Briefing Paper 16
Ethnicity and coronary heart disease: making sense of risk and improving care. February 2010
Cardiovascular disease (CVD) is predicted to become the dominant cause of death and disability across the globe over the next decade. With an apparently disproportionate susceptibility to cardiovascular disease, the causes and prevention of CVD is of critical importance to minority ethnic groups. This paper examines the complex interplay between the biological, psychosocial and behavioural causes of CVD, and considers the need for culturally appropriate services to increase awareness of coronary risk factors and support healthier lifestyles.
Author(s): Felicity Astin, Karl Atkin
[Briefing Paper]

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Delivering race equality: Focused implementation site project
Zahno, K. and Rhule, C., Central and North West London Foundation Trust, 2010
This report outlines the work done by the Central and North West London NHS Foundation Trust as one of the Department of Health’s 17 Focused Implementation Sites in its Delivering Race Equality Action Plan. CNWL’s work aimed to reduce the disproportionate admission and detention of black and minority ethnic people in psychiatric inpatient units and prisons. It sought to do this by engaging more actively with black and minority ethnic communities and service-users, to ensure that it provided more culturally competent mental health services.
[Health Resource]

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Report on the self reported experience of patients from black and minority ethnic groups
Department of Health and National Statistics, June 2009
This report examines variations in the self-reported views of NHS patients from different ethnic groups.  Using feedback from white respondents as a baseline, the survey examines patient responses to issues such as cleanliness, relationships and communication with doctors and other staff, and information relating to medication.
[Health Resource]

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Briefing Paper 13
HIV prevention among black Africans in England: a complex challenge. April 2009
This paper is about the HIV epidemic in the context of black Africans in England. It gives an overview of the current epidemiological status, HIV support and prevention needs and recommendations for policy and practice. It focuses on black African communities because they are disproportionately affected by HIV compared to other minority ethnic groups.
Author(s): John Owuor
[Briefing Paper]

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Briefing Paper 12
The health of Gypsies and Travellers in the UK. November 2008
The health status of Gypsies and Travellers is much poorer than that of the general population, even when controlling for confounding factors such as variable socio-economic status and/or ethnicity. Gypsy and Traveller health receives scant attention in policy documents on health inequalities, and meaning that problems of poor access to, and uptake of, health services may go unnoticed. This paper draws attention to some examples of good practice, and argues that these should to be funded and replicated across more localities.
Author(s): Zoe Matthews
[Briefing Paper]

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Briefing Paper 11
Addressing ethnic inequalities in maternity service experiences and outcomes: responding to women's needs and preferences.October 2008
This briefing examines the maternity experiences of women from BME communities in the UK, drawing on both qualitative and quantitative research. It sets out to identify barriers that may disadvantage minoritised women and offers suggestions for service improvement, while recognising the great heterogeneity that exists within and between minority ethnic ‘groups’ and the need, therefore, for flexible and nuanced responses.
Author(s): Kuldip K. Bharj, Sarah Salway
[Briefing Paper]

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Scoping exercise with black and minority ethnic groups on perceptions of mental wellbeing in Scotland
Newbigging, K. et al, Centre for Ethnicity and Health, Health Scotland,  August 2008
This study provides the results of interviews and an extensive literature review into perceptions of mental wellbeing by black and minority ethnic communities (BME).  The report explores different interpretations of what is meant by mental health, highlighting the importance of spirituality in black and minority perceptions of good  mental wellbeing.
[Health Resource]

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Briefing Paper 10
Health experiences of Chinese people in the UK. July 2008
Chinese people have a long history in the UK, but have a relatively low take-up rate in health and social care services. Health professionals have little understanding of their conception of health and illness and health needs are sometimes masked by myths and stereotypes or barriers to access. This paper outlines some of these barriers and highlights Chinese people’s diverse approaches to health and illness, advocating more choice and participation in their health and social care.
Author(s): Ruby C.M. Chau
[Briefing Paper]

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Briefing Paper 9
The health and social care experiences of black and minority ethnic older people. July 2008
Older people from black and minority ethnic groups are underrepresented in their use of health and social care services, and often appear to receive poorer treatment. Although good services exist, there appear to have been difficulties in bringing them into the mainstream.This paper outlines barriers to accessing services, including lack of information, language difficulties, stereotyped assumptions on the part of professionals and differing expectations about how services can help.
Author(s): Jo Moriarty
[Briefing Paper]

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Briefing Paper 8
Long-term ill health, poverty and ethnicity. February 2008
This paper examines the social and economic consequences of long-term ill health. These are often greatest for deprived groups and certain minority ethnic groups, as not only do they face the highest rates of long-term ill health and worklessness, but they are also most marginalised from support services. With a benefits system deemed complex, unpredictable and stressful, take-up of sickness-related benefits amongst black and minority ethnic groups is low, whilst policies and services aimed at encouraging people into employment can have negative impacts upon health or caring obligations.
Author(s): Kaveri Harriss, Sarah Salway
[Briefing Paper]

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Briefing Paper 7
User participation in health care services. February 2008
Low take-up of services among black and minority ethnic communities is still frequently explained as being due to ‘cultural’ and social preferences within these communities, despite evidence to suggest that users have little faith in those services that exist and lack support to use them. With poor representation of local communities amongst the NHS workforce, especially at senior levels, black and minority ethnic users also emphasise the need for better training for all staff. Despite the importance given by the Department of Health to ‘choice’ and involvement, user participation still remains an ambition rather than a reality for black and minority ethnic users. However, BME user participation is key to improving the organisation and delivery of health care services.
Author(s): Ossie Stuart
[Briefing Paper]

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Briefing Paper 6
Tackling health inequalities for minority ethnic groups: challenges and opportunities. July 2007
Health inequalities may vary both between ethnic groups and within ethnic groups. This paper considers how health inequalities may reflect inequalities in the distribution of health determinants, such as access to good housing, transport, education and employment opportunities, and considers methods of reducing health inequalities through NHS reform.
Author(s): Gurch Randhawa
[Briefing Paper]

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Briefing Paper 5
African and Caribbean men and mental health. May 2007
This paper explores the complexities involved when we link mental illness with issues of ‘race’, culture and ethnicity; reviews some of the evidence for African and Caribbean men; and makes suggestions for addressing these in mental health practice. The paper focuses on settled communities from African and Caribbean backgrounds and has a bias to the crisis end of services.
Author(s): Frank Keating
[Briefing Paper]

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Briefing Paper 3
Ethnic inequalities in health: the impact of racism. March 2007
This paper aims to present the evidence for the relationship between racism and health, acknowledging that different individuals will respond differently to racist harrassment. It also highlights the need, and possibilities, for service improvement, both for the victims of racism and for people from minority ethnic groups more generally.
Author(s): Saffron Karlsen
[Briefing Paper]

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Briefing Paper 2
Effective communication with service users. March 2007
Communication between service providers and people from minority ethnic communities has been highlighted as significant in many studies on inequalities in health and social care, with poor levels of communication limiting access to services and on relationships between service users and professionals. This paper argues that communication can be improved in many ways: by providing information about services in a range of languages and formats; by employing staff from minority ethnic communities at all organisational levels to improve cultural competence and by improving communication at the individual, family and instutional level.
Author(s): Ghazala Mir
[Briefing Paper]

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Briefing Paper 1
Improving the quality of palliative care. January 2007
There has been growing concern in recent years about the accessibility and the responsiveness of palliative care to the needs of minority ethnic groups. Perceived cultural barriers both from patients and health professionals may prevent provision of and access to appropriate services, whilst the differing patterns of disease in minority ethnic groups has meant that palliative care needs may not be met by existing 'cancer-focussed' services.
Author(s): Yasmin Gunaratnam
[Briefing Paper]

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Factors affecting hospital staff judgments about sickle cell disease pain
Elander,J. et al, Journal of Behavioral Medicine, 29(2), April 2006
This study examines healthcare professionals' views of pain amongst sickle cell sufferers, using a vignette study to examine their judgments towards patients with genuine symptoms of addiction compared to patients whose behavior merely resembles those symptoms.
[Health Resource]

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Potential barriers to the use of health services among ethnic minorities: A review
Emmanuel Scheppers, Els van Dongen, Jos Dekker, Jan Geertzen and Joost Dekker. Family Practice 2006; 23: 325–348
This literature review explores the barriers faced by black and minority ethnic patients when using health services, considering issues including issues such as language, the skills of practitioners and the patient's own patient of their illness.
[Health Resource]

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Migration and health in the UK
Kelly, R. et al, Institute for Public Policy Research, 1 February 2005
This report examines the impact of migration upon health in the UK, looking at new migrants as both NHS employees and service users.  It gives a comprehensive overview of the issues relating to migration and health, providing a breakdown of overseas staff working in the UK, and considering issues such as 'health worker braindrains'; the health impact of migration; health tourism, and migrant rights to access healthcare.
[Health Resource]

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Inequalities in maternal health: National cohort study of ethnic variation in severe maternal morbidities
Knight, M. et al, British Medical Journal, 338:b542, 2009
This report outlines the ethnic differences in severe maternal morbidity in the United Kingdom.  Using the monthly UKOSS mailing to obtain quantitative data, the report found significantly higher rates of morbidity among black and minority ethnic mothers.
[Health Resource]

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Pain management and symptoms of substance dependence among patients with sickle cell disease
Elander,J. et al, Social Science & Medicine, 57, 2003
Sickle cell disorders can lead to extremely painful symptoms which may require the prescription of analgesics.  Due to the potentially addictive nature of this treatment, practitioners often fear of dependency on painkillers amongst sickle cell patients.  This study examines pain management amongst patients, considering actual and perceived dependence on analgesics, and also factors which may influence these perceptions, including racism, stereotypes or insufficient staff training.
[Health Resource]

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Better services, better health: The healthcare experiences of black and minority ethnic disabled people
Shah, S. and Priestley, M., Leeds Involvement Project, 2001
This easy-to-read qualitative study investigates the healthcare experiences of disabled people from ethnic minorities.  The report highlights issues such as limited cultural competence, racism, disabilism, isolation and communication.
[Health Resource]

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