Racial disparities in women’s healthcare
By Integrated Care Journal-
PPP is driving discussion around correcting disparities and indeed improving outcomes in women’s healthcare.
The past year has seen a resurgence of activism around issues of social justice, including how gender and race intersect to cause multiple layers of oppression. The session sought to challenge the unacceptable disparities that exist in women’s healthcare for women from Black, Asian and minority ethnic (BAME) communities. Chaired by Dr Christine Ekechi, Co-Chair of the Race Equality Taskforce, at the Royal College of Obstetricians and Gynaecologists (RCOG), the conversation began by drawing attention to existing data demonstrating these inequalities. However, Christine highlighted the larger problem around data and racial disparities is the distinct lack of it: “we have a huge data gap and we need to fill it. ”
Tracey Bignall, Senior Policy Officer at the Race Equality Foundation, focused on the issue of maternal mortality, explicating some of the reasons behind the poorer outcomes experienced by BAME mothers. Outlining the fact that childbirth and maternal health is good across the UK as a whole, Tracey explored the shocking statistic that Black women are four times more likely to die in childbirth than their white counterparts. While these statistics are important, the causes of them remain unclear. Tracey explained, “it is consistently highlighted that more research must be done. The research needs more research. ”
A key message running throughout the entire panel centred on praxis: talking about racial disparities is important, but what we do about them is key. At NHS level, Tracey outlined the NHS Long Term Plan has made significant commitments towards addressing racial disparities within women’s healthcare; by 2024, 75 per cent of women from ethnic backgrounds must have continuity of care within their maternity experience. Tracy stressed that, “We know that system change takes a while – and for women – that may be too long. ” As such, she also recognised the work being done at grassroots level by women themselves to empower one another.
Dr Nadia Bukhari, pharmacist, Associate Professor at UCL and Chief Pharmacist at DoctHers, drew attention to racial disparities within the health and social care sector. Nadia noted the fact that by 2030, changing demographics for global health means that there will be a shortfall of 18 million jobs within the health and social care sector. However, Nadia suggested that “the global mismatch between the supply and demand is both a cause for concern and a potential opportunity. ”
Referencing the title of the WHO’s 2019 report on gender equity within the global health and social workforce, Nadia stated, “women have been delivering global health while men lead it. ” She further outlined how gender inequality within the workforce weakens health systems; 69 percent of global health organisations are headed by men while only 20 percent of global health systems have gender parity. Citing her work with DoctHers, a digital health platform that connects female doctors with underserved patients across Pakistan, Nadia highlighted how 50,000 female doctors in Pakistan are excluded from the workforce. Innovative solutions that utilise technology must be prioritised when addressing health disparities in the developing world, to ensure these communities are not left behind further. “The rights, inclusion and representation of women should be at the centre of any modern healthcare delivery system,” she affirmed.
Another key takeaway from the panel focused on representation at senior management level within the health sector to reflect the diversity of the population being served. Dr Ekechi said that while diversity within the lower ranks of the NHS was good, only 7.3 per cent of senior staff are from an ethnic background. Likewise, Dr Bukhari emphasised that “visibility must go beyond tokenistic gestures. ”
Dr Hina Shahid, GP and Chair of the Muslim Doctors Association explained the importance of intersectionality, ‘we cannot have a discussion about racialised health disparities without talking about racism. ’ Hina stressed the fact that ethnic minority groups are not homogenous and that gender, ethnicity and religion all intersect to form multiple layers of oppression. She also argued for the importance of considering the social determinants of health when making decisions, ‘the conditions in which people live, work and play influence health outcomes more than anything else. ’ Referencing her own experience as a Muslim woman of colour, Hina described the ‘triple penalty’; being female, from a BAME community and visibly Muslim makes these women the most disadvantaged in the work force.
Finally, Ashley Diaz-Granados, President & General Manager of the Lilly UK Ireland and Northern European Hub, spoke about the importance of allyship and encouraging diversity within the dataset for pharmaceutical companies. Sharing how her own experience of white privilege has shaped her career in the healthcare industry, Ashley argued for how allyship is crucial to creating meaningful change. Addressing racial disparities in health research and development starts with the pharmaceutical industry and Ashley explored some of the ways this can be done. ‘Everyone within an organisation must understand their own biases and be comfortable engaging in conversations about race, privilege and gender. Without such work, meaningful change isn’t possible,’ she explained. Just as the industry has broken major barriers to produce a Covid-19 vaccine in record time, Ashley finished by challenging ‘the industry to keep up this momentum to battle the twin epidemics of racism and gender inequity. ’
The panel concluded with a lively Q&A session surrounding how Covid-19 has lifted the lid on inequalities that previously remained hidden and whether this will bring lasting change. Overall, the panel raised important issues surrounding research, data and praxis. As Dr Christine Ekechi expressed, ‘it is with collective effort that we can begin to reverse racial disparities in women’s health. ’
Public Policy Projects is exploring health inequality in more depth in its State of the Globe report A Women's Health Agenda: Redressing the Balance. For more information, please contact firstname.lastname@example.org
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