Categorisation and Minoritisation

Selvarajah, Sujitha; Deivanayagam, Thilagawathi Abi; Lasco, Gideon; Scafe, Suzanne; White, Alexandre; Zembe-Mkabile, Wanga; Devakumar, Delan

doi:10.1136/bmjgh-2020-004508

Cited by 52 publications

(57 citation statements)

References 14 publications

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“…Primary care educators can use their position and knowledge of local community to influence systematic institutional change. Key drivers for change include socio-demographic changes, social values and legislative and accreditation frameworks [11,16], including those outlined by the World Health Organisation [26], GMC [12] and the Liaison Committee on Medical Education [61]. Having diversity and inclusion as a central theme within an institutional strategy, vision and mission statement enables institutional ownership and embedding within medical school educational and research activities [16].…”

Section: Institutional Factorsmentioning

confidence: 99%

“…However, to highlight specific issues, this article will focus on 'cultural diversity' as a term encompassing dimensions of ethnicity, nationality, language, religion and the social construct of 'race'. We use the term 'racially minoritised' to describe people or populations 'whose collective cultural, economic, political and social power has been eroded through the targeting of identity in active processes that sustain structures of hegemony' [11]. This term will be used throughout in preference to 'ethnic minority' or 'under-represented minority', as those who are racially minoritised may be the numerical majority but have experiences that are impacted by their race and ethnicity.…”

Section: Introductionmentioning

confidence: 99%

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Promoting cultural diversity and inclusion in undergraduate primary care education

Dutta

Maini

Afolabi

et al. 2021

Education for Primary Care

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In this article, we review key factors in promoting a culturally diverse and inclusive learning environment for all undergraduate medical students, and the role of primary care educators in preparing students to work with diverse teams, patients and communities. These factors include approaches to curriculum and assessment, student community, faculty development and recruitment, and wider institutional factors. By highlighting these, including areas where further research, evaluation and consensus are needed, we hope to support further discourse on how primary care educators can promote culturally diverse and inclusive undergraduate medical education.

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Section: Institutional Factorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Promoting cultural diversity and inclusion in undergraduate primary care education

Dutta

Maini

Afolabi

et al. 2021

Education for Primary Care

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show abstract

“…However, the pattern of lower rates in virtually all minority groups, despite their heterogeneity, should be a caution against locating explanations solely within their cultures [5]. The common experience amongst these groups is a position of a structural disadvantage as a minority within the UK [30], which could also impact the ways in which people feel able to express distress and the likelihood of their accessing help [31].…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Variation in rates of self-harm hospital admission and re-admission by ethnicity in London: a population cohort study

Polling

Bakolis

Hotopf

et al. 2021

Soc Psychiatry Psychiatr Epidemiol

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Purpose To compare sex-specific rates of hospital admission and repeat admission following self-harm between ethnic groups in London and test whether differences persist after adjustment for socio-economic deprivation. Methods A population-based cohort of all individuals aged over 11 admitted to a general hospital for physical health treatment following self-harm between 2008 and 2018, using administrative Hospital Episode Statistics for all people living in Greater London. Results There were 59,510 individuals admitted to the hospital following self-harm in the 10 year study period, ethnicity data were available for 94% of individuals. The highest rates of self-harm admission and readmission were found in the White Irish group. Rates of admission and readmission were lower in Black and Asian people compared to White people for both sexes at all ages and in all more specific Black and Asian ethnic groups compared to White British. These differences increased with adjustment for socio-economic deprivation. People of Mixed ethnicity had higher rates of readmission. Rates were highest in the 25–49 age group for Black and Mixed ethnicity men, but in under-25 s for all other groups. There were substantial differences in rates within the broader ethnic categories, especially for the Black and White groups. Conclusion In contrast to earlier UK studies, self-harm rates were not higher in Black or South Asian women, with lower self-harm admission rates seen in almost all ethnic minority groups. Differences in rates by ethnicity were not explained by socio-economic deprivation. Aggregating ethnicity into broad categories masks important differences in self-harm rates between groups.

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“…Current categorisations of ethnic populations are imprecise, time and context dependent and do not translate globally despite sharing international relevance (Selvarajah et al, 2020). When using categorisations, such as Black, Asian and Minority Ethnic (BAME) in the United Kingdom (UK) or Black, Indigenous and People of Colour (BIPOC) In the United States (US), it is important to be mindful of the historic and geographical contexts which have given rise to these categorisations (Selvarajah et al, 2020). These contexts include connections to suppression, for example, being used to categorise immigrants in the 1940s and 1950s (Selvarajah et al, 2020).…”

mentioning

confidence: 99%

“…When using categorisations, such as Black, Asian and Minority Ethnic (BAME) in the United Kingdom (UK) or Black, Indigenous and People of Colour (BIPOC) In the United States (US), it is important to be mindful of the historic and geographical contexts which have given rise to these categorisations (Selvarajah et al, 2020). These contexts include connections to suppression, for example, being used to categorise immigrants in the 1940s and 1950s (Selvarajah et al, 2020). The issues with such categorisations, however, go far beyond historical context (Selvarajah et al, 2020;Abbas, Memon, Khattab, & Abbas, 2020).…”

mentioning

confidence: 99%

A rapid literature review on inequalities and ethnicity in healthcare workers’ experiences of delivering care during the COVID-19 pandemic

Chisnall¹,

Vindrola‐Padros²

2021

Preprint

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A rapid literature review was conducted regarding inequalities faced by frontline BAME healthcare workers (HCWs) responding to the COVID-19 pandemic within the United Kingdom. A number of key themes and sub-themes were identified within the literature. Firstly, in relation to viral exposure. BAME HCWs are more likely to be exposed to COVID-19 on account of: frontline prevalence (driven by pre-existing systemic racism pre-pandemic, disproportionate redeployment and location of redeployment compared to White counterparts); complications with Personal Protective Equipment (PPE) (driven by lack of access, training and fit-testing compared to White counterparts); and, being afraid to speak up in a ‘bully’ culture (redeployment and PPE access worse for minoritized groups due to lack of ability to say ‘no’, fearful of repercussions). Secondly, in relation to emotional impact. BAME HCWs may experience heightened and unique emotional strain on account of: increased anxiety (due to their increased mortality risk, a greater ‘tear’ between personal risk and sense of duty, and through risk posed to family due to intergenerational living); and, due to racial abuse (experience of racially motivated verbal abuse from patients or patient families, and in some instances even peers, can dramatically change experience of providing care). There is a clear wealth of evidence which exemplifies inequalities in BAME HCWs’ experiences of care provision during COVID-19. Steps should be taken not only to prioritise physical BAME HCWs’ wellbeing but also their emotional and mental health needs. There is greater need for primary research, in particular qualitative data to narrate and capture the lived experiences of BAME HCWs during this pandemic.

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Categorisation and Minoritisation

Cited by 52 publications

References 14 publications

Promoting cultural diversity and inclusion in undergraduate primary care education

Promoting cultural diversity and inclusion in undergraduate primary care education

Variation in rates of self-harm hospital admission and re-admission by ethnicity in London: a population cohort study

A rapid literature review on inequalities and ethnicity in healthcare workers’ experiences of delivering care during the COVID-19 pandemic

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