Editorial
Article Type: Editorial From: Ethnicity and Inequalities in Health and Social Care, Volume 7, Issue 1.
It is with great pleasure that I write my first Editorial for Ethnicity and Inequalities in Health and Social Care (EIHSC). The previous Editors have done a sterling job in establishing EIHSC as a hugely valuable source of information for researchers, academics, students, practitioners, managers, policy makers,NHS Trusts and commissioning bodies, local authorities, social workers, psychologists, nurses, voluntary sector workers, service users and carers. My ambition is to firmly establish EIHSC as a leading international human rights journal with a unique approach to addressing entrenched discrimination in health and social care, by engaging with practitioners and by encouraging academic dialogue and policy change from the bottom up. Achieving better outcomes for the most vulnerable users of health and social care services in an evidence-based manner has always been my passion and I could not have taken this appointment at a more critical time when human rights and equality policies are being re-prioritised internationally.
When asked when we will know that a human rights culture has been successfully created in health and social care, I respond by saying when there will be a widely shared sense of entitlement to these rights, of personal responsibility and of respect for the rights of others, and when this influences all our institutional policies and practices. But we are far from creating and sustaining a more humane society, more responsive governments and better public services. That is why initiatives such as EIHSC matter.
Over the last ten years, EIHSC has collected strong evidence to suggest that black and minority ethnic users and other marginalised groups in society who come in contact with health and social care services tend to experience additional challenges and barriers from those that are faced by the mainstream population. Examples include: difficulty in accessing information, difficulty in understanding a complex, uncertain and locally varied system; stigma, low expectations or lack of confidence in one's right to access services;problems in accessing general practitioners and in obtaining an accurate diagnosis, assessment and referral from them and other gatekeepers; a lack of appropriate, accessible and attractive provision; and housing/financial circumstances and the extent to which private and/or family care may constrain individuals’ options. Black and minority ethnic users of health and social care services, particularly older people, may also find themselves lonely as their families tend to live in different countries. The issues of loneliness and lack of family care and friends’ networks are exacerbated among gay and lesbian groups. Older and disabled healthcare service users also experience a lack of initiative in fighting or even resisting disablism,racism and ageism by public service providers.
There is clearly more to be done and the articles of this issue bear further evidence to this claim. The first two papers present new and challenging evidence in the much debated and yet under-researched area of mental health. The usefulness of social entrepreneurship in highlighting effective service models in mental health equity is examined, while the relationship of food insecurity, diet quality and mental health is highlighted. These are put in the context of the most marginalised communities. Reflecting the truly international nature of the journal, the papers report on findings from studies that were carried out in Canada.
I was particularly impressed by the findings of the third paper which looks at the prevalence of suicide attempts among community dwelling US Chinese older adults. Quoting original findings from the PINE study, the paper argues that lower income is positively correlated with lifetime and 12-month suicide attempts. The Journal is thus calling for more attention to the need for improved understanding on suicidal behaviour among minority older adults in order to better inform culturally and linguistically sensitive prevention and intervention strategies.
The New Zealand study then provides us with some new and critical information on the correlation between taxing tobacco and reducing smoking especially amongst marginalised groups. It is indeed the first paper to investigate the effect of large recent New Zealand tobacco tax increases on low-income smokers’ adaptive behaviour. Finally, the last paper is based on research that was carried out in South Africa looking at stigma and disclosure as barriers to regular dental care for people living with HIV and AIDS. This is a group that is often forgotten in the literature and which continues to be discriminated against by service providers and society.
I am committed to keeping the Journal's unique practical approach to promoting equality, inclusion and human rights in health and social care by publishing scholarly research and practice-focused articles and case studies which:
explore what is currently known about discrimination and disadvantage with a particular focus on health and social care;
push the barriers of the equality discourse by identifying new avenues for practice and policy;
create bridges between policymakers, practitioners and researchers; and
identify and understand the social determinants of health equity and practical interventions to overcome barriers.
To mark the Journal's new direction, I am calling for papers for a special issue to publish in 2015 entitled Human Rights Revisited: Tackling Race Inequalities in Health and Social Care. We are interested in empirical research articles, case studies, viewpoint articles, review or literature review articles and conceptual articles, covering (but not limited to) the following topics:
mainstreaming human rights in health and social care services;
race equality as a human right in health and social care;
improving healthcare outcomes for minority groups through human rights;
mental health, race and human rights;
human rights in black and ethnic minority older people's health and social care; and
the black healthcare community sector and human rights.
Submissions must be received by 1 September 2014.
Theo Gavrielides
About the Editor
Dr Theo Gavrielides, Founder and Director of Independent Academic Research Studies (IARS), Co-Director of the Restorative Justice for All institute (RJ4All), Adjunct Professor at the Centre for Restorative Justice of Simon Fraser University and Visiting Professor at the Buckinghamshire New University.
