House of Lords Library – Published Tuesday, 12 December, 2023
Black women were at a greater risk of maternal mortality in the UK during 2018–20 when compared to White women, according to recent findings. The underlying causes of this disparity remain a complex picture. This briefing looks at the latest research findings, as well as a recent parliamentary report on Black maternal health and the government’s response.
Read the Report – Maternal mortality rates in the Black community
The Voice – 2023
The Black British Voices Project aims to create a nuanced and comprehensive account of the experience of being Black in Britain, by combining a public national survey with in-depth interviews of leading Black British commentators, including politicians, celebrities, writers, journalists and business people.The project aims to build understanding, drive change, increase prosperity, improve policy, overcome obstacles and maximise participation in key institutions and professions. The findings from the study found a staggering 87 per cent of participants said that Black people receive a substandard level of healthcare because of their race. Equality campaigners say the health and wellbeing of the Black British community is at risk and there is an urgent need for investment in culturally competent services to tackle racial health inequalities.
Read the Report – The Black British Voices Research Report 2023
University of Cambridge – 2023
The largest survey to date of the opinions and attitudes of Black people in Britain. The report reveals that extremely high levels of distrust and discrimination are still felt deeply across Black British communities when it comes to systems such as health, education and criminal justice
Further information – Black British Voices
Doctors of the World – 2023
This report argues that too many of the policy decisions that were made during the Covid-19 health emergency either did not understand the evidence on inequality or ignored it, and that this was particularly true for ethnic minorities and migrants.
Read the Report – Not by choice: the unequal impact of the Covid-19 pandemic on disempowered ethnic minority and migrant communities
NHS Race and Health Observatory – July 2023
People with a learning disability from Black, South Asian (Indian, Pakistani or Bangladeshi heritage) and minority ethnic backgrounds face shorter life expectancy triggered by poorer healthcare access, experience and outcomes.
The average age of death for people with a learning disability who are from an ethnic minority is 34 years, just over half the life expectancy of white counterparts, at 62 years of age. Of those with a learning disability who die in hospital, 51% from ethnic minority groups have a ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) recommendation, compared to 73% for those who are white.
These, and other findings, will be discussed as the independent NHS Race and Health Observatory launches its new recommendations report that examines two decades of research looking into discriminatory barriers preventing equitable healthcare treatment.
Supported by NHS England, the comprehensive five-part report contains data, personal interviews and analyses undertaken by the University of Central Lancashire, in collaboration with Manchester Metropolitan University, Learning Disability England and the Race Equality Foundation.
Read the Report – ‘We deserve better: Ethnic minorities with a learning disability and access to healthcare’
NIHR – 1st June 2023
In the UK, people from diverse ethnic minority groups have poorer access to, experiences with, and outcomes from mental healthcare services, compared to White British people. A large review of the evidence explored how these ethnic inequalities are created and sustained in mental healthcare.
The authors call for culturally informed approaches to mental health assessment and treatment. Approaches need to recognise and respond to the everyday realities of people from diverse ethnic minority groups, including racism.
The review included 66 studies on ethnic minority groups’ and mental health professionals’ perceptions and experiences of mental health services. The studies explored barriers to accessing services, as well as experiences and outcomes. The researchers assessed how ethnic inequalities in mental healthcare are created and sustained, and how they could be overcome.
The review found that mental healthcare services often did not consider how racism, migration stress, and complex trauma affect mental health. Mental health professionals described barriers to providing person-centred care such as a lack of time, discomfort when talking about race and spirituality, and fear of calling out racist practice when it was witnessed. The researchers call for more personalised care, and consideration of the complex interplay between social and economic circumstances, and systemic racism.
More than half of the studies analysed were published before 2013. Mental healthcare services may have become more aware of these issues since then. However, existing research indicates that there has been little progress in tackling ethnic inequalities over the past 50 years. This may be because of systemic racism and an overly ‘medical’ culture that prioritises diagnosis and drug treatments.
Further information – How can mental healthcare services meet the needs of people from ethnically diverse groups?
This Alerts is based on: Bansal N, and others. Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography. PLOS Medicine 2022; 19: e1004139.
NIHR 25th May 2023
An analysis of more than 2 million pregnancies found that babies born to Black women worldwide had poorer outcomes (such as baby death and stillbirth) than White women. This was true even after controlling for older age and a lower level of education among mothers (an indicator of poorer economic and social status).
Race and ethnicity have been associated with poor pregnancy outcomes in many countries. In the UK, the rates of baby death and stillbirth among Black and Asian mothers are double those for White women. Most studies examine trends for individual countries. This large database study explored how race and ethnicity is linked to pregnancy outcomes in wealthy countries.
Black women consistently had worse outcomes than White women across the globe. Hispanic women were three times more likely to experience baby death compared with White women. South Asian women had an increased risk of early birth and having a baby with an unexpectedly low weight (small for the length of pregnancy) compared with White women. Racial disparities in some outcomes were found in all regions.
The researchers call for a global, joined-up approach to tackling disparities. Breaking down barriers to care for ethnic minorities, particularly Black women, could help. More research is needed to understand why outcomes are for worse for ethnic minorities. The researchers recommend routine collection of data on race and ethnicity.
Further information – Black women around the world have worse pregnancy outcomes
This Alert is based on: Sheikh J, and others. Effects of race and ethnicity on perinatal outcomes in high-income and upper-middle-income countries: an individual participant data meta-analysis of 2 198 655 pregnancies. The Lancet 2022; 400: 2049 – 62.
Muslim Women’s Network UK, 2022
The aim of this inquiry is to illuminate the maternity experiences of Muslim women in the UK,
particularly of those from Black, Asian and other minority ethnic backgrounds and to better
understand the factors influencing the standard of maternity care they receive, which in turn could
be contributing to the inequality in outcomes for them and their babies. Given that the diverse
ethnic backgrounds of Muslim women, White Muslim women were also included in the research
to explore if their experiences differed from non-White Muslim women. The research also aims to
reduce inequalities by recommending improvements to the safety and quality of maternity care
given to women from racialised minority communities.
Full Report – INVISIBLE Maternity Experiences of Muslim Women from Racialised Minority Communities
Kings Fund 17th May 2023
This long read examines ethnic differences in health outcomes, highlighting the variation across ethnic groups and health conditions, and considers what’s needed to reduce health inequalities.
Further information – The health of people from ethnic minority groups in England
Women and Equalities Committee – 18th April 2023
In this report we review what is currently understood about the reasons for disparities in maternal deaths, analyse Government and NHS action to date and existing recommendations for change and consider the ongoing challenges to addressing disparities. This report is titled ‘Black maternal health’ to acknowledge and address the particularly stark disparity between Black and White women. However, our recommendations are intended to address the ethnic disparities more broadly, as well as the overlapping
disparity for women suffering socio-economic deprivation. There is no single quick-fix solution. However, we hope this report and our recommendations can act as an impetus for an effective and coherent cross-Government strategy, that can quickly begin to make
sustained progress.
Read the Report – Third Report – Black maternal health
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