Faima Bakar, Metro, February 26, 2020
Some people say they don’t ‘see’ race in an attempt to emphasise that everyone is equal. But race dictates many parts of people’s lives, for better or worse, and those differences need to be recognised.
Healthcare is one area where there are serious disparities between how white people and Black, Asian and other ethnic minorities (BAME) are treated.
One group who are being neglected by health services are elderly ethnic minorities, according to recent studies.
Dr Laia Becares, from the University of Sussex, tells Metro.co.uk that this is one of the most disadvantaged and excluded groups in society when it comes to health.
In a study published this month, she found that this neglect is institutionally racist.
She tells us there just isn’t enough research into things like this that affect BAME groups, and this leads to worrying and socially unjust knowledge gaps about the health and social conditions of an already disadvantaged part of the UK population.
She explains: ‘We have found that ethnic inequalities in health are mainly driven by lower socioeconomic resources and lifetime experiences of racism and discrimination.’
In other words, racism kills.
In fact, the health of white English people aged 61–70 is equivalent to that of Caribbean people in their late 40s and early 50s. The statistics are even more dire for Indian people who reach this level by their 40s and Pakistani people in their late 30s, and lastly Bangladeshi people in their 30s and 20s.
The reason these alarming inequalities occur between the ageing population is that BAME groups are currently under-monitored and poorly understood.
There is also a lack of data and longitudinal research in this area.
The current three UK national longitudinal birth cohort studies with samples suitable to study ageing processes (The National Survey of Health and Development, the National Child Development Study, and the 1970 British Cohort study) have negligible numbers of ethnic minority respondents.
So the results found from these long-term studies are not generalisable to all people.
This problem is in the assumption that the findings in studies about the health of white people can predict the patterns and behaviours of minorities. But it has been proved that some minority groups are more susceptible to certain conditions.
Dementia is one of these.
A UCL research team tell Metro.co.uk that they found that Black ethnic groups in the UK face above-average rates of dementia, and may also be less likely to get a timely diagnosis.
And yet there is a lack of appropriate and timely access to services for this group.
Jazz Browne is the chief executive of the Nubian Life Resource Centre, an independent care provider that caters to African/Afro-Caribbean older adults and provides daycare services for black people over 65. They are working with UCL to test the dementia prevention programme.
She tells Metro.co.uk: ‘Dementia disease is prevalent as are hypertension, diabetes and stroke within our client group.
‘Appropriate and timely access to services is an issue faced by BAME communities, it can be compounded by language barriers, lack of support or knowledge of services and a practical understanding of dementia.
‘The terminology and any condition related to the mental health of people of BAME heritage is rooted deep in negative stereotypes.’
Jazz says that there are some cultural barriers within the community too (stigma attached to mental health problems) but a general distrust into the health services also exacerbates the problem.
‘The question of whether BAME communities have trust and confidence in statutory services also needs to be explored; as mainstream care models exclude BAME communities through limited access routes and culturally specific services or signposting.
‘It is also important to note that when discussing the health and social care needs of the older people from BAME communities, their children born and raised in the UK have their own experiences of inequality and at times are reluctant to engage with statutory services based on those experiences.’
In another study published by UCL earlier this month, they identified disparities in drug prescriptions suggesting that Black and Asian people with dementia are not receiving the same quality of care as their white peers.
This is devastating for people such as Chris Hamilton, whose dad has dementia. His dad has been living with the condition for a few years while his mum is showing early signs of it.
Chris is the primary caregiver and has brought his dad home from the long-term care centre he’d been staying in the last three months.
‘He doesn’t have adequate healthcare but it’s better than a facility,’ he tells us.
‘Only the wealthy can really afford [this] or else you basically lose all assets. It’s a huge financial struggle.
My future retirement plans are wiped out. ‘And I don’t know how much longer I can do this. ‘I wash him, change him and cook his meals.
I get him up and walking and he is still talking now. When he was in long term facility he was deteriorating quickly and no longer walking.’
Older ethnic minorities from poorer backgrounds have less access to healthcare, they are less likely to be taken seriously when they do seek help, and there isn’t enough research into the conditions that they may be more prone to.
All that takes a toll on an individual’s physical and mental health.
Dr Laia adds: ‘We found that ethnic minority people who reported repeated occurrences of racial discrimination, over time and across domains had poorer mental health than ethnic minority people who did not report any experiences of racial discrimination.
‘There is clear evidence that racism is bad for mental health – and for physical health and health behaviours.
‘In order to address this, the focus shouldn’t be only on public health policy, but across all aspect of social welfare.
‘Importantly, we shouldn’t wait until old age, we must address the causes of ethnic inequalities in health (such as racism and racial discrimination) at all stages of the life course.’
In short, we desperately need to start thinking about the implications of race on long-term healthcare, both physical and mental. And we need the research to reflect the diversity of our population.