The differences that people might experience include:

• Life expectancy
• Quality or experience of care
• Access to care
• Prevalence of health conditions

Some of the factors that can contribute to health inequalities include:

• Socioeconomic background or status
• Protected characteristics, such as ethnicity, disability, sex, sexuality and religion
• Socially excluded groups, such as asylum seekers, sex workers and people experiencing homeless
• Geographical location, such as rural or urban

Credit: Interaction Institute for Social Change | Artist: Angus Maguire

EQUALITY

Giving everyone the same opportunities or resources regardless of circumstance.

EQUITY

Acknowledges that each person or groups has different circumstances and adjusts opportunities and resources accordingly.

• People who identify as LGBT experience higher rates of poor mental ill-health and lower wellbeing than those who do not identify as LGBT
• People from ethnic minority groups are more likely than white British people to report limiting long-term illness and poor health, with those identifying as white Gypsy and Irish Traveller reporting the poorest health
• The poorest 10 per cent of UK households would need to spend, after housing costs, 74 per cent of their income on food in order to follow the government’s official guidance on a healthy diet – compared to only 6 per cent of income for the richest 10 per cent of households.

Dementia – Opening Doors to Brain Workout

Tailoring Engagement to Communities

If we are going to tackle health inequalities, we need to know more about how people experience care. Engaging with the public and communities helps us to understand the perspectives of people who access health and social care services and helps shape future services. In Cardiff and the Vale of Glamorgan there is an incredibly diverse population, with people from a variety of ethnic groups, socioeconomic circumstances and a wide age range. This means there can be different challenges to engage due to diverse needs and beliefs of people.

Tailoring engagement events to specific communities can help us to understand the cultural nuances within those communities. This can lead to a better understanding of how communities experience the health and social care systems, cultural taboos, differences in language and what people in different communities place value on.

We caught up with Versha Sood to learn more about how the Regional Partnership Board’s Dementia Programme is tackling health inequalities and engaging with the public to develop better services.

“Actively involving people and communities in our work is what is most important”

Versha Sood, Dementia Lead, Cardiff and Vale Regional Partnership Board

Transracial Fostercare

The Power of Education and Understanding

Children and young people who have been in foster care have poorer health outcomes than their peers who have not experienced foster care, often due to Adverse Childhood Experiences and insecure attachments. Foster children from BAME backgrounds often get placed with foster carers of a different ethnicity to them, which is referred to as a transracial foster care placement. This can present additional challenges for children in care regarding issues of identity and belonging.

The Hub worked with Enfys to tell the story of Tinesha, a young girl in a transracial foster care placement, with the hope of raising awareness of this often overlooked issue. In this film, Tinesha shares her experience of challenges she has faced as well as some ways her foster carer has adapted to support her to explore her cultural identity.

Enfys is a developmental trauma service, which works predominantly with foster carers and social workers to help them understand the child, given differences in backgrounds and circumstances, and respond to needs in a therapeutic way.

“The advice I’d give foster carers who are fostering children of a different ethnicity is definitely education and cultural sensitivity”

Tinesha

North Wales Health Screening Project

Annual Health Checks

People with learning disabilities may find it harder to identify health problems and seek treatment than those who don’t have a learning disability. To tackle this health inequality, NICE recommends that everyone with a learning disability be offered an annual health check through their GP. Health checks provide a way to detect, treat and prevent health conditions that might otherwise have been unrecognised.

However, evidence suggests that only 25% of people with a learning disability are registered with their GP and a lot of people aren’t aware that they can have an annual health check. In response to this, the Health Screening Project was launched in North Wales in June 2021.

The project aimed to promote annual health checks and screenings and employed 8 individuals with learning disabilities as health screening advocates to achieve this.

A Toolkit for Supporting Refugee and Asylum-Seeking Children and Young People

North Wales RIC Hub supported the North Wales Social Care and Wellbeing Services Improvement Collaborative to develop a toolkit for supporting refugee and asylum seeking children and young people.

As part of the toolkit, North Wales RIC Hub conducted a literature search, which highlighted some of the issues experienced by child asylum seekers and refugees. This includes a number of pre- and post-migration issues, as well as an increased risk of mental health problems such as:

• Post-Traumatic Stress Disorder
• Depression
• Self-harm
• Behaviour problems
• Anxiety

The toolkit provides recommendations and good practice examples of how best to support this population group.

In this newsletter, we’ve collated some of the great work going on in the region and beyond to move towards a more equal and inclusive health and social care system.