our vision too – community views mark r d johnson mary seacole research centre opsis conference:...
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Our Vision Too – Community ViewsMark R D Johnson
Mary Seacole Research Centre
OPSIS Conference: Focus on the Needs of Vision Impaired People from Black & Minority
Ethnic Groups
(looking forward to World Sight Day 2007) Research regarding B&ME Groups, VI
and take-up of Services
Composition of ‘English’ Health & Social Care Users : 2001 13% from a ‘Minority’ group
England - Census 2001
White British
"Minority Groups"
White Irish
White Other
Asian Indian
Asian Pakistani
Asian Bangladeshi
Asian Other
Black Caribbean
Black African
Chinese
Mixed
Black Other
Other
The Population of BirminghamBirmingham Population: Male %
20.17
5.88
1.21
2.8769.87
ASIAN
BLACK
CHINESE
MIXED
WHITE
Birmingham Population: Female %
18.9
6.35
1.09
2.8570.81
ASIAN
BLACK
CHINESE
MIXED
WHITE
The Visual Impairment RegisterBirmingham - Males, 2003
5.5 11.7
0.5
0.8
2259.5
Black (groups)
S Asian (groups)
Chinese/ S-E Asian
Other #
DNA *
White
Birmingham - Females, 2003
3.37.5
0.20.5
23.5
65
Black (groups)
S Asian (groups)
Chinese/ S-E Asian
Other #
DNA *
White
The Literature Review
Poor quality evidence baseHigh levels of diabetes lead to an
expectation of worse eye health. Juvenile inherited eye conditions Raised levels of glaucoma in African
Caribbean populations, Keloid scarring – hinders surgeryMore cataract among South Asian
origins
The Research Base:
The ‘visual impairment’ research literature tends to ignore issues of race and ethnicity:
that relating to ‘race relations and ethnic diversity’, largely excludes attention to sight loss.
General Consensus
under-use of services by minority groups
and possibly of under-registration. low levels of knowledgefailure to recognise needs that can
be addressed. Many short-term, unreported and
under-evaluated ‘projects’
Factors Affecting Use of Services Ethnic Differences in Patterns of Disease Perceptions of Health, Body and Disease Cultural and Language differences in Descriptions Accessibility of Services (time and place) (Previous experiences of) Encounters with Services Alternative Treatment Options Lifestyle, Socio-Economic Status, Religion and
Cultural practices Racism – direct, personal, indirect or institutional Language, Education and Availability of Information Attitude, Awareness and Skill of Clinical staff
Improvement in Service Uptake Requires
Assertive Outreach, Cultural Competence, Partnership with minority ethnic groups
We would add: Commitment by management Resources Persistence
The Aim of the ProjectTo examine and develop ways of ensuring that
services are more effectively delivered to people from black and minority ethnic (BME) communities with visual impairments (VI).
To raise awareness of sight loss issues and services in black and minority ethnic communities and voluntary sector groups working in those communities
To raise the capacity of (VI) service providers to recognise the specific needs of people from minority ethnic groups, and establish the best ways of meeting these.
Some New & Refreshed Insights
a greater level of housing need culturally specific lifestyle issuesimpact on social and religious life lack of social and family understanding low expectations – ‘inevitable aging’stigma or “false” pride‘learned helplessness’
Responses have to be community-specific
The ‘Good Practice Model’Stage 1: Project Initiation: The
Conceptualisation and Initial PlanningStage 2: Recruit Key Worker(s).Stage 3: Review Local ServicesStage 4: Create Network of StakeholdersStage 5: Recruit Community FacilitatorsStage 6: Develop Project Agenda / Topic
Guide
The Model – Part Two
Stage 7: Conduct InterviewsStage 8: Review, Analyse and FeedbackStage 9: Devise or Refine Training and/or
Information PacksStage 10: Take Appropriate Action –
Further InterventionStage 11: EvaluateStage 12: (IF Appropriate) Establish and
Integrate Learning into Mainstream Practice
And How do we do that?
Two Checklists
A Checklist of issues to raise with and within communities and organisations
NB: Disability Rights are part of the Law
A Toolkit Checklist for Service Providers
NB: Race Equality Schemes are now required by Law
Key Recommendations:
Sight Loss support services need to recruit staff from within minority communities
Information must be translated into minority languages
Information needs to be actively promoted through community organisations
Sustained effort may be needed to overcome suspicion based on past experiences
Previous initiatives have foundered because of a lack of continuity – a longer-term perspective is required to bring change and create better relationships
The Outcome!
Community ViewsJasbir BehalForum – Community, Statutory, VOs &c.Sight Loss/Eye Health Information Fairs
Lobbying
Publications
More research and development
One new study
Glaucoma awareness and perceptions of risk among African-Caribbeans in Birmingham, UK
Vinette Cross, Peter Shah, Rustom Bativala, Peter Spurgeon
Diversity in Health and Social Care Volume 2, Number 2, June 2005 , pp.
81-90(10)
Further reading (or via WWW)
Our Vision Too: Improving the Access of Ethnic Minority Visually Impaired People to appropriate services Seacole Research Paper 4 Leicester: MSRC with Housing Corporation and Thomas Pocklington Trust (Asesha Morjaria-Keval and MRD Johnson), February 2005
‘Ethnicity, Sight Loss and Invisibility’ British Journal of Visual Impairment Vol 25,1 :23-33 (Johnson MRD, Morjaria-Keval A) 2006
Research Findings & Occasional Papers – www. pocklington-trust. org. uk
‘Co-ordinates’ orContact Details
CEEHD - Mary Seacole Research CentreDe Montfort University266 London Road, Leicester LE2 1RQTel: 0116 201 3906 (fax: 0116 201 3805)
[email protected] website: www.dmu.ac.uk/msrc or
www.ethnic-health.org.ukwww.library.nhs.uk/ethnicitywww.pocklington-trust.org.ukNB: [email protected]