How do marginalised groups navigate health and social care services in the North East?
Evidence Hub
How do marginalised groups navigate health and social care services in the North East? A study of 33 care professionals and 39 marginalised LGBTQ+ people.
Background
While poverty plays a major part in health inequality, there is growing evidence of the health harms from social inequalities such as discrimination.
This study helps us understand how social inequalities can impact on people’s access to and use of health and social care services.
The research
Despite recent legal and social improvements for some LGBTQ+ people, not everyone can benefit from these. This study heard from marginalised LGBTQ+ people facing multiple social inequalities (such as homelessness, racism, or domestic violence), and professionals supporting them. We spoke to 72 people, and recorded 66.5 interview hours.
Key findings:
The majority are the priority
Current policies and funding decisions push minority groups further into the margins
Workplace cultures make a difference
When diversity policies are not accepted by staff, this can create unsafe services for minority groups
If poverty is viewed as the main disadvantage
Experiences of racism, sexism, and other forms of discrimination are not seen to be important
Conclusions
Improving access to early help and preventative services is in everyone’s best interest. Broadening our definitions of disadvantage, and learning about intersectionality, is crucial for inclusion and health equity.
For organisations that want to improve their reach into marginalised populations, workplace culture is key. Taking time out to listen to local communities, to reflect on our own organisations, and involve staff in the inclusion of marginalised groups may help to improve engagement.
Full details of the study, along with implications for policy and practice can be found in the report, with the Public Advisors’ report, summary documents, and videos on the project website.
What happens next?
The study findings were checked with public contributors at an online event in September 2024. Since then the findings have been shared with the NENC ICB Healthcare Inequalities Workstream Group, presented across academic networks, in blogs for Fuse and the Anti-Stigma Network, in nationwide webinars, at local events across Newcastle/Gateshead, and discussed with a local Imam.
The two published papers have been submitted to the NHS LGBT+ Health Evidence Review and form the basis of three upcoming training sessions for the Newcastle Health Research Partnership and NHS England’s GP training programme. The study was also nominated for an award by Pride Action North.
Next steps
An NIHR Support Fund proposal has been submitted that seeks to improve treatment access for a group who face multiple barriers to services. Working closely with the local communities, the co-designed research will support the delivery of culturally-relevant drug and alcohol treatment service for South Asians and Muslims in Newcastle upon Tyne.
Get in touch
Study lead: Mark Adley
Read the full research paper
Acknowledgements
The study from which this paper was drawn was funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NENC) (NIHR200173). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
PhD Supervisors and co-authors: Prof Amy O’Donnell, Dr Stephanie Scott – Newcastle University
Public Advisors: Ellie, Karl, Kassim, and Liv
Special thank you to the study participants for sharing their stories.