Socioeconomic deprivation and ethnicity inequalities in disruption to NHS hospital admissions during the COVID-19 pandemic: a national observational study

IntroductionHospital admissions in many countries fell dramatically at the onset of the COVID-19 pandemic. Less is known about how care patterns differed by patient groups. We sought to determine whether areas with higher levels of socioeconomic deprivation or larger ethnic minority populations saw larger falls in emergency and planned admissions in England.MethodsWe conducted a national observational study of hospital care in the English National Health Service (NHS) in 2019–2020. Weekly volumes of elective (planned) and emergency admissions in 2020 compared with 2019 were calculated for each census area. Multiple linear regression analysis was used to estimate the reductions in volumes for areas in different quintiles of socioeconomic deprivation and ethnic minority populations after controlling for national time trends and local area composition.ResultsBetween March and December 2020, there were 35.5% (3.0 million) fewer elective admissions and 22.0% (1.2 million) fewer emergency admissions with a non-COVID-19 primary diagnosis than in 2019. Areas with the largest share of ethnic minority populations experienced a 36.7% (95% CI 24.1% to 49.3%) larger reduction in non-primary COVID-19 emergency admissions compared with those with the smallest. The most deprived areas experienced a 10.1% (95% CI 2.6% to 17.7%) smaller reduction in non-COVID-19 emergency admissions compared with the least deprived. These patterns are not explained by differential prevalence of COVID-19 cases by area.ConclusionsEven in a healthcare system founded on the principle of equal access for equal need, the impact of COVID-19 on NHS hospital care for non-COVID patients has not been spread evenly by ethnicity and deprivation in England. While we cannot conclusively determine the mechanisms behind these differences, they risk exacerbating prepandemic health inequalities.

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Community Targeting of Uncontrolled Hypertension: Results of a Hypertension Screening and Education Intervention in Community Churches Serving Predominantly Racial/Ethnic Minority Populations

Health Promotion Practice ◽

10.1177/1524839920933897 ◽

2020 ◽

pp. 152483992093389

Author(s):

Heather M. Prendergast ◽

Sandra Escobar-Schulz ◽

Marina Del Rios ◽

Renee Petzel-Gimbar ◽

Charles McPherson ◽

...

Keyword(s):

Ethnic Minority ◽

Uncontrolled Hypertension ◽

Minority Populations ◽

Hypertension Screening ◽

Ethnic Minority Populations ◽

Group 2 ◽

The Impact ◽

Racial Ethnic ◽

Group 1

Background. Uncontrolled hypertension is the primary risk factor for the development of cardiovascular complications and particularly burdens racial/ethnic minority populations. Aim. To determine the effectiveness of a community hypertension screening, education, and empowerment intervention on blood pressure (BP) improvement. Method. We screened 152 participants across four churches in predominantly racial/ethnic minority neighborhoods for elevated BP. During this visit, those with BP ≥ 140/90 mmHg were enrolled in the study and completed interventions. Individuals with moderately elevated BP (≥140/90 and <160/100 mmHg; Group 1) viewed a 3-minute hypertension education video. Individuals with severely elevated BP (≥160/100 mmHg; Group 2) additionally viewed echocardiograms images with subclinical changes from uncontrolled hypertension and had a brief on-site medication review with a pharmacist. Both groups received automated BP monitors and information on neighborhood federally qualified health centers for primary care. Participants returned to each church for follow-up 3 months later. We analyzed BP difference at 3 months and percentage with controlled BP for each group. Results. For Group 1, mean baseline and follow-up BPs were 143.5/88.0 mmHg and 138.5/85.8 mmHg, respectively. For Group 2, BPs significantly decreased from 165.4/98.3 mmHg to 150.4/90.8 mmHg. After the intervention, participants with controlled BP for Groups 1 and 2 were 35.5% and 55.2%, respectively. Discussion. Participants in both groups had BP improvements. Greater improvements were in individuals at higher cardiovascular risk due to severely elevated BPs (≥160/100 mmHg). Conclusion. This pilot highlights the impact that streamlined empowerment interventions with dedicated health personnel can have in high-risk communities with elevated BPs.

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Cultural Revolution on the Border: Yunnan's 'Political Frontier Defence'

The Copenhagen Journal of Asian Studies ◽

10.22439/cjas.v19i0.24 ◽

2004 ◽

Vol 19 ◽

pp. 27-54 ◽

Cited By ~ 1

Author(s):

Michael Schoenhals

Keyword(s):

Ethnic Minority ◽

Cultural Revolution ◽

Minority Populations ◽

General Terms ◽

Human Cost ◽

History Of ◽

Provincial Capital ◽

Ethnic Minority Populations ◽

The Impact ◽

First Time

This paper addresses an important but so far neglected episode in the post-1949 history of China – the impact of the so-called 'Cultural Revolution' on the country's ethnic minority populations. Specifically, it attempts to deal with the movement as it unfolded in the province of Yunnan where, at one stage, it became an attempt by a political leadership in the provincial capital, dominated by military officers and supported by members of the central authorities in Beijing, to alter the landscape of the ethnic minority populations along the frontier. Using information culled from local histories and contemporary sources, the paper traces the history of what even by the standards of the Cultural Revolution (1966-76) came to be regarded as an exceptionally flawed and counterproductive policy. It foregrounds the human cost of its implementation and, for the first time, goes some way towards explaining – in more than simply general terms of labels like 'excesses' and 'ultra-leftism' – the trauma of those who survived it, a trauma that to this day still lingers in popular memory.

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Now Available!: Psychological Treatment of Ethnic Minority Populations by The Council of National Psychological Associations for the Advancement of Ethnic Minority Interests (CNPAAEMI)

PsycEXTRA Dataset ◽

10.1037/e491172006-016 ◽

2005 ◽

Author(s):

Keyword(s):

Ethnic Minority ◽

Psychological Treatment ◽

Minority Populations ◽

Ethnic Minority Populations ◽

Minority Interests

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Challenging Myths about the Mental Health of Ethnic Minority Populations

PsycEXTRA Dataset ◽

10.1037/e501562012-020 ◽

2007 ◽

Author(s):

Stanley Sue

Keyword(s):

Mental Health ◽

Ethnic Minority ◽

Minority Populations ◽

Ethnic Minority Populations

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Community-centred interventions for improving public mental health among adults from ethnic minority populations in the UK: a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-041102 ◽

2021 ◽

Vol 11 (4) ◽

pp. e041102

Author(s):

Cleo Baskin ◽

Geiske Zijlstra ◽

Mike McGrath ◽

Caroline Lee ◽

Fiona Helen Duncan ◽

...

Keyword(s):

Mental Health ◽

Ethnic Minority ◽

Minority Groups ◽

Public Mental Health ◽

Risk Of Bias ◽

Minority Populations ◽

Ethnic Minority Groups ◽

Ethnic Minority Populations ◽

The Uk ◽

Intervention Description

ObjectivesUndertake a scoping review to determine the effectiveness of community-centred interventions designed to improve the mental health and well-being of adults from ethnic minority groups in the UK.MethodsWe searched six electronic academic databases for studies published between January 1990 and September 2019: Medline, Embase, PsychINFO, Scopus, CINAHL and Cochrane. For intervention description and data extraction we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and Template for Intervention Description and Replication guide. Quality was assessed using Cochrane risk of bias tools. Grey literature results were deemed beyond the scope of this review due to the large number of interventions and lack of available outcomes data.ResultsOf 4501 studies, 7 met the eligibility criteria of UK-based community interventions targeting mental health in adults from ethnic minority populations: four randomised controlled trials, one pre/post-pilot study, one cross-sectional study and one ethnographic study. Interventions included therapy-style sessions, peer-support groups, educational materials, gym access and a family services programme. Common components included a focus on tackling social isolation, using lay health workers from within the community, signposting and overcoming structural barriers to access. Four studies reported a statistically significant positive effect on mental health outcomes and six were appraised as having a high risk of bias. Study populations were ethnically heterogeneous and targeted people mainly from South Asia. No studies examined interventions targeting men.ConclusionsThere is a paucity of high-quality evidence regarding community-centred interventions focused on improving public mental health among ethnic minority groups. Decision makers need scientific evidence to inform effective approaches to mitigating health disparities. Our next steps are to map promising community activities and interventions that are currently being provided to help identify emerging evidence.

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