Reflexivity, Cultural Safety, and improving the health of racially minoritised communities

Abstract

In February, 2022, the NHS Race and Health Observatory published a robust review of the evidence on health-care inequalities among racially minoritised communities in the UK. 1 NHS Race & Health ObservatoryEthnic inequalities in healthcare: a rapid evidence review. https://www.nhsrho.org/publications/ethnic-inequalities-in-healthcare-a-rapid-evidence-review/Date: 2022 Date accessed: March 4, 2022 Google Scholar This review covered mental health care, maternal and neonatal health care, digital inclusion and access to health-care services, genetic testing and genomic services, and inequalities in the UK National Health Service (NHS) workforce. It identified recurring themes, including inadequate ethnicity reporting and data on the experiences of minority ethnic groups and discrimination, and resultant delays in seeking care from health-care institutions due to fear of racism, as well as inadequate service provision and interpreter services. 1 NHS Race & Health ObservatoryEthnic inequalities in healthcare: a rapid evidence review. https://www.nhsrho.org/publications/ethnic-inequalities-in-healthcare-a-rapid-evidence-review/Date: 2022 Date accessed: March 4, 2022 Google Scholar One recommendation for mental health services was systemic changes in psychiatric care beyond the testing of culturally appropriate or adapted interventions to address distrust of health-care services and the impact of racist experiences on mental health. 1 NHS Race & Health ObservatoryEthnic inequalities in healthcare: a rapid evidence review. https://www.nhsrho.org/publications/ethnic-inequalities-in-healthcare-a-rapid-evidence-review/Date: 2022 Date accessed: March 4, 2022 Google Scholar Some of the studies included in the NHS Race and Health Observatory's review highlight the need for health-care staff to be trained in cultural competency, but this was not a report recommendation. To add to the report recommendations, cultural competency should be challenged by respectfully drawing from decolonising innovations, 2 Curtis E Jones R Tipene-Leach D et al. Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition. Int J Equity Health. 2019; 18: 174 Crossref PubMed Scopus (240) Google Scholar , 3 Lokugamage AU Rix EL Fleming T Khetan T Meredith A Hastie CR Translating Cultural Safety to the UK. J Med Ethics. 2021; (published online July 19.)http://dx.doi.org/10.1136/medethics-2020-107017 Crossref PubMed Scopus (4) Google Scholar , 4 Marya R Patel R Inflamed: deep medicine and the anatomy of injustice. Allen Lane, London2021 Google Scholar as we outline below.