Racial inequity is being tackled in healthcare - what can healthcare providers learn from the NHS?
By Hannah Anderton, Senior Associate at Purpose Union
October marks Black History Month in the UK, a time for acknowledging and celebrating the rich successes of Black British individuals and communities, but also for addressing the longstanding impact of colonialism and systemic racism, the impact of both we can still see rooted in institutions and companies today.
Reflecting on our recent work at Purpose Union, understanding racial inequity in healthcare continues to be a leading concern for global health organisations. Recent research by the BMA found that only 55% of Black and minority ethnic doctors think there is respect for diversity and inclusion in their workplace, and research by Black Equity Organisation found that 65% of Black people had been discriminated against by healthcare professionals because of their ethnicity. Many organisations are taking steps towards improving such statistics and embedding anti-racism in healthcare. The NHS is a prime example of an organisation coming to terms with institutional racism and taking measures to become an increasingly anti-racist healthcare institution.
It has been two and half years since the NHS established the Race and Health Observatory (RHO), an independent body designed to report on health inequalities among different ethnic groups and provide advice on the route to eradication of said inequalities. The RHO found that “ethnic inequalities in health outcomes are evident at every stage throughout the life course, from birth to death”, further evidence that Black and other minoritised groups in the UK have been failed by systemic and historical patterns of racial abuse since the beginning of documented medical research.
The remit of the RHO is to mobilise the evidence they have gathered, and they are calling upon the expertise of both an experienced and representative board of advisers and a group of lived-experience stakeholders, in order to generate and support implementation of anti-racist policies. Earlier this year in an open statement, the RHO stated that “now is the time for comprehensive and holistic action” - whilst the recent proliferation of anti-racism policies are positive in direction, everyone must take responsibility for practical confrontation of racism in all its forms.
While the NHS is taking its steps towards embedding anti-racism, it's clear that racial inequity pervades all areas of healthcare. Current debates suggest both unconscious and conscious processes are driving below-adequate levels of care, with deficiencies visible across exclusion from medical trials, misdiagnoses, discrimination in patient care, and we still live in a time in the UK where Black women are four times more likely to die in childbirth than white women.
We at Purpose Union are working with a number of organisations on their anti-racism work, including global pharmaceutical brand Sanofi. Their Global Clinical Lead, Raolat Abdulai said, “for many years, clinical trials have not been representative of our diverse population. There are barriers, including a historical lack of trust in research or medical institutions, and, in some countries, another big barrier is access to these clinical trials.” Sanofi is striving to achieve inclusivity by design by partnering with typically underrepresented groups across clinical trials, working to ensure that all demographics with the potential to be affected by a disease, are included in the development of its treatment.
There is a clear need for transformative measures to correct the distrust in healthcare which derives from structural racism and institutions are building the information we need to prevent repetition of failures. An obvious step towards addressing racial inequity is for healthcare providers to create clear and impactful DEI strategies that start with providing honest accounts of their role in perpetuating the problem to-date. From there targeted DEI frameworks can be built to permeate all areas of an organisation. This could look like improving data collection, inclusive and strategic recruitment, training across all seniority layers, developing community campaigns, creating accountable coalitions and beyond.
The lessons we can learn from the NHS are clear: decolonising healthcare requires organisations being transparent and accountable, developing clear DEI strategies, investing in long-term anti-racism resources and advocating for and listening to the stories from those with lived experience of racism. By doing this, we can start to create tangible and impactful change that not only benefits internal colleagues across healthcare organisations, but also the patients they serve.
Further reading:
There are a number of Black voices across varying sectors making contributions to decolonising healthcare and promoting equity. To highlight a few:
Sexual & Reproductive Health Registrar Annabel Sowemimo a leading advocate for gender and racial equity in health care. Author of Divided and founder of charity the Reproductive Justice Initiative (RJI).
Artist Larry Achiampong, who alongside David Blandy has designed the ‘Genetic Automata’ exhibition at the Wellcome Collection, a creative space for exploring the intersection of race, identity and the history of medical research.
Malone Mukwende who as a medical student in 2020 authored Mind the Gap: a clinical handbook aimed to combat the lack of diversity in the study of medicine, providing advice on the diagnoses of skin conditions on black and brown skin.
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