health authority has incorporated skilled medical professionals and knowledgeable team leaders for fulfilling health-related requirements in the community., NHS has established a sustainable health plan that indicates the reduction of health biases in the UK. The aim of the health equality strategy is to detect the seriousness of inequality issues in the BME community of the UK. Furthermore, the establishment of the team diversification strategy is to diminish health inequality and eradicate the health disparity among the concerned minority community. The strategy of NHS represents the health improvements which are based on the levels of “system, place and neighbourhood” (Robertson et al., 2021). The national strategy and policy of the UK health ministry is the broader aspect of decreasing health disparity. The “primary care networks (PCNs)”, local health associates, place-based local health partners, ICSs and boards for health and well-being the stakeholders of this strategy (Robertson et al., 2021). The national strategy and policy by NHS has concentrated on recognising several health factors that are responsible for inducing poor health among the community people. There are also some steps that can be takn to reduce the health inequality and inprove health and they are discussed below.

Every doctors and medical staff has to ge the mentality thatthey need to support every individual without their class or education. The design that will be made to changr the old system everybody needs to support that. In orde to inprove healt the medical staffs has to pay attention towards the habbit related to health of the people and need to try to inprove the life style.The changes that are going to be made, addressing them is also a big challenge.

In addition, the recent implementation of the “integrated care systems (ICSs)” has helped in improving the staff experience and escalating the diversification in the senior leadership from the BME community.ICE is an organization that helps to build a partnership between the organization who have the intention to provide health and care service. Also a statutory committee was formed in the joint form local authorities in the high level and NHS organization and the newly formed committee will fall under the sustem of NHS. Additonally it can be added that some action were takenby the government of UK for ICS and first of them is that Health and Care bill 2021-2022 .This action take place through the ICS and partnership of integrated department and also the partnership that are place based and try to bring positive effects to the locl society and inprove their health condition (Gov.uk, 2023). NHS planning and operational guidance has build a particular guidance to inprove the health condition and reduce the health inequality.. In this regard, the “Institute of health equity” has concentrated on establishing healthy lives and a fair society by addressing a set of health determinants which are essential to positively contribute to community health (GOV.UK, 2022). The local authorities of the UK and the policymakers have focused on scaling the health disparity by including health groups and specifying the “life course stages” (GOV.UK, 2022). On the other hand, the “local government association” of the UK has determined the acquisition of positive outcomes by implementing the leadership diversity strategy. On the other hand, the local authorities of the UK, such as “health and wellbeing boards, ICS partnerships and local economic partnerships”, have assisted in enabling the whole strategic approach (GOV.UK, 2022). In terms of reducing the health inequalities some steps are need tobe taken such as first of all theyneed to focus on the social inequality that leds to health inequality and social inequality is based on the matter such as income, lifestyle, economyand many more. There are some actions are also required in the area of policy and also need to involve a huge range of organizations who are determined to do welfare. The actions and plans can be relocated again to get a better result.

The diversified leadership role has helped in maintaining health equity and providing healthcare justice to the BME community. On the other hand, in 2006, the “Health Inequalities National Support Team (HINST)” established a strategy to decline the health inequality gap in the UK (Public Health England, 2017).The department was made to give support to the local areas such as primary care trust, local authority and also to the partners of them to handle the health inequality (Assets.publishing.service.gov.uk, 2023). The process of NHS is involved with the review of huge data based intelligence, key documents and key informations along with interviews. The department has decided to publish alarge number of reports that will help to understand the program a lot. In this way, the policymakers, commissioners and local strategy planners have developed some actions for declining health inequality. Thus, the systematic approaches are included in the four strands which have been demonstrated below.

• Reinforcing the social and local community networks
• Amalgamation of the peer support health workers and community connectors
• Setting the health priority by the local community, designing the health equality program and services, along with the strategic evaluation
• Incorporation of good accessibility of health resources is involved in the strategic approaches of the UK government,

On the other hand, the diversified leadership approaches have identified the collaboration and strategic partnership opportunities that support the scaling of health disparity. Thus, in order to decline the health disparity, the health authority of the UK has incorporated skilled medical professionals and knowledgeable team leaders for fulfilling health-related requirements. In this regard, an adequate amount of investment has been initiated to implement health strategies and increase the treatment quality.

The team of HINST has worked in such a way that they serve seventy local community that includes those population of England who are poorest.Based on the government report, NHS has established a sustainable health plan that focused on the reduction of health disparities in the UK (GOV.UK, 2022). However, the health equality strategy aims to identify the seriousness of inequality issues in the BME community of the UK. However, the recent implementation of the “integrated care systems (ICSs)” has helped in improving the staff experience and escalating the diversification in the senior leadership from the concerned community (Robertson et al., 2021). On the other hand, there are certain principles regarding health equality which consist of the appropriate evidence and findings regarding the health strategy. The health equality principles imposed by the UK government have focused on health improvements by providing the first and fastest health services to the minor population, such as BME. Thus, the government of the UK has determined the acquisition of positive outcomes by implementing the leadership diversity strategy.

Conclusion

In order to summarise the whole discussion, it can be concluded that the health inequality issues of the BME community in the UK have been analysed in this context. The health disparities have reduced life expectancy irrespective of countries respective to their economic situation. The health report of the “BME (black and minority ethnic)” community suggests the experience of deteriorated health conditions due to health disparities caused by poverty. A report state that during the time of 2020-2021 one of the five person in UK were under proverty which refers to the number 20% and one out of four children are living under proverty in UK (Jrf.org.uk, 2023). Based on the health survey of England, BME groups have encountered improper health conditions at younger ages, and this happened due to inappropriate socio-economic positions. In this regard, the report focused on identifying the severity of health inequality in the BME group of the UK and appropriate strategies to diminish the health biases. Thus, the health equality issues and the reasons behind the issues have been evaluated in this context. The application of Functionalist theory suggests that inequality is desirable as well as essential for maintaining a balanced society. On the other hand, conflict theory describes inequality that causes due to the domination of certain communities. In the case of illustrating the health inequalities, it has been identified that the majority of the individuals from the selected population have failed to collect quality care due to financial deprivation. However, NHS has imposed the “local and national strategies” and “leadership diversification strategy” for diminishing health inequality and eradicating the health disparity among the concerned minority community. Therefore, it can be recommended that proper implication and regulation of the strategies will help to reduce the health disparity among the BME community in the near future.

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