Racism and health inequalities: failure to act will inflict preventable ill health on future generations
As nursing students, there are things we can do to combat systemic discrimination and improve health
The death of George Floyd in the United States in May sparked protests across the world and put racism firmly in the spotlight.
Racism has been identified as a key social determinant of health and a driver of ethnic health inequalities, yet when we talk about racism as a society, the impact on a person’s health is often not discussed.
The COVID-19 pandemic, however, has made the issue of race hard to ignore, with evidence showing that people from a black, Asian and minority ethnic (BAME) background encounter disproportionate risk and mortality.
Systemic discrimination is the normal experience of many people
COVID-19 is unprecedented but racism is nothing new, and these inequalities are manifestations of the systemic discrimination that many people from a BAME background face on a daily basis.
But it is important to remember that health inequalities are not inevitable – they can be significantly reduced, even prevented. So what can we, as nursing students, do to help tackle them?
We can start by identifying and articulating the unfair and systemic differences in health, and encouraging and participating in conversations about health inequalities and racism.
Social determinents of health shape the lives of many, and equality, diversity and inclusion are integral to the care we deliver to patients.
Structural racism is a stressor, and chronic stress harms health
This year I have learned about the detrimental effects chronic stress and discrimination can have on a person’s mental and physical well-being. Like all psychological stressors, structural racism can initiate a biological stress response, which can lead to long-term psychiatric and somatic disorders.
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Chronic stress can cause or exacerbate many other health problems, such as heart disease, hypertension and stroke – another reason why mental and physical health should not be viewed as independent of each other.
‘As nursing students, we need to understand the links between racism and poor health outcomes’
Eradicating health inequalities cannot be done by the health community alone. The unequal death toll from COVID-19 shows the government needs to make urgent improvements to the population’s health, and prioritise addressing the underlying socio-economic inequalities and preventable health outcomes.
We cannot change the past, but the future is everybody’s responsibility. If we are to promote health and social justice, we need to work together to find ways to tackle health inequalities – now, more than ever.
How to tackle racism and health inequalities as a nursing student
- Engage in research There is strong evidence to suggest that factors including ethnicity, education, culture, race, gender, sexual orientation and religion influence how healthy a person is. We need to engage with the evidence base, which shows the negative effect of racism on health outcomes, and try and educate others
- Be a health equality champion If your placement area does not already have a health equality champion, put yourself forward for the role. As well as something different and rewarding to achieve on placement, it will benefit many staff and patients.
- Don’t be afraid to speak out The Nursing and Midwifery Council (NMC) code says we must challenge poor practice and discriminatory attitudes that might affect an individual's care. Do not be afraid to speak out – our voice matters, and if something feels wrong, it most likely is.
- Identify unconscious bias Clinical supervision and reflection can be used to help identify our unconscious bias. We all have preconceived beliefs that we hold about others, but as healthcare professionals, we need to reflect and challenge our own beliefs. Sometimes we need to unlearn things in order to develop professionally and enhance our skills in caring for people. Engaging in clinical supervision enables us to broaden our perspectives, learn about cultural competence and enhance our collaborative skills
- Embrace diversity Embracing diversity opens us up to a wide variety of perspectives and views. We must recognise diversity and individual choice, and be willing to increase our knowledge of different cultures and cultural perspectives
Let’s be curious, engage in discussion and challenge discrimination
As nursing students, it is important that we are curious, willing to engage in critical yet reflective discussion, and challenge any discrimination we face during our training. We also need to understand the links between racism and poor health outcomes. This will enable us to identify health disparities sooner, and have the competence to provide people with a better, happier and healthier way of life.
Racism and health inequalities are inevitably harmful. If we fail robustly to address this as a society, we are likely inflicting preventable health problems on future generations.
If all goes to plan, this time next year I will be almost ready to qualify. I hope that wherever I take up my first staff nurse post, it will be a place where diversity is embraced and any form of discrimination is challenged.
Francesca Hufton is a second-year mental health nursing student at Canterbury Christ Church University