BME Health Inequalities

The Census report (2011) and NHS Digital 2017 report a number of health inequalities BAME people face, these include:

Pakistani and Bangladeshi women reported illness rates that were 10% higher than those of white women consistently through three census periods (1991,2001,2011)
The White Gypsy and Irish Traveller groups report particularly poor health, both men and women have twice the White British rates for limiting long term illness
Chinese people reported consistently better health outcomes in 1991, 2001 and 2011 Census compared to other groups
The Pakistani, Bangladeshi. Black Caribbean, White Irish and other Black census groups have worse health outcomes than the White British group for both men and women.
Death rates from coronary heart disease amongst first generation South Asian adults are approximately 50% higher than the England and Wales average
White women are up to 2.5 times more likely to be affected by osteoporosis and white men have been found more likely than black men to develop this condition
The death rate from strokes among adults born in the Caribbean is more than 50% higher than the England and Wales average
Perinatal mortality among Pakistani born mothers is nearly twice the national UK average

Most South Asian groups have low incidence of lung cancer
Malignant melanoma mainly affects white people
Infant mortality for gypsy/traveller communities is 5 times the national average
High hospitalisation rates for schizophrenic disorder amongst Afro-Caribbean population have been a constant research finding for many years
Women born in India and East Africa have a much higher suicide rate than those born in England and Wales.
Type 2 diabetes is up to six times more common in South Asian people and up to 3 times more likely to African and African-Caribbean people
69%, adults from the Black ethnic group are likely to be overweight or obese, more than twice as likely to be overweight or obese as adults in the Chinese ethnic group (32%)

White British adults (16+) were more likely to drink at hazardous levels, harmful or dependent compared with all other ethnic groups. 30.8% of White British men, compared with 18.4% of men from Other White backgrounds, 6.6% of Black men, 4.7% of Asian men and 12.9% of men from Other or Mixed ethnic backgrounds
25% of men in the ‘Mixed’ ethnic group smoke, while only 3% of Asian women smoke
Over 50% of people in the Bangladeshi and Pakistani ethnic groups lived in the most deprived 20% of areas in England in 2011. There is a 9 year gap in male life expectancy between the most and least deprived areas of England, and a 7 year gap for females.

Considerations relating to faith can include:

Buddhists and Hindus may refuse some drugs that are believed to inhibit clarity of mind
Circumcision is primarily carried out for religious or cultural reasons. Female circumcision is illegal in the UK and must be reported by Ambulance staff
Hinduism classifies disease into two categories, those that can be effectively treated and cured, or those that cannot. It further classifies untreatable diseases as those which can be managed for an acceptable quality of life, such as diabetes, and those which cannot, such as terminal cancer. If treatment cannot provide the patient a quality life, then it is considered better to give no treatment beyond palliative measures
Some religions believe that suffering is part of life and leads to a better state of existence – for them, cutting suffering short means interfering with progress towards liberation/salvation/atoneme
Jehovah’s witnesses may refuse transfused, or stored blood– the collection of blood may also be refused by followers of this faith– this must be respected though communication of risk involved is imperative.

Making a Difference to Patients