Improving health and care

We are committed to focussing on areas in health and care that have long shown ethnic inequalities in access, experience or outcomes – working to reshape policy and practice so that they support fair health and care for all, from neonatal health to end of life care.

Black women are 4 times more likely than white women to die in pregnancy or childbirth in the UK. Reference

Black African and Black Caribbean people are over 8 times more likely to be subjected to Community Treatment Orders than White people. Reference

In Britain, South Asians have a 40% higher death rate from CHD than the general population. Reference

We will begin by focussing on:

Maternal health outcomes

Maternal health, or lack of it, is one of the starkest examples of racial health inequalities in the UK. While overall maternal mortality rates have fallen over the past decade, evidence points to a widening gap in maternal mortality between women from different ethnic backgrounds.

Black British mothers are up to five times more likely than White mothers to die during pregnancy or within the first six weeks after childbirth. The risk of dying from pregnancy-related causes is three times higher for mothers of mixed ethnicity than for White mothers and twice as high for women of Asian ethnicity.

We also know that women from all Black and minority ethnic groups are at greater risk than their White counterparts of having their pregnancies result in pre-term birth, stillbirth, neonatal death, or a baby born with low birth weight.

We have established a multi-professional advisory group to drive work on reducing ethnic inequalities in maternity care. The group will support research and innovations in key areas from which strategic policy recommendations for sustainable change can be proposed and implemented.

The NHS Race and Health Observatory has brought together an advisory group of experts in this area to help drive robust research and targeted intervention in this area.

  • Professor Jacqueline Dunkley-Bent, Chief Midwifery Officer, NHS England and NHS Improvement (Co-chair)
  • Dr Daghni Rajasingam, Consultant Obstetrician, Guy’s and St Thomas’ NHS Foundation Trust (Co-chair)
  • Faye Bruce, Chair, Caribbean and African Health Network
  • Christine Ekechi, Consultant Obstetrician and Gynaecologist, Imperial College Healthcare NHS Trust
  • Janet Fyle, Advisor, Royal College of Midwifery
  • Professor Gina Higginbottom, Emeritus Professor of Ethnicity and Community Health, University of Nottingham
  • Margaret Myatt, Consultant Midwife, Brighton and Sussex University Hospitals NHS Trust
  • Benash Nazmeen, Specialist Midwife, Bolton NHS Foundation Trust
  • Wendy Olayiwola, National Maternity Lead for Equality, NHS England and NHS Improvement
  • Mehali Patel, Senior Research Officer, Sands, Stillbirth and Neonatal Death Charity
  • Dr Gloria Rowland, Chief Nurse, South West London NHS
  • Professor Sarah Salway, Professor of Public Health, The University of Sheffield
  • Tinuke and Clo, Co-founders, FiveXMore

Mental health pathways

Evidence shows that Black and minority ethnic people, particularly those in Black groups, are over-represented in mental health pathways, meaning they are more likely to be diagnosed with severe mental illness, are more likely to receive compulsory treatment, and are more likely to experience adverse care outcomes.

Professor Sir Simon Wessely was invited by the government to carry out an Independent Review of the Mental Health Act, which reported in 2018. The review found that profound ethnic inequalities exist within the mental health system, and concluded ‘that structural factors which engender racism, stigma and stereotyping increase the risk of differential experiences in Black and minority ethnic communities.’ Although the review made some recommendations to correct these inequalities, it also accepted there is a long way to go in developing our understanding before they can be truly rectified. 

The Observatory’s advisory group on mental health includes:

  • Prof JS Bamrah, Consultant Psychiatrist, North Manchester General Hospital and Chair of BAPIO (Co-chair)
  • Steve Gilbert OBE, Anti Racism Consultant (Co-chair)
  • Sarah Amani, NHS England
  • Evelyn Asante-Mensah, Chair, Pennine Care NHS Foundation Trust
  • Prof Dinesh Bhugra, King’s College London
  • Paul Farmer, Chief Executive, Mind
  • Sarah Hughes, Chief Executive, Centre for Mental Health
  • Poppy Jaman, Global Ambassador for Mental Health; CEO, City Mental Health Alliance
  • Dr Sri Kalidindi CBE, Psychiatrist, Maudsley; National Clinical Lead for Rehab, NHS England
  • Jinjer Kandola, CEO, Barnet, Enfield & Haringey NHS Mental Health Trust
  • Saiqa Naz, Cognitive Behavioural Therapist, Sheffield Health and Social Care NHS Foundation Trust
  • Edwin Ndlovu, Nurse and COO, East London NHS Foundation Trust
  • Dr Trudi Seneviratne OBE, Registrar, Royal College of Psychiatrists
  • Dr Shublade Smith, Consultant Psychiatrist, South London and Maudsley NHS Foundation Trust