Socio-economic & Ethnic Inequalities in Health Consolidation

Socio-economic and ethnic inequalities in health– Consolidation Dr Farhan Noordali Health Science Theme Lead [email protected] By the end of this session you will be able to:  Understand that risk factors can affect health and lead to chronic conditions  Un...

Socio-economic and ethnic inequalities in health– Consolidation Dr Farhan Noordali Health Science Theme Lead [email protected] By the end of this session you will be able to:  Understand that risk factors can affect health and lead to chronic conditions  Understand risk factors as a guide or predictor for potential ill-health in certain groups  Comprehend how socioeconomic status and/or ethnicity can influence people’s health and wellness Socioeconomic status and Health consolidation  Multiple deprivation The Index of Multiple Deprivation (IMD) 2019 is the official measure of relative deprivation for small areas (or neighbourhoods) in England The IMD ranks every small area (Lower Super Output Area) in England from 1 (most deprived) to 32,844 (least deprived) Each domain is given a weighting and is based on a group of indicators Task 1 (10-15 mins) Jim (25 yrs, male) lives in a very deprived, low SES area in Bolton, England Consider the cumulative effects of a lack of education along with the 6 other factors/domains listed in the IMD can lead to unfavourable health outcomes for Jim Income: Gym/sport membership or equipment unaffordable to Jim Pause the video and use the worksheet provided on Moodle  Task 1: Example answers Barriers to Living housing/servi Income Employme Education Health Crime ces environme nt nt Gym/sport If unemployed, Less likely to be If he has a High crime puts Living in a Lack of membership or might be due to health literate health him off outdoor better recreational equipment ill health or (more accurate condition, it physical activity neighbourhood facilities/clubs unaffordable might have health beliefs may worsen (and associated in his high stress and knowledge, due to other If involved in benefits) not community for Can only afford and thus to domains’ crime, risks possible physical activity low-cost If employed, better lifestyle factors punishment unhealthy food low income choices) that affect Healthcare Higher relate to Disability employment services may be likelihood for Cannot afford “Income” Social mobility accessibility prospects limited or of pollution/noise better housing column options limited less likely in less quality pollution with less poorer If he grew up in People of lower Work education, neighbourhood this area, may Poorer housing Poorer income more environment stuck on low and work have witnessed may mean neighbourhoods likely to smoke may not be income environments violence as a living with more have higher and drink healthy child. Children family crime rates and (chemical Less likely to exposed to members- psychosocial Health hazards, live and work in violence may overcrowding, stressors insurance for physically healthy experience higher risk of people of other exerting, environments psychological infection and countries psychologically issues and psychosocial  Ethnicity and Health consolidation  Task 2 (10 mins) Ravi (32 yrs, male) arrived in the UK as a refugee but now has citizenship. He and his young family fled from the Sri Lankan Civil War. (They cannot speak English fluently) 1. Which illnesses does Ravi’s ethnicity mean he is at greater risk for? 2. What might they have experienced before and during the war and how might it affect their health and wellbeing? 3. What might transit and migration to UK mean for their physical and mental health? 4. What issues may they face in terms of accessing healthcare, education and work? Also consider their social integration and whether they can settle harmoniously  Task 2: Example answers 1. Which illnesses does Ravi’s ethnicity mean he is at greater risk for? South Asian (higher risk of Diabetes and Cardiovascular disease) 2. What might they have experienced before and during the war and how might it affect their health and wellbeing? Breakdown in health systems in the country of origin (unavailability general healthcare, medication) Victims of, or witnessed, violence (risk of injury, anxiety and PTSD) 3. What might transit and migration to UK mean for their physical and mental health? Malnutrition, unclean drinking water, poor sanitation (risk of infection) 4. What issues may they face in terms of accessing healthcare, education and work? Also consider their social integration and whether they can settle harmoniously Healthcare: May not seek healthcare effectively or may be given limited access / denied WHO (202  The intersection of socioeconomic status and Ethnicity Socio-political considerations of inequality Socioeconomic inequality and ethnic inequality are already problematic alone but… Inequality is especially disadvantageous when wealth is unevenly distributed across ethnic groups (Alesina et al. 2012) Generating Lack of social cohesion Social immobility Hatred Creating envy Potentiating conflict These issues invariably have negative consequences for health  Institutionalised discrimination Institutionalised discrimination is the unjust and discriminatory mistreatment of an individual or group of individuals by society and its institutions as a whole Through unequal intentional or unintentional bias or selection; This bias is not necessarily a conscious choice to discriminate (it maybe subconscious Socio-political considerations of inequality First, inequality in income along ethnic lines is likely to exacerbate the salience of group identity, limit social cohesion by increasing between-group animosity, impede institutional development, and can even cause conflict Second, income differences across ethnic groups are often both the cause and the consequence of discriminatory policies including the unequal provision of public goods or services across groups A recent manifestation of this is the denial of the COVID-19 vaccine for ethnic Palestinians by Israel whilst offering mass rollout of Summary Socioeconomic status, employment and occupational context all have various risk factors associated which can have a profound effect on health outcomes Ethnic inequalities, though reducing and improving, still can lead to social immobility, institutionalised discrimination along with their associated negative health outcomes Socioeconomic status and ethnic inequality often intersect and are exacerbated by one another, further disadvantaging certain demographic groups References Alesina, Alberto F, Stelios Michalopoulos, and Elias Papaioannou (2012), “Ethnic Inequality” NBER WP 18512, CEPR Discussion Paper 9225. Amnesty International (2021) Israel: denying Covid-19 vaccine to Palestinians is 'institutionalised discrimination'. [online] Available from: https://www.amnesty.org.uk/press-releases/israel-denying- covid-19-vaccine-palestinians-institutionalised-discrimination (Accessed 08 January 2021). Questions Feel free to email me any questions you may have