Why we need an Office for Minority Health

• Radhakrishna N S
• 06 August, 2020

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By: Radhakrishna N S

By Dinesh Bhugra
Professor Emeritus Mental Health & Cultural Diversity
King’s College, London

ANOTHER day and another enquiry has been ordered to look at why there are disparities be­tween black, Asian and minority ethnic (BAME) individuals and the majority white population.

Yet another commission on race and ethnic dis­parities was announced recently. There have been several enquiries, commissions and reports into inequalities and racism in the UK as a whole.

An enquiry by Public Health England (PHE) spe­cifically in response to increased deaths of BAME groups from coronavirus concluded that the Bang­ladeshi population had the highest fatality rates. A recent paper in the Lancet looked at perhaps the largest number of cases in the UK and reported that south Asians who died as the result of the virus were overall younger, and more likely to have type-2 diabetes leading to higher rate of critical care admissions, although black people and other minority groups also had a higher likelihood of ad­mission and having diabetes. These groups gener­ally were more likely to receive invasive mechanical ventilation, and mortality rates were highest among south Asians.

Health inequalities are a fact of life for minority ethnic groups. Social determinants such as poverty, unemployment or jobs insecurity, overcrowding, lack of access to green spaces and other causes af­fect our health and wellbeing. Racism, both institu­tional and individual, plays a role in why individu­als delay seeking help, and these delays contribute to poor outcomes.

For the past 50 years or so, there has been plenty of research evidence to suggest that BAME com­munities in general are poor, have more chronic longstanding illnesses with other conditions and also have a shorter lifespan. Some of these factors are influenced by practices such as smoking, alco­hol use and diet, which may contribute to over­weight and obesity. Poor physical health affects our mental health and wellbeing and in turn, poor mental health influences our physical wellbeing.

So, what do we need? Health – be it physical or mental – is linked with other factors such as educa­tion, employment, housing, social security, and justice. So, we need to have joined-up thinking for all, but especially for BAME groups. The reality is that institutional racism exists in many institutions and organisations, and we need to challenge that at a number of levels. Health is the most important asset we have and to help preserve it, prevent com­plications and improve quality of life should be the number one priority of any government.

One solution is to set up an Office for Minority Health (OMH) as a public body under parliamen­tary law and based in the Cabinet Office. Such a body can act as a repository of information on the health and social care needs of these groups. More important, it will be able to liaise across various government departments and ministries to reduce duplication of effort and bureaucracy. It will be re­sponsible for asking hospital trusts to ensure that services they provide are culturally sensitive and staff are trained in cultural competence.

The OMH can provide training and award char­ter marks to the trusts that have achieved the agreed standards. Furthermore, it can work with other organisations such as schools, universities, employers, voluntary agencies, and religious and faith leaders to engage with the communities to develop strategies for health promotion and pre­vention of ill-health.

The aim of such a body will be to improve the health of racial and ethnic minority groups through the development of culturally relevant and cultur­ally appropriate health policies across the lifespan of individuals, leading to culturally appropriate services which are more likely to be used by the minority groups. It will also focus on health promo­tion, illness prevention and health improvement at population, community and individual levels and also through healthcare systems, thereby helping to eliminate health disparities.

Its main role will be to keep under review elimi­nation or otherwise of ethnic inequalities across government, statutory organisations and bodies, social institutions and others. It must share exam­ples of good practice, improve data collection and produce evidence to support policymaking. It will have to establish and support research and clinical networks to ensure an overall overview of policy development and delivery which can, in turn, be used to assess the effectiveness of policy changes.

The OMH has the potential to bring everything under one roof, cut bureaucratic costs and inte­grate research and joined-up delivery of healthcare for minority individuals whose needs may differ and who may require help in culturally appropriate settings. The time is now to launch a campaign for the setting up of a body which can oversee BAME health in a way that is culturally sensitive. We do not need more enquiries, and the money to be spent on them can be used to establish the OMH. This article first appeared on the BMJ (British Medical Journal) website in July.