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Diversity
- 1. Diversity Map 3: Thedistribution of people from Black and minority ethnic groups Understanding the diversity of our local population will help to inform the decisions of commissioners on shaping future health and well-being servicesi . Some examples of using diversity monitoring information: • 7% of Barnet residents are from African and Caribbean communities there will be a greater genetic disposition towards sickle-cell anaemia. Death rates and complications from diabetes is higher amongst and from its complications is higher amongst people from Asian and African-Caribbean ethnic originii . • Similarly, high blood pressure and one of its most important complications – stroke – is more common amongst people of Black ethnic originiii,iv with higher morbidity rates if blood pressure is not controlled wellv . • Our large Asian and Mediterranean (Greek and Turkish heritage) communities may be more pre-disposed to being diagnosed with thalassaemia. • Schizophrenia is diagnosed more commonly in people of African Caribbean origin than in people from other ethnic groups.vi Edgware Hale Burnt Oak Colindale West Hendon Golders Green Childs Hill Hendon Garden Suburb Finchley Church End East Finchley Mill Hill Totteridge West Finchley Woodhouse Coppetts Underhill Oakley Brunswick Park East Barnet High Barnet Proportion of ward population from Black and minority ethnic groups (%) >29 27 – 29 26 – 27 21 – 26 11 – 21 Edgware Hale Burnt Oak Colindale West Hendon Golders Green Childs Hill Hendon Garden Suburb Finchley Church End East Finchley Mill Hill Totteridge West Finchley West Finchley WoodhouseWoodhouse Coppetts Underhill Oakley Brunswick Park East Barnet High Barnet Proportion of ward population from Black and minority ethnic groups (%) >29 27 – 29 26 – 27 21 – 26 11 – 21 Proportion of ward population from Black and minority ethnic groups (%) >29 27 – 29 26 – 27 21 – 26 11 – 21
- 2. • Rates ofsuicide and deliberate self-harm are higher among young Asian women compared to other communities.vii The reasons to explain this behaviour are complex, but highlight the need to develop flexible and culturally sensitive services. • Developing cancer screening programmes is another area of challenge. Breast cancer diagnosis amongst south Asian women is relatively low in their countries of origin, though their rates increase when they emigrate to western European countries. Reluctance to self-screen is high within this community, coupled with a belief that they are not at risk means that when they do present themselves, symptoms of disease are more advanced. Understanding this behaviour must inform health awareness campaigns. • Barnet’s large Jewish community has a large Ashkenazi sub-group who are known to be genetically pre-disposed towards breast cancer. However, the lack of faith monitoring means that it is difficult to develop targeted screening campaigns by the public bodies and relies on a high level of awareness within the community. Breast cancer often presents itself in women aged under 40 years within this community. • It is difficult to quantify the size and breadth of our refugee and asylum seeking communities. Applications to the Homeless Person’s Unit are mainly from people identifying themselves as ‘White Other’. Preferred languages to be communicated with include Eastern European and Balkan states. Applications are also received from Farsi and Afghani speaking communities in Barnet. But it must be accepted that many refugee and asylum seeking people live in the private rented sector and fall below the radar of public authorities. Health conditions for refugee and asylum seekers are often complicated by their journey to England and their experiences of officialdom both in their countries of origin and here. Many are not registered with local GPs, and it must be acknowledged that many GPs are not clear about their obligations about providing healthcare services to these groups of people. Monitoring diversity Diversity monitoring emerged from the Race Relations Amendment Act 2000 duty placed on public authorities to collect ethnicity data about its workforce. However, most public authorities have widened the scope to collect a range of diversity data relating to both employment practice and service delivery. Where possible, data is collected information on age, disability, ethnicity, faith/belief, gender and sexual orientation by asking people to answer questions based on individual self- identification. Sometimes, people do not wish to share information about themselves. We accept this, but want to encourage people participating in consultations or surveys that sharing diversity information is as important as finding out people’s opinions on the services received by the primary care trust or local authority.
- 3. i Dundas R, MorganM, Redfern J, Lemic-Stojcevic N, Woolfe C. Ethnic differences in behavioural risk factors for stroke: implications for health promotion. Ethnicity & Health 2001; 6: 95-103 ii Balarajan R. Ethnicity and variations in the nation’s health; Health Trends. 1996; 27: 114-9 iii Lane D. Beevers DG. Lip GY. Ethnic differences in blood pressure and the prevalence of hypertension in England. J Human Hypertension 2002; 16:267-73 iv Stewart JA, Dundas R,Howard RS, Rudd AG, Woolfe CDA. Ethnic differences in incidence of stroke: prospective study with stroke register. Br Med J 1999; 318: 9167-71 v Lemic-Stojcevic N, Dundas R, Jenkins S, Rudd A, Woolfe C. Preventable risk factors for coronary heart disease and stroke amongst ethnic groups in London. Ethnicity & Health 2001; 6: 87-94 vi Cochrane R & Sashidharan. Mental health and ethnic minorities: A review of literature and implications for services in Ahmad W, Sheldon T, Stuart O; Ethnicity and Health. NHS Centre for Review and Dissemination, Social Policy Unit. Leeds, 1996 vii Bahl, V. Mental illness: a national perspective. In Ethnicity: an Agenda for Mental Health. Bhugra, D and Bahl, V. Gaskell, London, 1999.