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On race and ethnicity during a global pandemic: An ‘imperfect mosaic’ of maternal and child health services in ethnically-diverse South London, United Kingdom
BACKGROUND: The SARS-CoV-2 pandemic has brought racial and ethnic inequity into sharp focus, as Black, Asian, and Minority Ethnic people were reported to have greater clinical vulnerability. During the pandemic, priority was given to ongoing, reconfigured maternity and children's healthcare. Th...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249549/ https://www.ncbi.nlm.nih.gov/pubmed/35783482 http://dx.doi.org/10.1016/j.eclinm.2022.101433 |
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author | Silverio, Sergio A. De Backer, Kaat Dasgupta, Tisha Torres, Ofelia Easter, Abigail Khazaezadeh, Nina Rajasingam, Daghni Wolfe, Ingrid Sandall, Jane Magee, Laura A. |
author_facet | Silverio, Sergio A. De Backer, Kaat Dasgupta, Tisha Torres, Ofelia Easter, Abigail Khazaezadeh, Nina Rajasingam, Daghni Wolfe, Ingrid Sandall, Jane Magee, Laura A. |
author_sort | Silverio, Sergio A. |
collection | PubMed |
description | BACKGROUND: The SARS-CoV-2 pandemic has brought racial and ethnic inequity into sharp focus, as Black, Asian, and Minority Ethnic people were reported to have greater clinical vulnerability. During the pandemic, priority was given to ongoing, reconfigured maternity and children's healthcare. This study aimed to understand the intersection between race and ethnicity, and healthcare provision amongst maternity and children's healthcare professionals, during the SARS-CoV-2 pandemic. METHODS: A qualitative study consisting of semi-structured interviews (N = 53) was undertaken with maternity (n = 29; August-November 2020) and children's (n = 24; June-July 2021) healthcare professionals from an NHS Trust in ethnically-diverse South London, UK. Data pertinent to ethnicity and race were subject to Grounded Theory Analysis, whereby data was subjected to iterative coding and interpretive analysis. Using this methodology, data are compared between transcripts to generate lower and higher order codes, before super-categories are formed, which are finally worked into themes. The inter-relationship between these themes is interpreted as a final theory. FINDINGS: Grounded Theory Analysis led to the theory: An ‘Imperfect Mosaic’, comprising four themes: (1) ‘A System Set in Plaster’; (2) ‘The Marginalised Majority’; (3) ‘Self-Discharging Responsibility for Change-Making’; and (4) ‘Slow Progress, Not No Progress’. The NHS was observed to be brittle, lacking plasticity to deliver change at pace. Overt racism based on skin colour has been replaced by micro-aggressions between in-groups and out-groups, defined not just by ethnicity, but by other social determinants. Contemporaneously, responsibility for health, wellbeing, and psychological safety in the workplace is discharged to, and accepted by, the individual. INTERPRETATION: Our findings suggest three practicable solutions: (1) Representation of marginalised groups at all NHS levels; (2) Engagement in cultural humility which extends to other social factors; and (3) Collective action at system and individual levels, including prioritising equity over simplistic notions of equality. FUNDING: This service evaluation was supported by the King's College London King's Together Rapid COVID-19 Call, successfully awarded to Laura A. Magee, Sergio A. Silverio, Abigail Easter, & colleagues (reference:- 204823/Z/16/Z), as part of a rapid response call for research proposals. The King's Together Fund is a Wellcome Trust funded initiative. |
format | Online Article Text |
id | pubmed-9249549 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-92495492022-07-02 On race and ethnicity during a global pandemic: An ‘imperfect mosaic’ of maternal and child health services in ethnically-diverse South London, United Kingdom Silverio, Sergio A. De Backer, Kaat Dasgupta, Tisha Torres, Ofelia Easter, Abigail Khazaezadeh, Nina Rajasingam, Daghni Wolfe, Ingrid Sandall, Jane Magee, Laura A. eClinicalMedicine Articles BACKGROUND: The SARS-CoV-2 pandemic has brought racial and ethnic inequity into sharp focus, as Black, Asian, and Minority Ethnic people were reported to have greater clinical vulnerability. During the pandemic, priority was given to ongoing, reconfigured maternity and children's healthcare. This study aimed to understand the intersection between race and ethnicity, and healthcare provision amongst maternity and children's healthcare professionals, during the SARS-CoV-2 pandemic. METHODS: A qualitative study consisting of semi-structured interviews (N = 53) was undertaken with maternity (n = 29; August-November 2020) and children's (n = 24; June-July 2021) healthcare professionals from an NHS Trust in ethnically-diverse South London, UK. Data pertinent to ethnicity and race were subject to Grounded Theory Analysis, whereby data was subjected to iterative coding and interpretive analysis. Using this methodology, data are compared between transcripts to generate lower and higher order codes, before super-categories are formed, which are finally worked into themes. The inter-relationship between these themes is interpreted as a final theory. FINDINGS: Grounded Theory Analysis led to the theory: An ‘Imperfect Mosaic’, comprising four themes: (1) ‘A System Set in Plaster’; (2) ‘The Marginalised Majority’; (3) ‘Self-Discharging Responsibility for Change-Making’; and (4) ‘Slow Progress, Not No Progress’. The NHS was observed to be brittle, lacking plasticity to deliver change at pace. Overt racism based on skin colour has been replaced by micro-aggressions between in-groups and out-groups, defined not just by ethnicity, but by other social determinants. Contemporaneously, responsibility for health, wellbeing, and psychological safety in the workplace is discharged to, and accepted by, the individual. INTERPRETATION: Our findings suggest three practicable solutions: (1) Representation of marginalised groups at all NHS levels; (2) Engagement in cultural humility which extends to other social factors; and (3) Collective action at system and individual levels, including prioritising equity over simplistic notions of equality. FUNDING: This service evaluation was supported by the King's College London King's Together Rapid COVID-19 Call, successfully awarded to Laura A. Magee, Sergio A. Silverio, Abigail Easter, & colleagues (reference:- 204823/Z/16/Z), as part of a rapid response call for research proposals. The King's Together Fund is a Wellcome Trust funded initiative. Elsevier 2022-05-29 /pmc/articles/PMC9249549/ /pubmed/35783482 http://dx.doi.org/10.1016/j.eclinm.2022.101433 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Articles Silverio, Sergio A. De Backer, Kaat Dasgupta, Tisha Torres, Ofelia Easter, Abigail Khazaezadeh, Nina Rajasingam, Daghni Wolfe, Ingrid Sandall, Jane Magee, Laura A. On race and ethnicity during a global pandemic: An ‘imperfect mosaic’ of maternal and child health services in ethnically-diverse South London, United Kingdom |
title | On race and ethnicity during a global pandemic: An ‘imperfect mosaic’ of maternal and child health services in ethnically-diverse South London, United Kingdom |
title_full | On race and ethnicity during a global pandemic: An ‘imperfect mosaic’ of maternal and child health services in ethnically-diverse South London, United Kingdom |
title_fullStr | On race and ethnicity during a global pandemic: An ‘imperfect mosaic’ of maternal and child health services in ethnically-diverse South London, United Kingdom |
title_full_unstemmed | On race and ethnicity during a global pandemic: An ‘imperfect mosaic’ of maternal and child health services in ethnically-diverse South London, United Kingdom |
title_short | On race and ethnicity during a global pandemic: An ‘imperfect mosaic’ of maternal and child health services in ethnically-diverse South London, United Kingdom |
title_sort | on race and ethnicity during a global pandemic: an ‘imperfect mosaic’ of maternal and child health services in ethnically-diverse south london, united kingdom |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249549/ https://www.ncbi.nlm.nih.gov/pubmed/35783482 http://dx.doi.org/10.1016/j.eclinm.2022.101433 |
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