Background

​There is now unequivocal evidence documenting ethnic inequalities in health in the UK, whereby most ethnic minoritised groups have poorer physical and mental health than the white majority group. Ethnic inequalities in health can be largely explained by underlying social and economic inequalities, and experiences of racial discrimination.

​A growing body of evidence is now beginning to document ethnic inequalities in health care, with studies reporting ethnic inequalities in access to and satisfaction with primary and secondary services. Ethnic inequalities in access to mental health services are markedly stark. Amid these alarming ethnic inequalities in health and health care, there is the concern that ethnic inequalities may be even worse for people with multiple conditions, but there is little evidence to document this. In this project we sought to understand whether there were ethnic inequalities in health care among people with multiple health conditions, and identify where care could be improved and ethnic inequalities addressed.

Aims

The overall aim of this project was to contribute to reducing ethnic inequalities in health care quality, by providing solid evidence regarding the inequalities that currently exist. Specific aims were:

1. ​To use nationally representative data to provide an up-to-date description of how multiple conditions vary across ethnic groups in the UK;

2. To describe ethnic differences in health care utilisation, access, and quality for people with multiple conditions;

3. To make the evidence on ethnic inequalities in health care for people with multiple conditions accessible to policy/practitioner/public as well as academic audiences

​Methods

In order to achieve these aims we reviewed the evidence on ethnic inequalities in health and health care among people with multiple conditions; summarised the evidence on health service initiatives within the UK to reduce or contain ethnic inequalities in health care utilisation and/or health outcomes of relevance for people with multiple conditions; and analysed survey data and electronic health records to address gaps identified in the literature review.

Key findings

• We found sizeable numbers of people from minoritised ethnic groups living with MLTC.

• Our research showed that continuity of care is less available to some ethnic minority groups, including for people with MLTCs.

• Exclusion from the Quality and Outcomes Framework program means that we are less able to have high quality intelligence that leads to improved health care which at best maintain the state of health inequalities and at worst, exacerbates them.

• We identified poor patient experience for minoritised ethnic people with MLTC which may exacerbate the inequalities that we uncovered.

• Within the health care setting, there may be opportunities to target clinical and self-management support for people with multiple conditions from minoritised ethnic groups.

Outputs

The study generated several publications all of which can be found on our Outputs page