Health inequalities in UK are major factor in high BAME Covid cases

Introduction

Since the early days of covid the statistics have shown that people from black and south Asian backgrounds are at great risk of dying from covid-19. Segregating the BAME ('Black, Asian and minority ethnic’) people from the white people have in terms of getting high quality treatments is shameful, however a common practice across the UK. The case study response focuses on the Guardian’s (2021) article of “Health inequalities in UK are major factor in high BAME Covid cases” by Linda Geddes.

The scope of the study underlies an understanding of growing health inequalities and lack of access to critical care for the majority of BAME groups across the UK (United Kindom). The group has a greater chance of being exposed to coronavirus due to the fact that some minority ethnic groups are likely to live in multigenerational households and working in the conditions where covid exposure is more (Citro, 2004).

The paper looks beyond the socio-cultural implication of the inequality practice to the legal structure that allows this practice and offers some possible solutions. After providing a brief description the writing provides discussion on the issues raised through underlying theories before offering possible solutions. The recommendations are purely based on evidence and conclude the suggested areas of future research.

Description

The major issues are identified as BAME people are often deprived of the basic rights of their healthcare leading to the inequalities. They often face denial of services or have poor experiences at the GP’s (Ryan, and Nanda, 2022). They are often identified as not being financially stable as the white groups. Most of the time the south Asians are working in professions where they are getting more exposure to covid and hence contributing to this group’s sufferings. The secondary causes of getting a covid infection is their extensive work hours, lack of appropriate housing system, unhygienic conditions, and exposure to covid patients. This questions governments' roles of establishing equality. The issue also raises questions on the human rights and violation of basic code of conduct when it comes to the practising medical support to human beings.

Key stakeholders of the study include minority groups in particular the Asian groups. The people who come from a black race are more likely to experience a differentiation with white people (Ashford et al. 2020). The Office for National Statistics has found that minority groups are likely to work longer hours and less likely to be eligible to be furloughed. People who are suffering from chronic diseases like diabetes or obesity are more likely to get a chance of being infected. The local authorities, and the central government is also a part of stakeholders. On moral ground, practising inequalities in health care is raising ethical, social and racial inequality issues.

Discussion

There are diverse perspectives of the issue of inequality. Four major issues of the BAME people have been identified as endangered during covid surge are discussed here. The core issue is that the south Asian people are being deprived of some government defined health services and they are often reporting poor GP (General practitioner) experiences. They are not receiving enough support from the local health centres. Secondly, there is strict race and background differentiation between the BAME people and white people (Beaunoyer et al. 2020). The Asians often belong to the low income group along with a concept of living in a multigenerational house. This is contributing to the factors of being affected by covid. According to Ruth Watkinson of University of Manchester, people from minority ethnic groups are likely to suffer from chronic health conditions such as type 2 diabetes and high blood pressure or obesity as compared to the British people and this is a combined reason behind increased death across BAME groups. Another issue is that the BAME group of people are coming in face-to-face contact with people who are suffering from coronavirus and the chances of being infected are getting raised. The issues raised is impactful since 5,873 (or 26%) of the 22,332 people who have died out of covid during the time frame of 31st march to 12th May, were the majority of the people who had chronic diabetes and obesity problem according to NHS (National Health Service) England (Bentley, 2020). The risk of being diagnosed with diabetes in Asian people is comparatively more with the people of white ancestry. Hygiene conditions and poor incomes are suspected to be contributing to the covid conditions. Some stakeholders are the governments, local nurses and healthcare practitioners, GP’s minority and ethnic group of people. The black, Asian and people coming from low income groups or perceived disability are at the risk of facing health inequalities.

In 1954, Gordon Allport, “an early leader in comprehensive social science analysis of prejudice and discrimination, articulated the sequential steps by which an individual behaves negatively toward members of another racial group: verbal antagonism, avoidance, segregation, physical attack, and extermination” (Allport, 1954). These discriminations are associated with issues of not getting equal treatments in the GP’s and having poor experience while it comes to getting the health issues resolved (Buffel et al. 2021). The inequalities are addressed as the discrimination or unfair treatment on the basis of personal characteristics such as age, race and gender. Majority of people are getting deprived of their rights to choose suitable GP practices. Becker (1971), describes classic theory “Taste of Discrimination” which affects the beliefs of individuals. In some parts of the UK, people have conceived prejudice regarding the BAME group and they would never include them in the traditional practices of healthcare. There exists societal rejection and racist behaviours when it comes to include BAME group in the same health legislation as the white people. Racially biassed cognitive categories are creating discriminated profiles for workers. The BAME group people lack access to hygiene living conditions and are often seen to be spending life at multigenerational homes. Lack of income and unhealthy food habits as well as genetics are leading them towards being obese and diabetic. These are the main contributors to the covid related deaths (Furceri et al. 2022). Explicit prejudice or some of the more subtle forms of ingroup versus-outgroup perceptual biases, cause lack of employability or furloughed for the BAME group, making the situation worse. Roots of such prejudices are realistic conflict theory, which states that “when resources are scarce, people will be more prejudiced against other groups” (Guterres, 2022). Organisational process has also been identified as behaviour which leads to adverse outcomes and provides disadvantages racial groups. This behaviour is often seen to be faced by the BAME group while they look for housing.

Some possible solutions will be to encourage the healthcare practitioners to go through the NHS guidelines and provide equal treatment for the patients. The solution will include a portrayal of Equality acts in the forms of charts in hospitals so that the members will be well aware of it. People from any race or background have the right to choose GP practice and the practice should comply with individual’s wishes (Liao, and De Maio, 2021). The rights of choosing hospital services while referred are part of equality which is not practised in the case study. Decisions about drug treatment are subjected under consent taking and any vaccine services provided by the NHS are to be available by all people of the country. The equality act also justifies the need for adequate income and employability for individuals. With an adequate income the people from BAME group are expected to flourish in their livelihood and might incur less anxiety and diabetes issues. Theories and legislation related to the issue includes Equality Act, Regulations 2014 and Regulations 9 from Health and Social Care Act 2008, The Human Rights Act 1998 article 8, The Ethical Standards in Public Life etc. (Scotland) Act 2000 (cqc.org.uk, 2023). The Equality Act 2010 explains the issues of not getting equal treatments in the GP’s and having poor experience while it comes to getting the health issues resolved (ageuk.org.uk, 2023). The law protects from victimisation, harassment, direct discrimination in health, public, consumer related and employability services. According to the act, access to health services, getting good quality of care and being treated appropriately by qualified professionals are basic rights of an individual residing in a country. Being protected from abuse and negligence is part of getting the healthcare rights covered (Nazroo et al. 2020). Hence, it is evident that the health inequalities and inadequacy of equality law practice is actually contributing to spread of Covid virus among the BAME group and following the theory can effectively manage the core issue. Another major theory that is relevant to the issue management is using the health and social care act of 2008. This shares the concept of person centric care. Providers are expected to work in partnership with the person and make reasonable adjustments to support the help seekers. Every person whether he is from a minority group or not is labelled for treatment options and care depending on their needs and preferences. If a patient comes with a prior condition like diabetic or obesity the law acts towards taking informed decisions and providing customised care (equalityhumanrights.com, 2023). Every service user has the right to privacy according to the human rights act 1998. Article 8 has the right to provide respect to private and family life. According to the law every person has the right to freedom of thought, conscience and religion. Based on the rights, the BAME group of people are liable for good housing and person centric healthcare approaches. The act also explains that individuals have choices of working hours and duties. Keeping the BAME people in forefront duties during covid was not a good decision and this was clever safeguarding of white ancestry. The ethical standards in public life act of 2000 is also contributing to the issue (Perry et al. 2021). This has been issued under the code of conduct for the counsellors dealing with healthcare practices. The act secures the observance of high standards of conduct by councillors and creates accountability in the field of providing correct medical assistance to individuals.

There are examples which justified the solution. The case study shows for a GP surgery the patient’s right to provide consent and choose the services are not preserved and social discrimination is occurring (Schoon, and Henseke, 2022). As per the equality law, choosing medical care is a basic human right. The young generation from BAME groups is required to be given enough support on their employment through improving their education and training. This in turn will help them to have a good life and reduce the risk of being affected by covid. People who work longer hours should get flexible hours of working and provided with local healthcare support. Conducting regular covid tests on people with prior history of diabetes or obesity cases is important (Linda Geddes, 2021). The rapid test can help diagnose the disease to the earliest hour even if a mild symptom is observed. It can improve health inequalities concepts. Understanding a patient's thought is identified as the primary step to mitigate the barriers of equal health opportunities. The solution is justified by the Health belief model where individual levels of influence are created. The perceived barriers are mitigated at base level starting from school lunch. The readiness to change can be created by improving mutual participation. Self-control and change in conception of prejudices are expected to mitigate the barriers of inequality in the healthcare domain.

Conclusion and Recommendation

An overall summary to the issues can be found as:

1. Inadequate care perspectives and unequal treatment among patients of different backgrounds

2. Inadequate distribution of income of housing

3. Inadequacy of conducting tests and having chronic disease like diabetes and obesity

The preferred choices are providing training and education to the BAME group so that they can have a good income and improve their lifestyle choice. Another choice will be to introduce the equality act in every GP’s and hospital by government so that the law enforces equal treatment to individuals. Another solution is the rapid test which is conducted on people who have a prior history of being diagnosed with diabetes and obesity and anxiety.

The topic definitely needs more research to be conducted in this area as the research is having a wide spread of inequalities to be identified in healthcare. The sources of discussion are moderate to find. These data are mostly confidential and one can only get them on government websites. Hence, accessing them was moderately tough. The most difficult area to struggle was to find the right legislation that provides a solution to the issues and linking theories to practise. Giving justification of the theories was also a challenging part.

Looking for further insights on Health in the Tropics? Click here.

References

Book

Citro, C.F. ed., 2004. Measuring racial discrimination (p. 317). Washington, DC: National Academies Press.

Ryan, J.M. and Nanda, S., 2022. COVID-19: Social inequalities and human possibilities. Routledge.

Journals

Ashford, N.A., Hall, R.P., Arango-Quiroga, J., Metaxas, K.A. and Showalter, A.L., 2020. Addressing inequality: the first step beyond COVID-19 and towards sustainability. Sustainability, 12(13), p.5404. [Accessed on 09/02/2023]

Bentley, G.R., 2020. Don't blame the BAME: Ethnic and structural inequalities in susceptibilities to COVID‐19. American journal of human biology, 32(5), p.e23478. [Accessed on 09/02/2023]

Buffel, T., Yarker, S., Phillipson, C., Lang, L., Lewis, C., Doran, P. and Goff, M., 2021. Locked down by inequality: Older people and the COVID-19 pandemic. Urban Studies, p.00420980211041018. [Accessed on 09/02/2023]

Furceri, D., Loungani, P., Ostry, J.D. and Pizzuto, P., 2022. Will COVID-19 have long-lasting effects on inequality? Evidence from past pandemics. The Journal of Economic Inequality, pp.1-29. [Accessed on 09/02/2023]

Guterres, A., 2020. Tackling the inequality pandemic: A new social contract for a new era. Nelson Mandela Annual Lecture. [Accessed on 09/02/2023]

Liao, T.F. and De Maio, F., 2021. Association of social and economic inequality with coronavirus disease 2019 incidence and mortality across US counties. JAMA network open, 4(1), pp.e2034578-e2034578. [Accessed on 09/02/2023]

Nazroo, J., Murray, K., Taylor, H., Bécares, L., Field, Y., Kapadia, D. and Rolston, Y., 2020. Rapid Evidence Review: Inequalities in relation to COVID-19 and their effects on London. University of Manchester, The Ubele Initiative, University of Sussex. [Accessed on 09/02/2023]

Perry, B.L., Aronson, B. and Pescosolido, B.A., 2021. Pandemic precarity: COVID-19 is exposing and exacerbating inequalities in the American heartland. Proceedings of the National Academy of Sciences, 118(8), p.e2020685118. [Accessed on 09/02/2023]

Schoon, I. and Henseke, G., 2022. Social inequalities in young people's mental distress during the COVID-19 pandemic: Do psychosocial resource factors matter?. Frontiers in public health, 10.

Webistes

ageuk.org.uk, 2023. What standards you should expect from NHS services, Available at: https://www.ageuk.org.uk/information-advice/health-wellbeing/health-services/nhs-complaints/ [Accessed on 09/02/2023]

cqc.org.uk, 2023. Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 9, Available at: https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-9-person-centred-care#guidance [Accessed on 09/02/2023]

equalityhumanrights.com, 2023. Respect-your-private-and-family-life, Available at: https://www.equalityhumanrights.com/en/human-rights-act/article-8-respect-your-private-and-family-life#:~:text=Article%208%3A%20Right%20to%20privacy,his%20home%20and%20his%20correspondence. [Accessed on 09/02/2023]

Linda Geddes, 2021. Health inequalities in UK are major factor in high BAME Covid cases. Available at: https://www.theguardian.com/society/2021/jan/28/health-inequalities-in-uk-are-major-factor-in-high-bame-covid-cases [Accessed on 09/02/2023]