NHS Race and Health Observatory Action Resource Centre

NHS Race and Health Observatory (RHO) are an independent expert body, established by the NHS, to examine the health inequalities experienced by Black and minority ethnic communities in England (RHO, 2023). Unity Insights were commissioned by RHO to conduct a review of existing literature in the health and social care environment and provide RHO with examples (in the form of case studies) of good practices and effective interventions to reduce ethnic and racial health inequalities. Unity Insights also supplied RHO with a resource bank of collected literature, summarising the findings of the research.

The research approach of this project was split into two phases. The core activities of Phase 1 were creating a framework based on predefined criteria and core clinical areas, conducting a review of research interventions and policy documents, and then screening these publications. The framework assessed publications based on factors such as the relevance of the setting to the UK context and the robustness of the study methodology.

In Phase 2, Unity Insights created the ‘Data Extraction Framework’ template. This framework was created as a structured document serving as a central repository for the relevant key data points from the publications during full text screening and information extraction. The specific areas of information included key learnings, study design, and main outcomes of the publications. To account for possible limitations of the research, reports of bias and generalisability were also extracted. Once all suitable publications were integrated into the framework, specific publications were selected based on key focus areas to be written into case studies based on suitable information gathered from the literature review.

Some of the key themes which emerged from this research were:

• Trust: People from diverse ethnic backgrounds lack trust in the system and can feel unwelcome in clinical settings.
• Cultural competency: Health professionals are not ‘culturally competent’ (i.e., lack understanding of different ethnic cultures).
• Some health indicators do not account for ethnic diversity: For example, ethnic differences in ‘normal’ spirometry results used to diagnose chronic obstructive pulmonary disorder. Healthy Black individuals tend to have lower spirometry results when their lung capacity is measured, compared with White individuals of similar age and height.

These case studies may contribute to the  surmounting of ethnic health inequalities, as communicating these key findings and policy recommendations may facilitate change in the treatment of individuals from different ethnic groups within the NHS.