Health of Ethnic Minority Communities in Wigan Linda Adhana Health Development Officer BME Communities Public Health Department Ashton Leigh & Wigan PCT BME communities in Wigan • Long term resident communities – predominantly S. Asian and Chinese communities • Gypsy and traveller communities • Asylum seekers and refugees – wide range of nationalities from around the world • New migrants from Europe – European Accession Countries (Poland, Slovakia, Czech Republic, Lithuania, Estonia, Latvia, Slovenia, Hungary) • International students Health Inequalities • Health Survey for England 2004 : – Prevalence of cardiovascular disease increased from 4.8% to 9.1% in Pakistani men between 1999 and 2004 – Diabetes four times as prevalent in Bangladeshi men and three times as prevalent in Pakistani and Indian men than the general population Health Inequalities : Gypsy and Traveller Communities • Women live 12 years less and men 10 years less than the general population • High incidence of stillbirths, perinatal and infant mortality • Higher incidence of childhood accidents • Children may not be immunised • Insecure and poor living conditions on unregulated sites • Cultural and attitudinal barriers in accessing services • Low literacy rates and poor attendance at school Health Inequalities : Asylum Seekers and Refugees • Health needs related to past experiences of war, detention, torture, rape, physical and mental trauma • Poverty and poor quality living conditions • Lack of social support • Language and cultural barriers, not understanding how the health system works • Mental stress of constant uncertainty over asylum claim and future life • Homelessness and destitution – can occur at all stages of the asylum process Health Inequalities : New Migrants from Europe • Workers Registration Scheme – loss of employment in the first year can lead to homelessness and destitution • Housing – poor quality, overcrowded • Risk of exploitation and poor working conditions • Language and cultural barriers, not understanding how health and social care systems work • Roma communities – poor health related to persecution in home country Complex Health and Social Care Needs • Varied and complex health and social care needs • Immigration status can make care and support more complicated • Language and cultural barriers • Lack of awareness of how services work • Staff not familiar with working cross-culturally, and with interpreters. May not be familiar with specific health and social care needs, and systems and regulations relating to asylum and immigration Safeguarding Women and Children • Education – some countries children do not have to attend school • Different cultural expectations regarding discipline and safety • FGM (Female Genital Mutilation/ Female Circumcision) – widely practiced in the Horn of Africa • Risk of exploitation and abuse of women and children who become homeless and destitute • High mobility – less able to trace children • Trafficking of women and children • Domestic violence Public Health Issues • Mental health • Physical Health • Health Protection and Health Promotion • Sexual Health • Poverty and Destitution • Housing, Homelessness • Domestic Violence • Child Protection • Workplace Health • Links to Benefits and Advice Services Project Proposal • Health Visitor (Band 7) and two Support Workers (Band 5) : As part of an expanded homeless and vulnerable persons team • Benefits : – Able to build up specialist knowledge of cultural issues and complex health and social care needs – Able to support mainstream services with specialist knowledge and advice – liaison and signposting role – Innovative practice for health improvement and health promotion , eg gender based sessions, language based sessions, attend community ‘drop ins’, ‘health trainers’ from gypsy & traveller communities – Support child protection functions and promote child welfare – Support BME Health Development Team in preventative health and improving health inequalities Photo Credits 1. Meissner, N. UNHCR 2. UNHCR 3. Chalasami, R. UNHCR. 4. Pagetti, F. UNHCR 5. Chalasami, R. UNHCR.
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