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Hi Sarah It all sounds so familiar! In the early nineties when I first suggested that one way forward to better and more culturally competent care was to have a workforce that more nearly reflected the community it served, there were ructions! People thought I meant 'black on black' care and many staff felt attacked and hastened to inform me that they 'provided exactly the same care to everyone'! This was exactly my point and led to another of my 'sayings': "To treat me equally, you might have to treat me differently." I developed Positively Diverse to give people a structural framework to use to define the problems and to come up with solutions and interventions which focused on those problems. This was to get away from implementing someone else's solutions in the wrong environment. One size does definitely not fit all! Impact Assessment is key to moving forward, I believe. I have developed a framework for this, which is included in the DES and GES guidance that I have done for the NHS, available online as well as in hard copy. Creating a disability equality scheme a practical guide for the NHS http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4139666&chk=B6%2BbZY Creating a Gender Equality Scheme: A practical guide for the NHS http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4143259&chk=yfLSUu There is also a lot of helpful stuff around the difference between equal ops and diversity and about equality, equity and outcomes. Would be very interested in doing some work to make things more clear-cut for workers in the area. Regards Barbara Burford ----- Original Message ----- From: Sarah Corlett To: [log in to unmask] Sent: Wednesday, February 28, 2007 11:49 AM 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]