Hi Sarah
I think I understand what you are trying to do. But for your Q & A, I think that a starting point with PCTs and health services to tackle health inequalities might be a difficult approach. The determinants of inequalities in health in the UK are largely economic and social... Linda Ewles writes a useful chapter on this issue (key topics in public health , 2005). Health services and health promotion activities can be applied to tackle 'downstream' issues faced by people who are poor or excluded. Upstream measures are often beyond the realm of health services and the NHS (and are aimed at national economic and social policy). A key activity to reduce inequality is poverty reduction... For the individual practitioner concerned with reducing health inequalities there are five options: lobbying, partnership working, community development, promoting healthy behaviours and improving access to health care.
Linda Ewles mentions very little about promoting race or disability equality.
Thanks
Cheikh Traoré
Greater London Authority
-----Original Message-----
From: Health of minority ethnic communities in the UK [mailto:[log in to unmask]] On Behalf Of Sarah Corlett
Sent: 28 February 2007 11:49
To: [log in to unmask]
Subject: tackling health inequality - promoting equality: what's the difference?
Greetings
Sorry for multiple postings but I am trying to put together some ideas in a short accessible/ practical briefing or Q&A on the differences and similarities between concepts and action around tackling health inequalities and promoting equality to help both policy and NHS people get their heads round the questions and wondered if people had thoughts.
Essentially I come across some confusion amongst some of my public health (and other) colleagues in PCTs and in policy development, who as far as I can tell (but I am probably being a bit simplistic) tend to think that what they do to tackle health inequalities has the objective of achieving equality (or equity... another whole discussion point) and therefore they are unclear how promoting equality is diferent and what the various equality duties mean for them in addition to what they do already.
I am sure one aspect is that it is unusual as far as I can see (apart from honourable exceptions such as James Nazroo and colleagues) for the influence of discrimination on health to be examined rigorously. People do study barriers to accessing health services but do not seem as part of that to consider for instance cultural stereotyping by staff and things like lack of interpreting services are not seen as discriminatory let alone institutionally racist. In fact I think probably what discrimination actually is may be difficult for (public health) people to pin down and I think some people in the NHS think that we are all so nice and we treat everyone equally (hah!) so what's it got to do with us?
One example of the confusion (but this time seeing the agendas as entirely separate) in our PCT public health has been asked to lead on the development of an equity strategy and HR have got the lead for a single equality scheme but apparently little senior level discussion about possible synergy.
I also actually do have in my sights policy development at a higher level (yes, Dept Health) and would like to answer questions such as "doesn't the Choosing Health white paper do that (promote equality)?" and "what does the equality agenda have to do with us (PH policy people)?"
Sooo after this longwinded introduction does anyone understand what I am talking about and want to put their oar in/ direct me to useful work? Needless to say I will share what I come up with and ensure that the experience and knowledge of this e-group is reflected and acknowledged in what I produce and of course people will be able to use and adapt it for their own purposes.
Thanks very much!
Sarah
Sarah Corlett
Consultant in Public Health
Lambeth Primary Care Trust
1 Lower Marsh
London, SE1 7NT
Tel: 020 7716 7097
em: [log in to unmask]
Lambeth Primary Care Trust will be smokefree from 30 December 2005. To protect the health of patients, staff and visitors, smoking will not be allowed in Trust buildings or grounds. For advice and support on giving up, contact Lambeth Stop Smoking Service on 0800 856 3409 or [log in to unmask]
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