Tackling racism in UK health research: what people can learn from reading the paper

Researchers from the Ethnicity and Health Unit at Imperial College are working to understand and end the inequalities in health research faced by Black, Asian and minority ethnic communities.

The newly published BMJ paper ‘Tackling racism in UK health research’ from our ethnicity and health experts highlights the challenges the sector faces in becoming truly equitable. Drawing on examples of the changes organisations have made to address deep set issues the paper provides a practical insight into areas that need addressing and potential solutions.

An under researched area

Co-author Mala Rao, Director of the Ethnicity and Health Unit and Medical Adviser to the NHS England Workforce Race Equality Strategy, describes the themes explored in the paper:

"This is the first ever systematic analysis of racism, discrimination and inequality in UK health research and I hope it will instigate action to improve ethno-racial equity in this important aspect of health delivery. It supports NHS England’s strategy to address the less favourable treatment and poorer experience and opportunities of its racialised minority staff. Having contributed to that strategy from its inception, and seen how it’s driving change across NHS Trusts, I hope that my concern that similar strategies in health research are woefully lacking—despite the inextricable link between clinical practice and research—will begin to be addressed by this paper."

Themes covered in the paper include racism in research commissioning, patient and public involvement, academia, the assessment of research excellence, research dissemination and the paper closes with a ‘call for change’. Each area is described and demonstrated with real world examples with suggested practical solutions to address them.

A broad look at the UK research landscape

Richard A. Powell, Project Evaluation Manager, NIHR ARC NWL, co-authored the paper and states that we need to transform how we view and approach racism in academia.

“The critical learning is not the pervasive nature of racism across the health research landscape, but the need to view that racism through the remedial lens of equity rather than equality if historical ethno-racial injustices are to be addressed. This means not seeking competitive parity on a level playing field when the game itself is unjust, discriminating against and denying the effective and active participation of players from marginalised communities. It’s about committing to an equity approach that transforms the rules of the game itself, creating unequal opportunities that actively empower meaningful participation and thereby help remedy past injustices.”

The paper looks to role models to demonstrate best practice such as the themed BMJ issue on racism in medicine, which contributed to the subsequent decision to launch an NHS Race and Health Observatory and the work of the NIHR to track, report, and evaluate diversity throughout research organisations.

The impact of health inequalities

This paper forms part of the more expansive work being carried out by the Ethnicity and Health Unit. The team are taking action to address longstanding inequalities within the UK health research sector and beyond. The work being carried out focuses on understanding health issues relevant to the Black, Asian and Ethnic Minority communities and on harnessing this new scientific knowledge to bring about real change.

Ganesh Sathyamoorthy, co-author and Trustee Sickle Cell Society and Assistant Director Ethnicity and Health Unit is a leading voice on health inequalities, recently, in particular, relating to vaccine uptake, and has been using his platform to speak to healthcare professionals nationwide on this important topic.

“The COVID-19 pandemic has bought into sharp relief the health inequalities impacting on minority communities, in particular their experience in terms of using health services, delivering health services and undertaking health services research. Initially, the unit has focussed it’s work on vaccine equity amongst black and minority ethnic communities. We are also working to support the delivery of the new NHS induction for overseas doctors. The aim of the unit is to improve health services for black and ethnic minority people by working with the staff delivering health services and researchers delivering health research.”

Further reading

• The Workforce Race Equality Standard Report 2021 (NHS England)

• The Medical Workforce Race Equality Standard 2021 (NHS)

• The London Workforce Race Equality Strategy (NHS England)

• Equality and diversity in health governance systems: are we getting it right and are there lessons from COVID-19?