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Content ArticleIn its manifesto ahead of the 2024 UK general election, the NHS Race & Health Observatory calls for a unification of efforts towards eradicating racial and ethnic health disparities in the nation’s healthcare system.
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News Article
Ethnic minorities in England ‘need more GP visits’ before cancer diagnosis
Patient Safety Learning posted a news article in News
Ethnic minorities and young people require more visits than other people to the GP before being diagnosed with cancer, according to new analysis. On average, one in five people across England require three or more GP interactions before being diagnosed with cancer. But for people from ethnic minority backgrounds, the figure rises to one in three, according to analysis of the NHS cancer patient experience 2022 survey by QualityWatch, a joint programme from the Nuffield Trust and the Health Foundation. For young people aged between 16 and 24, about half needed at least three GP visits before being diagnosed, with 20% needing at least five visits. Despite this, young people were still more likely to be diagnosed at an early stage in their cancer. Prof Kamila Hawthorne, the chair of the Royal College of GPs, said that identifying cancer symptoms in young people could be challenging as the risk for the group was generally much smaller. Hawthorne said: “Ensuring patients receive timely and appropriate referrals for suspected cancers is a priority for GPs – and to this end, they are doing a good job, making more urgent referrals and ensuring more cancers are being diagnosed at an early stage than ever. “Whilst GPs are highly trained to identify cancers, this remains challenging in primary care, not least and particularly with some cancers, because the symptoms are often vague and typical of other, more common conditions.” Dr Liz Fisher, senior fellow at the Nuffield Trust, said: “Delays to a cancer diagnosis pose real risks for people and an early diagnosis plays a pivotal role in determining the treatments available to people and determining outcomes. “The NHS has set an ambitious goal to dramatically increase early detection of cancer, but performance in this area has stubbornly stalled in recent years. Everyone’s experience of cancer diagnosis is different but the risks to delays aren’t felt equally, with younger people and those from minority ethnic groups requiring more visits to health professionals to secure a diagnosis.” Read full story Source: The Guardian, 24 April 2024 -
News Article
Black people who spot cancer symptoms are taking twice as long to be diagnosed
Patient Safety Learning posted a news article in News
Black and Asian people who spot cancer symptoms are taking twice as long to be diagnosed as white people, a shocking new study shows. Research by Bristol Myers Squibb (BMS) and Shine Cancer Support shows that people from minority ethnic backgrounds face an average of a year’s delay between first noticing symptoms and receiving a diagnosis of cancer. These groups report more negative experiences of cancer care than white people, limited knowledge about the diseases and lack of awareness of support services, which all contribute to later diagnostic rates. “In a year that’s revealed that the UK’s cancer survival lags behind comparable countries, I am saddened but unsurprised that people from minority ethnic groups face additional hurdles that delay their diagnosis.” said Ceinwen Giles, co-ceo of Shine Cancer Support. “We know that catching cancer earlier saves lives, yet with year long waits for some people, collaborative efforts between health leadership, advocacy groups and the pharmaceutical industry are required.” Read full story Source: The Independent, 9 April 2024 -
Content ArticleCancer Equals is a campaign launched by Bristol Myers Squibb, to understand and help address the many factors that lead to delays in cancer diagnosis and variations in cancer experiences between people from different backgrounds. Cancer Equals research shows that people from minority ethnic groups experience seven months longer delays between noticing cancer symptoms and diagnosis compared to white individuals. Many factors lead to these delays in diagnosis and differences in people’s experience of cancer – no one’s story is the same. Delays to diagnosis will and do impact prognosis, changing the course of peoples’ lives. Health disparities and inequalities are an ongoing and pressing issue, with the UK government, NHS and patient groups committed to increasing earlier diagnosis and improving outcomes for people living with cancer.
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News Article
Trust’s treatment of Muslims heavily criticised by board director
Patient Safety Learning posted a news article in News
A board director has publicly criticised his trust for its treatment of Muslim staff and patients. Mohammed Hussain posted on social media that some board members at Bradford Teaching Hospitals “are not heard and listened to”, and that there is a “dissonance” between its espoused values and the “lived experiences” of minority ethnic staff. Mr Hussain, a non-executive director since 2019, was responding to a post by CEO Mel Pickup, who had said the trust had a “variety of support offers for colleagues observing Ramadan”. He said there are “many examples” of Muslim families experiencing poor responses to complaints to the trust, while claiming that “outstanding” Muslim staff are having to “move out of the area to progress because they are not promoted internally”. The trust said its launching an investigation into the concerns raised by Mr Hussain. Read full story (paywalled) Source: HSJ, 12 March 2024 -
News Article
UK report reveals bias within medical tools and devices
Patient Safety Learning posted a news article in News
Minority ethnic people, women and people from deprived communities are at risk of poorer healthcare because of biases within medical tools and devices, a report has revealed. Among other findings, the Equity in Medical Devices: Independent Review has raised concerns over devices that use artificial intelligence (AI), as well as those that measure oxygen levels. The team behind the review said urgent action was needed. Prof Frank Kee, the director of the centre for public health at Queen’s University Belfast and a co-author of the review, said: “We’d like an equity lens on the entire lifecycle of medical devices, from the initial testing, to recruitment of patients either in hospital or in the community, into the early phase studies and the implementation in the field after they are licensed,.” The government-commissioned review was set up by Sajid Javid in 2022 when he was health secretary after concerns were raised over the accuracy of pulse oximeter readings in Black and minority ethnic people. The widely used devices were thrown into the spotlight due to their importance in healthcare during the Covid pandemic, where low oxygen levels were an important sign of serious illness. The report has confirmed concerns pulse oximeters overestimate the amount of oxygen in the blood of people with dark skin, noting that while there was no evidence of this affecting care in the NHS, harm has been found in the US with such biases leading to delayed diagnosis and treatment, as well as worse organ function and death, in Black patients. The team members stress they are not calling for the devices to be avoided. Instead the review puts forward a number of measures to improve the use of pulse oximeters in people of different skin tones, including the need to look at changes in readings rather than single readings, while it also provides advice on how to develop and test new devices to ensure they work well for patients of all ethnicities. Read full story Source: The Guardian, 11 March 2024 -
Content ArticleA core responsibility of the NHS is to maintain the highest standards of safety and effectiveness of medical devices available for all patients in its care. Evidence has emerged, however, about the potential for racial and ethnic bias in the design and use of some medical devices commonly used in the NHS, and that some ethnic groups may receive sub-optimal treatment as a result. In response to these concerns, the UK Government commissioned this independent review on equity in medical devices. In its final report, the Review sets out the need for immediate action to tackle the impact of ethnic biases in the use of medical devices. Its findings and recommendations have also been published in a short animation. The Government’s response to the Review's 18 recommendations has also been published alongside its final report.
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News Article
Ethnic minorities in England have worse access to GPs
Patient Safety Learning posted a news article in News
Areas across England where the highest proportion of ethnic minorities live have the poorest access to GPs, with experts attributing this disparity to an outdated model being used to determine funding. As of October 2023, there were 34 fully qualified full-time-equivalent GPs per 100,000 patients in the areas with the highest proportion of people from ethnic minority backgrounds, according to a Guardian analysis of NHS Digital and census data. This is 29% lower than the 48 general practitioners per 100,000 people serving neighbourhoods with the highest proportion of white British people. Although ethnic minorities tend to be younger than the white British population, minority ethnic areas still have the lowest number of GPs per person even when factors such as age, sex and health necessities are considered. Prof Miqdad Asaria at the London School of Economics department of health policy said it was “very concerning” that ethnic minorities “have systematically poorer access to primary care which is likely to be a key driver of current and future health inequalities”. “Primary care plays a crucial role in preventing disease, diagnosing and treating illness, and facilitating access to specialist or hospital treatment for people who need it,” he added. Read full story Source: The Guardian,15 February 2024 -
News Article
'Ethnic bias' delayed care before Liverpool woman's death
Patient Safety Learning posted a news article in News
"Cultural and ethnic bias" delayed diagnosing and treating a pregnant black woman before her death in hospital, an investigation found. The probe was launched when the 31-year-old Liverpool Women's Hospital patient died on 16 March, 2023. Investigators from the national body the Maternity and Newborn Safety Investigations (MSNI) were called in after the woman died. A report prepared for the hospital's board said that the MSNI had concluded that "ethnicity and health inequalities impacted on the care provided to the patient, suggesting that an unconscious cultural bias delayed the timing of diagnosis and response to her clinical deterioration". "This was evident in discussions with staff involved in the direct care of the patient". The hospital's response to the report also said: "The approach presented by some staff, and information gathered from staff interviews, gives the impression that cultural bias and stereotyping may sometimes go unchallenged and be perceived as culturally acceptable within the Trust." Liverpool Riverside Labour MP Kim Johnson said it was "deeply troubling" that "the colour of a mother's skin still has a significant impact on her own and her baby's health outcomes". Read full story Source: BBC News, 16 February 2024 -
Content ArticleRacial and ethnic disparities in health are substantial and persistent in the USA. They occur from the earliest years of life, are perpetuated by societal structures and systems, and profoundly affect children’s health throughout their lives. This series of articles in The Lancet Child & Adolescent Health summarises evidence on racial and ethnic inequities in the quality of paediatric care, outlines priorities for future research to better understand and address these inequities and discusses policy solutions to advance child health equity in the USA. Racial and ethnic inequities in the quality of paediatric care in the USA: a review of quantitative evidence Policy solutions to eliminate racial and ethnic child health disparities in the USA
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Content ArticleThis report is divided into two sections. The first section is contextual and reviews literature, both national and international, that provides insights into the experiences of Black and Ethnic Minority (referred to in this report as BME) and internationally recruited nurse (IRNs). The second section focuses specifically on the literature related to health and social care regulatory bodies within the UK, and the reporting of professionals in relation to fitness to practise.
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Content ArticleThe ethnicity data gap pertains to three major challenges to address ethnic health inequality: Under-representation of ethnic minorities in research Poor data quality on ethnicity Ethnicity data not being meaningfully analysed. These challenges are especially relevant for research involving under-served migrant populations in the UK. This study in BMC Public Health aimed to review how ethnicity is captured, reported, analysed and theorised within policy-relevant research on ethnic health inequities. The authors concluded that the multi-dimensional nature of ethnicity is not currently reflected in UK health research studies, where ethnicity is often aggregated and analysed without justification. Researchers should communicate clearly how ethnicity is operationalised for their study, with appropriate justification for clustering and analysis that is meaningfully theorised.
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Content ArticleNational Voices is committed to tackling racial inequalities – in healthcare, health status, within their own organisations and across the charity sector. With unacceptable statistics, like Black women are four times more likely to die around pregnancy than White women, and Black babies are almost three times more likely to die than White babies – still now, in 2023 – the need for effective action could not be stronger.
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News Article
UK minority ethnic transplant patients face double inequity, MPs say
Patient Safety Learning posted a news article in News
NHS “inaction” for more than a decade is causing unnecessary deaths of black, Asian and minority ethnic transplant patients, a report by MPs has concluded. An inquiry into organ donation in the UK found that minority ethnic and mixed heritage people faced a “double whammy of inequity”: they are more likely to need donors, because they are disproportionately affected by conditions such as sickle cell and kidney disease, and they are less likely to find the right blood, stem cell or organ match on donor registers. Matching tissue type is vital to the chances of successful treatment, and compatible donors who are not relations are more likely to be found among donors from a similar ethnic background. While there are more donors than in previous years, theall-party parliamentary group (APPG) for ethnicity transplantation and transfusion’s inquiry report says just 0.1% of blood donors, 0.5% of stem cell donors and less than 5% of organ donors are of minority ethnic or mixed background. As a result, white people are nearly twice as likely to find a stem cell donor and 20% more likely to find a kidney donor. The inquiry found a “staggering lack of consistent and detailed ethnicity data” within healthcare systems, which “undermines accountability and jeopardises the lives of those awaiting life-saving treatments”. Responding to the findings, Habib Naqvi, the chief executive of the NHS Race and Health Observatory, said such stark ethnic disparities in organ donor participation were of “grave concern” and required “more investment from health providers and targeted campaigns to raise awareness” to build trust in the healthcare system. Jabeer Butt, the chief executive of the Race Equality Foundation, said the inequalities were unacceptable. “Every person, regardless of ethnic background, deserves an equal chance at receiving life-saving transplants and donations when needed. This is a solvable problem, but it requires a shared commitment to action across government, health organisations and communities. Lives depend on it,” he said. Read full story Source: The Guardian, 4 December 2023 -
News Article
Trusts failing on waiting list ask told to ‘get act together’
Patient Safety Learning posted a news article in News
Trusts have been told to ‘get their act together’ on health inequalities, after HSJ research suggested only a small minority have so far published data on disparities in waiting times between different patient groups. Planning guidance issued by NHS England in September 2021 said trusts’ board performance reports should include a disaggregation of waiting lists by ethnicity and deprivation group. Through freedom of information and media requests, HSJ attempted to obtain such data from the 20 trusts with the largest waiting lists, but only three currently appear to have met the requirement in full. The remainder either said they were still undertaking the work, were thinking about how to publish it, or failed to respond. Roger Kline, an academic researcher and former director of NHSE’s workforce race equality standard, said trusts should have been collecting and publishing the data for years. He said: “We know there are issues around health and healthcare of some groups of people, most notably in poor working class communities and black and minority ethnic communities. It shouldn’t be seen as an optional extra, this should be part of good public health work and good equitable healthcare provision." “This data should be on the trust website. It should be an active part of the conversations with local communities. Well done to the trusts that are pushing this forward. The ones that are not need to get their act together.” Read full story (paywalled) Source: HSJ, 3 May 2022 -
News Article
US pediatricians’ group moves to ban race-based medical guidance
Patient Safety Learning posted a news article in News
The American Academy of Pediatrics is attempting to ban race-based medical guidance which the organisation attributes to long-standing inequities in healthcare. In a statement on Monday, the AAP said: “Race is a historically-derived social construct that has no place as a biologic proxy. Over the years, the medical field has inaccurately applied race correction or race adjustment factors in its work, resulting in differential approaches to disease management and disparate clinical outcomes.” “Although it will continue to be important to collect clinical data disaggregated by race and ethnicity to help characterize the differential lived experiences of our patients, unwinding the roots of race-based medicine, debunking the fallacy of race as a biologic proxy, and replacing this flawed science with legitimate measures of the impact of racism and social determinants on health outcomes is necessary and long overdue,” the academy added. A re-examination of AAP treatment recommendations that began before George Floyd’s 2020 murder by police in Minneapolis, and intensified after it and the resulting nationwide protests, has doctors concerned that Black youngsters have been under-treated and overlooked, said Joseph Wright, lead author of the new policy and chief health equity officer at the University of Maryland medical system, a network of hospitals. According to Wright, the academy has begun to scrutinise its “entire catalog,” including guidelines, educational materials, textbooks and newsletter articles. The academy went on to recommend a series of policies to medical societies, institutions and pediatricians. “All professional organizations and medical specialty societies should advocate for the elimination of race-based medicine in any form,” it said. It urged institutions to collaborate with learner-facing organizations such as the Accreditation Council on Continuing Medical Education to expose more people to health equity content with a “specific focus on the elimination of race-based medicine”. Read full story Source: The Guardian, 2 May 2022 -
News ArticleDuring the peak of the omicron variant wave of the coronavirus this winter, Black adults in the United States were hospitalised at rates higher than at any moment in the pandemic, according to a report published last week by the Centers for Disease Control and Prevention. Black adults were four times as likely to be hospitalised compared with White adults during the height of the omicron variant surge, which started in mid-December and continued through January, the report said. In January, the CDC found, hospitalisation rates for Black patients reached the highest level for any racial or ethnic group since the dawn of the pandemic. As the highly transmissible omicron variant usurped the delta variant’s dominance, people who were unvaccinated were 12 times more likely to be hospitalised than those who were vaccinated and boosted against the coronavirus, according to the report. And fewer Black adults had been immunised compared with White adults, said the report, which analysed hospitalization rates in 99 counties in 14 states. Teresa Y. Smith saw evidence of the phenomenon outlined in the CDC’s report as she treated patients as an emergency physician at SUNY Downstate in Brooklyn. She has felt the crush of the pandemic’s unequal impact since the pre-vaccine waves but has contended with the consequences of health disparities for much longer. Her hospital sits in a heavily Black and Latino borough, where — as in so many communities of color across the country — social, political, economic and environmental factors erode health and shorten lives. In December, she watched as the number of cases and admissions resulting from the omicron variant “just exploded in a short, short amount of time,” saying then, “there is no subtlety to it.” And while the vaccinated patients she treated were less likely to be “lethally sick,” many still needed to be admitted to the hospital. Read full story Source: The Washington Post, 18 March 2022
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News Article
NHS accused of racism as black nurses report being put in Covid areas
Patient Safety Learning posted a news article in News
The NHS has been accused of “shocking and systemic” racism during the pandemic as black healthcare workers say they were given poor PPE and pushed into the Covid frontline first. Hundreds of black and brown healthcare staff across the UK have spoken to academics at Sheffield Hallam University about their experiences of racism during the pandemic. The accounts raised issues of racism within the health service which led to black and brown nurses and midwives being put at greater risk than their white colleagues, due to poorer PPE, training, workload and shift patterns. Rosalie Sanni-Ajose, a senior theatre practitioner, who worked across multiple London NHS hospitals through an agency called Yourworld told The Independent: “During the pandemic, we found that most of us (black agency nurses) have been placed in ITU to look after Covid patients are on a Continuous positive airway pressure (CPAP) machine or the ventilator." “Then when I work in A&E, they divided areas into sections - green area, red area, and the normal areas. So some of the ethnic minority staff were then put in the red areas all the time. Further some of us, we have comorbidities like asthma, or diabetes, or have an exemption that has been clearly stated they not allowed to work there.” Through its research, which involved 350 black and brown nurses, midwives and healthcare staff across the UK, Sheffield Hallam University found 77% of respondents said they’d been treated unfairly when they challenged racism. Just over 50% of the respondents said they’d experienced unfair treatment in the pandemic in relation to Covid deployment, PPE or risk assessment. One third have left their job as a result of racism, while more than half have experienced poor mental health due to the racism they experienced. The academic team, lead by Professor Anandi Ramamurthy said the healthcare professionals’ reports reveal “a story of systematic neglect and harassment which predates the pandemic.” Read full story Source: The Independent, 5 March 2022 -
News Article
Study reveals stark disparities in cancer rates between ethnic groups
Patient Safety Learning posted a news article in News
Stark disparities in cancer rates between different ethnic groups have been laid bare in new research showing black people are twice as likely to get prostate cancer while white people have double the chance of getting skin and lung cancers. The analysis of NHS Digital cancer registration data by Cancer Research UK provides the most complete recording ever of cancer rates by ethnicity in England, offering crucial data on how some rates vary. The results are published in the British Journal of Cancer. White people in England are more than twice as likely to get some types of cancer, including melanoma skin cancer, oesophageal, bladder and lung cancers compared with people from black, Asian or mixed ethnic backgrounds, according to the research. Black people are almost three times more likely to get myeloma and almost twice as likely to get prostate cancer compared with white people. The study also found that black people are more likely to get stomach and liver cancers, and Asian people are more likely to get liver cancers. Genetics are thought to play a part in some of the findings, Cancer Research UK said. For example, white people are more likely to get skin cancer because they tend to burn more easily in the sun. Preventable risk factors also appear to be involved, the charity added, as white people are more likely than most minority ethnic groups to smoke or be overweight or obese. These are the two largest risk factors in developing cancer and help explain why white people are more likely to get some types of cancer than other ethnic groups. Read full story Source: The Guardian, 2 March 2022 -
News Article
Pregnancy risk tool cuts baby loss in black and Asian women
Patient Safety Learning posted a news article in News
A new pregnancy screening tool cuts the risk of baby loss among women from black, Asian and ethnic minority backgrounds to the same level as white women, research suggests. The app calculates a woman's individual risk of pregnancy problems. In a study of 20,000 pregnant women, baby death rates in ethnic groups were three times lower than normal when the tool was used. Experts say the new approach can help reduce health inequalities. The screening tool is already in use at St George's Hospital in London and is being tried out at three other maternity units in England, with hopes it could be rolled out to 20 centres within two years. Researchers from Tommy's National Centre for Maternity Improvement, led by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives, developed the new tool. Professor Basky Thilaganathan, who led the research team at St George's Hospital, said the new approach could "almost eliminate a large source of the healthcare inequality facing black, Asian and minority ethnic pregnant women". "We can personalise care for you and reduce the chances of having a small baby, pre-eclampsia and losing your baby," he said. The current system of a tick-box checklist to assess pregnancy risk has been around for 70 years, and is limited. The new digital tool, which uses an algorithm to calculate a woman's personal risk, can detect high-risk women more accurately and prevent complications in pregnancy, the researchers say. Both pregnant women and maternity staff can upload information on their pregnancy and how they are feeling to the app during antenatal appointments and at other times. Dr Edward Morris, president of the Royal College of Obstetricians and Gynaecologists, said it was "unacceptable" that black, Asian and minority ethnic women faced huge inequalities on maternity outcomes. "The digital tool provides a practical way to support women with personalised care during pregnancy and make informed decisions about birth. Read full story Read Tommy's press release Source: BBC News, 28 February 2022 -
News ArticleThe NHS has been accused by a major charity of failing to address the emerging gap in Covid booster vaccine coverage for racialised communities. Blood Cancer UK has told The Independent it has “serious concerns” over what it claims is a “shocking” lack of urgency from the NHS in addressing the gap in booster vaccine doses for immunocompromised people from black and minority ethnic communities. The charity has said NHS England has failed to set out any “concrete” plans since it revealed 84% of immunocompromised people from a white British background had three vaccine doses by mid-December, compared to just 43% of immunocompromised people from a Pakistani background. The news comes after the government announced people over 75 and immunocompromised children would be eligible to receive a fourth Covid vaccine by Spring. According to an analysis published by Open Safely, a team of data scientists at Oxford University, of those who are part of the shielding population, as of the 22 February just 72% of Black people have had their booster does, and 73% of south Asian people. This compares to 89% of white people. NHS England has highlighted a number of actions it is taking to address the situation such as using pop-up sites within communities and providing free transport. Speaking with The Independent chief executive of Blood Cancer UK Gemma Peters, said: “We have serious concerns about how the poor roll-out of third doses for the immunocompromised has left people from some communities much less well-protected than people from a white British background. But while it is deeply troubling that a racial disparity in access to third vaccine doses has been allowed to develop, just as shocking has been NHS England’s apparent lack of urgency in addressing it." Read full story Source: The Independent, 25 February 2022
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News ArticlePregnancy-related deaths among US mothers climbed higher in the pandemic’s first year, continuing a decades-long trend that disproportionately affects Black people, according to a new government report. Overall in 2020, there were almost 24 deaths per 100,000 births, or 861 deaths total, numbers that reflect mothers dying during pregnancy, childbirth or the year after. The rate was 20 per 100,000 in 2019. Among Black people, there were 55 maternal deaths per 100,000 births, almost triple the rate for white people. The report from the National Center for Health Statistics does not include reasons for the trend and researchers said they have not fully examined how Covid-19, which increases risks for severe illness in pregnancy, might have contributed. The coronavirus could have had an indirect effect. Many people put off medical care early in the pandemic for fear of catching the virus, and virus surges strained the healthcare system, which could have had an impact on pregnancy-related deaths, said Eugene Declercq, a professor and maternal death researcher at Boston University School of Public Health. He called the high rates “terrible news” and noted that the US has continually fared worse in maternal mortality than many other developed countries. Reasons for those disparities are not included in the data, but experts have blamed many factors including differences in rates of underlying health conditions, poor access to quality healthcare and structural racism. Read full story Source: The Guardian, 23 February 2022
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News Article
NHS to tackle 'unfair' maternity outcomes
Patient Safety Learning posted a news article in News
A taskforce has been set up to tackle disparities in maternity care experienced by women belonging to ethnic minorities and those living in deprived areas. Black women are 40% more likely to miscarry than white, studies suggest. Maternal death rates are also higher among black and Asian women. Royal College of Obstetricians and Gynaecologists head Dr Edward Morris told BBC News implicit racial bias was affecting some women's care. Patient Safety and Primary Care Minister Maria Caulfield said: "For too long disparities have persisted which mean women living in deprived areas or from ethnic minority backgrounds are less likely to get the care they need and, worse, lose their child. "We must do better to understand and address the causes of this. "The Maternity Disparities Taskforce will help level-up maternity care across the country, bringing together a wide range of experts to deliver real and ambitious change so we can improve care for all women - and I will be monitoring progress closely." Chief midwifery officer Prof Jacqueline Dunkley-Bent, who will co-chair the taskforce, said: "The NHS's ambition is to be the safest place in the world to be pregnant, give birth and transition into parenthood - all women who use our maternity services should receive the best care possible." The taskforce will meet every two months and focus on: improving personalised care and support plans addressing how wider societal issues affect maternal health improving education and awareness of health when trying to conceive, such as taking supplements and maintaining a healthy weight increasing access to maternity care for all women and developing targeted support for those from the most vulnerable groups empowering women to make evidence-based decisions about their care. Read full story Source: BBC News, 23 February 2022 Source: BBC News, -
News ArticleMedical records contain a plethora of information, from a patient’s diagnoses and treatments to marital status to drinking and exercise habits. They also note whether a patient has followed medical advice. A health provider may add a line stating that the patient is “noncompliant” or “non-adherent,” signalling that the patient has been uncooperative and may exhibit problematic behaviours. Two large new studies in the US found that such terms, while not commonly used, are much more likely to appear in the medical records of Black patients than in those of other races. The first study, published in Health Affairs, found that Black patients were two and a half times as likely as white patients to have at least one negative descriptive term used in their electronic health record. About 8% of all patients had one or more derogatory terms in their charts, the study found. The most common negative descriptive terms used in the records were “refused,” “not adherent,” “not compliant” and “agitated.” The second study, published in JAMA Network Open, analysed the electronic health records of nearly 30,000 patients at a large urban academic medical centre between January and December 2018. The study looked for what researchers called “stigmatising language,” comparing the negative terms used to describe patients of different racial and ethnic backgrounds as well as those with three chronic diseases: diabetes, substance use disorders and chronic pain. Overall, 2.5% of the notes contained terms like “nonadherence,” “noncompliance,” “failed” or “failure,” “refuses” or “refused,” and, on occasion, “combative” or “argumentative.” But while 2.6% of medical notes on white patients contained such terms, they were present in 3.15% of notes about Black patients. Looking at some 8,700 notes about patients with diabetes, 6,100 notes about patients with substance use disorder and 5,100 notes about those with chronic pain, the researchers found that patients with diabetes — most of whom had type 2 diabetes, which is often associated with excess weight and called a “lifestyle” disease — were the most likely to be described in negative ways. Nearly 7% of patients with diabetes were said to be noncompliant with a treatment regimen, or to have “uncontrolled” disease, or to have “failed.” The labels have consequences, warns Dr. Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center. “Patients whose physicians tend to judge, blame or vilify them are much less likely to have trust in their doctors, and in the medical system overall,” Dr. Schillinger said. “Having health care providers who are trustworthy — who earn their patients’ trust by not judging them unfairly — is critical to ensuring optimal health and eliminating health disparities.” Read full story (paywalled) Source: The New York Times, 20 February 2022
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News ArticleSoon after her son Jaxson was born, Lauren Clarke spotted that his eyes were yellow and bloodshot. “We kept asking if he had jaundice, but each time we were told to keep feeding him and just put Jaxson in front of a window,” she says. It was only when Clarke was readmitted six days later with an infection that Jaxson’s jaundice was detected by a midwife. By this time, his levels were becoming dangerously high. “We spent a further five days in hospital for Jaxson to be treated with light therapy and antibiotics. If I hadn’t had to go back to hospital, he could have died or had serious long-term health conditions,” she says. This week, the NHS race and health observatory will announce new funding for research into the efficacy of jaundice screening in black, Asian and minority ethnic newborns on the back of a recent report showing that tests to assess newborn babies’ health are not effective for non-white children. The research cannot come too soon. Jaxson’s aunt, Gemma Poole, a midwife from Nottingham, created her company, the Essential Baby Company, to develop resources and training about the specific needs of women and babies with black and brown skins, after Jaxson’s jaundice was initially missed by clinicians. Poole believes the trauma her nephew, brother and sister-in-law had to go through could have been avoided if health professionals had known better ways to spot jaundice in non-white babies. “The colour of gums, the soles of the feet and hands, the whites of eyes, how many wet and dirty nappies and if the baby is waking for feeds and alert could be more reliable indicators if a black or brown baby has jaundice,” she says. Read full story Source: The Guardian, 16 July 2023
