How can healthcare education effectively prepare healthcare professionals to recognise, address and mitigate health inequalities within diverse patient populations?
No patient wants to be in hospital, away from their family, home and everything they find comfort in. But this is the situation many patients facing health inequalities find themselves in, far more than those who do not face these barriers. “Health inequalities are avoidable, unfair and systematic difference in health between different groups of people” (The King's Fund, 2024); these inequalities are prevalent throughout the country but are more concentrated in certain locations. The effects of inequality are multiplied for those who have multiple types of disadvantages, for example learning disabilities and a lack of stable housing.
There is the problem of patients experiencing these inequalities ending up with a greater need of more healthcare input. This is because individuals with a low income may value the costs of healthy behaviours, such as exercising or buying healthy food, more highly than the benefits of preventative measures. The result of this prioritisation is that these individuals will present to healthcare providers at a later stage of illness, leading to poor health outcomes and subsequent extended periods of time spent in hospital (Propper, 2024). Another issue patients may face is bias from clinicians who may not experience the same inequality as them; this can have an impact on the way patients are treated in the hospital.
Challenges that those facing inequality have are a lack of access to education and opportunities which prevents them from reaching positions where they could make a difference, such as medical school. Healthcare education requires time and dedication which those with health inequalities may not possess. Costs associated with healthcare education can prevent it being accessible to everyone, translating into a lack of diversity among healthcare providers. Another challenge is the biases present among educators and students; there is a known lack of diversity in research participant populations. This leads to under-representation in reading material for students who, as professionals, must treat diverse patient populations and may not be able to correctly recognise and treat patients with barriers. (Coe et al., 2023)
Tackling health inequalities and the way they are handled in the clinical environment requires an understanding of the complex interaction between many factors, since many patients do not experience isolated disadvantages. The level of understanding and training required for healthcare professionals to treat patients experiencing inequalities demands it be a central part of healthcare education. To help healthcare professionals recognise and mitigate health inequalities could involve mirroring the diverse patient population in the workforce.
While these challenges exist, there are many ways healthcare education can be adapted to ensure that professionals are able to recognise inequalities in patients. Integrating education of social determinants of health into curricula can have a big impact as it allows students to start thinking about these factors early on. Case studies about linking homelessness and considering discharge from hospitals being a part of assessments at OSCEs can be a way that these topics are examined in medical schools as often, the exams sat by students primarily focus on purely clinical scenarios with very little emphasis on social aspects of patient care. (RCGP, 2018)
Propper, C. (2024). Socio-economic inequality in the distribution of health care in the UK. Oxford Open Economics, 3(Supplement_1), pp.i577–i581. doi:https://doi.org/10.1093/ooec/odad090.
Coe, D., Bigirumurame, T., Burgess, M., Rouse, J. and Wroe, C. (2023). Enablers and barriers to engaging under-served groups in research: Survey of the United Kingdom research professional’s views. NIHR Open Research, [online] 3, p.37. doi:https://doi.org/10.3310/nihropenres.13434.1.
HOW DATA CAPTURED BY NCEPOD SUPPORTS THE IDENTIFICATION OF HEALTHCARE INEQUALITIES A REVIEW -2022. (n.d.). Available at: https://www.ncepod.org.uk/pdf/current/Healthcare%20Inequalities.pdf.
The King's Fund (2024). Health Inequalities in a Nutshell. [online] The King’s Fund. Available at: https://www.kingsfund.org.uk/insight-and-analysis/data-and-charts/health-inequalities-nutshell.
ROYAL COLLEGE OF GENERAL PRACTITIONERS A Core Curriculum for Learning About Health Inequalities in UK Undergraduate Medicine. (n.d.). Available at: https://www.rcgp.org.uk/getmedia/4b2e0a97-3133-48b1-8834-c1be82c0dd9c/RCGP-A-Core-Curriculum-for-Learning-About-Health-Inequalites-in-UK-Undergraduate-Medicine.pdf
