Introduction
Problems with health-related inequality have emerged extensively after the outbreak of COVID-19. Ethnic minorities, such as Blacks, Asians, Indians, and other non-European British residents, usually have more health-connected problems compared to white British people. They become ill more often, are more affected by social or environmental problems, have less financial and social stability, and, consequently, have higher chances of dying (Geddes, 2021; Iob, Steptoe and Fancourt, 2020; Otu et al., 2020). This is a large problem and challenge for the British health system, which is designed to support all country’s residents. There are various reasons for such inequality: low health literacy among ethnic minorities, inability to afford medical services, and cultural barriers. All of them are to be studied in this essay to reveal how the situation might be improved with equal access to health services. The essay is divided into three basic paragraphs: the description of the case, the discussion about it, and recommendations, ending with a conclusion.
Case Description
Ethnic minorities face larger mortality from COVID-19 and related illnesses. According to The Guardian article, people in the BAME (Black, Asian, and Minority Ethnic) social group are less prone to be vaccinated and visit medical specialists rarer than in other groups (Geddes, 2021). They usually work with people, and thus, they have more chances of becoming ill. They are generally more loaded by work while having a lower income; thus, their quality of life is quite low (Geddes, 2021). Due to their lower access to health services, they are more prone to suffer from chronic diseases. They, too, live in disadvantaged regions, which are usually more polluted, have no access to quality food and medical facilities, and usually have higher criminality levels (Geddes, 2021). This makes them much more vulnerable to diseases and other life troubles: they become ill first when it is a pandemic.
In general, their cultural differences become their burden, creating problems in their lives. They often feel inconvenienced, tend to reject their COVID-19 or other diseases and refuse to visit a doctor (Geddes, 2021). In that way, ethnic minorities in the UK have problems managing a healthy and happy life for themselves, and the COVID-19 pandemic sharply uncovered those issues. There is a clear sign of inequality: ethnic minority people from the BAME group have much lower life quality and, particularly, access to medical services. It is characterized as a problem of the medical system, as it cannot provide them with all the necessary information and medical help (Geddes, 2021). In another case, they probably would have no reasons to reject vaccines and be hesitant to visit a doctor. There are several recommendations of how those problems could be solved, based on the case description and possible solutions for BAME people’s vulnerabilities.
Case Discussion
Reasons for Health Inequalities
At first, BAME people usually have lower socioeconomic status, lower life quality, and a lack of stability. They have salaries lower than white UK citizens and usually have to work hard in vulnerable positions, which means they will contact the ill person more likely during work (Peate, 2020). In general, they often lack career perspectives at the workplace and suffer from insufficient inclusion, unable to integrate into the collective (Otu et al., 2020). Their health literacy is low, so they often do not know which medical health they may obtain or do not even trust medical services. In addition, they often cannot afford medical help or insurance due to high costs. They have low nutrition quality and are more susceptible to pollution, as they usually live in the more polluted regions (Bentley, 2020). Thus, social problems connected with their statuses, such as low health literacy, issues at the workplace, insufficient funds to afford medical help, and bad living quality, are the reasons for the health inequalities.
In addition, there are issues connected with cultural differences and, thus, misunderstandings between various social groups. People from the BAME population usually have a cultural background very different from the white British population. According to Tajfel and Turner’s social identity theory, there are always barriers between social groups. People have social identities and tend to divide the world into “them” and “us,” leading to mutual misunderstanding. As BAMEs often have difficulties overcoming those barriers, they are alienation and an inability to improve their lives (Ahmed, 2020). Such a position increases the stress level, which negatively influences the risk of becoming ill. Medical education in the UK lacks inclusion, too: there is a lack of ethnically diverse medical examples, and thus, BAME people feel alienated from the study process (Bedi, 2020). To understand how those health inequalities may be solved, BAME people’s vulnerabilities should be studied and elucidated at first.
The BAME People Vulnerabilities
People from this social group tend to feel insufficient support from health services, leading to them hesitating to obtain medical health. Even if they become ill, they often do not visit a doctor or clinic, preferring to ignore the illness (Otu et al., 2020). They cannot afford to do it or feel no trust in healthcare services. BAME people still face racism, which increases their stress levels, lowers their life quality, and hinders their work advancement (Ahmed, 2020). According to the systems theory, behavior is influenced by a variety of factors, which should be studied separately. The risk of racism, the knowledge that they will probably not obtain desired medical help, and the constant lack of financial stability influence the behavior of avoiding healthcare services, typical for BAMEs. Those socioeconomic problems lead to a worse health level among ethnic minorities than the rest of the population and, thus, to inequality.
They are vulnerable to all social problems due to their lower life stability and high workload. BAME people have higher suicide rates than other social groups, especially during the COVID-19 pandemic and the related lockdown (Iob, Steptoe, and Fancourt, 2020). Thus, such life-worsening factors as pandemics, social disruptions, environmental pollution, economic crises, and common social problems, such as criminality, are more dangerous for those people than other social groups. They often live in more polluted areas, where life is cheaper; such regions often have more criminal activity, which also increases the risk of becoming physically and mentally ill (Bentley, 2020). Those conditions worsen their life and make them much more prone to become ill with a fatal outcome.
Many BAME people work in the services sector, including medicine, working with people actively. While there are less than 15% of in the UK population, more than 30% of those who died from COVID-19 are BAME (Peate, 2020). Ironically, those who work in health services are much more vulnerable. While only 20% of medical workers are BAME, they contribute to more than 60% of COVID-related deaths (Chaudhry et al., 2020). There were reported that the first dozen of doctors who died from COVID-19 were BAME people: such sad information shows how vulnerable they are in their workplaces, including the healthcare field (Otu et al., 2020). There is evidence that ethnic minorities in the healthcare sector have lesser access to medical protective equipment than white British people (Bentley, 2020). Along with the problems with nutrition, imposing pollution, and high-stress levels, it makes them highly vulnerable to becoming ill.
Due to the mentioned low trust in health services, BAME people usually do not go to a doctor even when they are ill. They often hesitate to visit medical services, so they often do not vaccinate, leaving themselves vulnerable to COVID-19. While, in general, 80% of British people are willing to use the anti-COVID vaccine, only less than 30% of the Black population and slightly more than half of the Bangladeshi population are ready to vaccinate (Iyengar et al., 2021). They are vulnerable to mental health problems, frequently connected with COVID-19, losing their life quality, and have higher risks of committing suicide (Iob, Steptoe, and Fancourt, 2020). While they often become ill due to high levels of stress and lower medical support, they visit doctors and medical facilities rarer. It leads to the continuous worsening of the health in the BAME population group, making it less likely that their life will improve.
Lastly, there is evidence that BAME people have a higher susceptibility to COVID-19 due to their genetic and metabolic properties. Genetic diseases, such as sickle anemia and cytokine storm tendency, lower their immunity (Ahmed, 2020). Poor nutrition and low vitamin level, especially vitamin D, also decrease their defense against various illnesses. The fact that they live in polluting areas is especially bad for them, as they are vulnerable to pollution: various polluting chemicals destroy the immunity of BAME people extremely quickly (Otu et al., 2020). While their genetic and metabolic inclinations cannot be changed, their life quality can be improved, making them much more stable for infections.
Possible Solutions
As surveys show that ethnic minorities in the UK are unwilling to vaccinate, increasing their health literacy would help improve their health. To do that, public health services may pay attention to informing people, especially BAME, about the vaccine’s composition, mechanism of action, and side effects (Iob, Steptoe, and Fancourt, 2020). It should include the possibility of obtaining the explained information for those who cannot understand how medical services may help them. Inclusion in the medical services sector ensures that ethnic minorities will be able to understand everything about the available medical support and obtain it (Iyengar et al., 2021). Their health literacy will increase, and they will be able to improve their health.
Another solution is the possible unification of people with similar ethnic backgrounds: in such unions, there will be easier to find medical help and support each other. The research of Ahmed (2020) proposes an alliance formation that will unite BAME people in the UK, enabling them to solve their problems together. By supporting each other, ethnic minorities are more likely to integrate successfully into UK society. According to the Bandura’s social learning theory, people tend to observe and model others’ behavior to adapt to the social environment. Thus, if ethnic minority people will have developed communities, it is more likely that their life will become better. For example, those who have more knowledge in some subjects, such as health literacy or language, may help others improve their proficiency
Researches show that BAME people are more vulnerable in their workplaces: thus, diversity management would help them feel better. There was a proposal to increase the inclusion of minorities in medical education by implementing the medical examples designed for them, not only for white people (Bedi, 2020). Such an approach would ensure that BAME people have more professional knowledge and better integrate into society. Workplace inclusion is another important aspect: it means the absence of racism and other negative attitudes toward minorities while respecting their cultural background and giving them the opportunity to implement their skills (Otu et al., 2020). It will improve their life satisfaction and provide them with more opportunities for career growth and earning more money, thus managing their lives better.
Recommendations
Based on the case of the health inequalities in England and possible solutions for them, several recommendations may be developed about how to implement those solutions. The implementation of the inclusion principles at work and in education would improve the socioeconomic position of BAME people. Diversity management is an important discipline that studies how people with different backgrounds may be managed to work and spend time together without conflicts. It will help resolve issues connected with cultural barriers, such as racism or other inappropriate behavior.
Improving public health literacy would make the situation better: BAME people will be less afraid of the vaccination and will be more prone to visit health specialists. Ethnic minorities often have little knowledge about healthcare services and, thus, have little trust in them, including vaccination. It may be changed by launching awareness campaigns and explaining how medical services will help people solve their problems. Even if ethnic minorities work in the healthcare sector, they often lack enough medical support, and the deaths of BAME medical workers are an example. It means that there is a large need to improve the work quality of minority medical workers by providing them with insurance and all necessary medical help.
Lastly, the unification of BAME people would help them to support each other and solve all mentioned problems collectively, which will be more efficient. For that, non-commercial organizations may be established, and the existing ones may be supported to help solve inequality issues. Internet services may be used to ensure that ethnic minorities are connected, for example, via social networks, and each of them may find support when needed. In this case, they may quickly find and contact each other, asking questions; those who know the answers will reply to them. In addition, they may help each other to defend themselves in critical situations, for example, when one of them becomes severely ill. Such cooperation will make them more likely to solve the mentioned challenges, as people are always stronger together.
Conclusion
The case shows that health inequities are present in the UK, being especially prevalent among BAME people due to various factors. First, they suffer from sociocultural issues, such as low life quality, a lack of work perspectives, cultural barriers and racism, and low incomes with high workloads. Second, they have weak health literacy: while they often cannot afford medical help, they do not even try, having little trust in the medical services. While some ethnic minorities, especially Blacks, have genetic vulnerabilities to diseases, the situation may be greatly improved by introducing diversity management principles at work and in education. Their health literacy may be increased by launching special campaigns explaining how diseases are transmitted and treated. Lastly, BAME people may unite, helping each other improve their life quality, health literacy, and safety.
Reference List
Ahmed, M.H. (2020). Black and Minority Ethnic (BAME) Alliance against COVID-19: One Step Forward. Journal of Racial and Ethnic Health Disparities, 7(5). doi:10.1007/s40615-020-00837-0.
Bedi, S. (2020). Increasing knowledge and inclusivity – encompassing BAME in medical education. Medical Teacher, pp.1–2. doi:10.1080/0142159x.2020.1817350.
Bentley, G.R. (2020). Don’t blame the BAME: Ethnic and structural inequalities in susceptibilities to COVID ‐19. American Journal of Human Biology, 32(5). doi:10.1002/ajhb.23478.
Chaudhry, F.B., Raza, S., Raja, K.Z. and Ahmad, U. (2020). COVID 19 and BAME health care staff: Wrong place at the wrong time. Journal of Global Health, [online] 10(2). doi:10.7189/jogh.10.020358.
Geddes, L. (2021). Health inequalities in UK are major factor in high BAME Covid cases. [online] The Guardian.
Iob, E., Steptoe, A. and Fancourt, D. (2020). Abuse, self-harm and suicidal ideation in the UK during the COVID-19 pandemic. The British Journal of Psychiatry, 217(4), pp.1–4. doi:10.1192/bjp.2020.130.
Iyengar, K.P., Vaishya, R., Jain, V.K. and Ish, P. (2021). BAME community hesitancy in the UK for COVID-19 vaccine: suggested solutions. Postgraduate Medical Journal, p.postgradmedj-2021-139957. doi:10.1136/postgradmedj-2021-139957.
Otu, A., Ahinkorah, B.O., Ameyaw, E.K., Seidu, A.-A. and Yaya, S. (2020). One country, two crises: What Covid-19 reveals about health inequalities among BAME communities in the United Kingdom and the sustainability of its health system? International Journal for Equity in Health, [online] 19(1). doi:10.1186/s12939-020-01307-z.
Peate, I. (2020). Why are more BAME people dying from COVID-19? British Journal of Nursing, 29(10), pp.545–545. doi:10.12968/bjon.2020.29.10.545.
