Note - this section is currently under review with the intention of producing a new update in Spring 2017
Key Issues (December 2013)
Wirral Black & Minority Ethnic (BME) population issues
- Information relating to ethnicity in Wirral is limited. Wirral is by no means unique in this respect; many other areas are faced with this issue due to the limitations and relative inconsistencies in the recording of BME population data.
- This possible lack of local data on the health and wellbeing needs of the increasing range of Wirral BME communities can in part be addressed by reviewing national data as it is likely to present a similar picture for Wirral residents.
- National and previous local evidence might suggest that BME groups may not be accessing health and social care services in accordance with their level of need or in a timely manner.
- Research suggests poorer communication, undue expectation, possible stereotyping , need for further training and cultural awareness that can combine to impact on BME residents in relation to their service provision and access
- Census 2011 shows us an increase in the BME population, from 3.46% in 2001 to 5.03% in 2011 (From 10,900 people in 2001 to 16,101 people in 2011)
- More BME residents live in Birkenhead and Tranmere ward than any other part of Wirral followed by Claughton, Rock Ferry and Hoylake & Meols.
- There is a need for more robust data on the population prevalence of Black and Minority Ethnic (BME) groups to aid assessing levels of access to services particularly. The current methods, both nationally and locally of capturing data around ethnicity and migration would not appear able to cope with population change happening faster than it has in the past.
Wider Black & Minority Ethnic (BME) population conditions
- Black & Minority Ethnic (BME) groups generally have worse health than the overall population, although the patterns of ethnic health inequalities are very diverse within and between different ethnic groups.
- Cardiovascular (CVD) and Coronary Heart Disease (CHD) affect BME and general populations differently with Irish and South Asian men at higher risk of health related problems. Some male and female populations such as Chinese and Black African have significantly lower risk to CVD and CHD, it is suggested that modifying lifestyle behaviours will reduce prevalence for CVD, CHD, stroke, hypertension and a number of related diseases.
- Stroke and Hypertension can show disproportionate effects on certain BME populations such as South Asians Black Africans and Black Caribbean
- Diabetes – South Asian, Caribbean and Gypsy Traveller populations are substantially at greater risk to the impact of diabetes. A combination of lack of self-management, health care and ineffective communication with services can combine to make worse the condition.
- Cancer – although there are lower rates of cancer in some male and female populations’ such as West Indian, South Asian and East/West African for certain cancers there are equally a number of ethnic population groups in which there are higher rates of certain cancers.
- Mental Health and ethnicity suggests a focus shifting from predisposition to mental illness, to inequality in service access and provision and differences in health outcomes may be contributing underlying factors to higher population rates for a range of mental illnesses. There could also be a limited amount of data on illnesses for certain ethnic groups and some of the groups presenting later and in crisis due to perceived stigma and lack of service knowledge. It is suggested there could be higher rates of poor mental health generally, admissions, Community Treatment Orders and seclusions are evident for certain ethnic groups and for males and females by type of mental health illnesses.
- Dementia is not widely understood in ethnic population groups due to the limited wide-scale research. Later presentation, and so a diagnosis then access to services, occurs when the illness can be seen as natural ageing in some ethnic group families. Research into Irish Communities suggests dementia is an increasing issue for their elder population.
- Smoking - the numbers of people from ethnic groups smoking has disproportionate effects on men and women and within different ethnic groups. Much lower rates of Bangladeshi women smokers from national prevalence comparison and Irish women is in turn compared to highest rates in Indian, Bangladeshi and Irish men. The use of cessation services is thought to be limited as linked to reasons why ethnic groups are already not accessing existing health promotion/preventative services.
- Obesity would appear to have a greater impact on Black African, Bangladeshi and Pakistani women. Differences according to how ethnic population obesity comparisons are made should be borne in mind as well as cultural, religious, subsequent lifestyle changes and socio-economic variations. The subsequent negative health outcomes for obesity are similarly problematic to those for the general population
- Obesity in Children – with information derived from the national and local National Child Measurement Programme it suggests that being obese and/or overweight is impacting on all populations but particularly on certain BME population groups.
- Alcohol appears to be an issue for men from Irish, Polish and other eastern European populations in terms of frequency and amount consumed. More specific local data is limited on alcohol issues for ethnic minority populations.
- Sexual Health – STIs affect different ethnic groups – with some being below and others above national comparators. Due to sexual health being a subject often not discussed by the members of number ethnic groups the need for culturally appropriate and targeted service interventions is more relevant and would likely raise awareness and prevents further issues.
- Women’s Health – access to maternal services can be lower by ethnic minority women with reasons such as late access, previous experience and uncertain awareness of important prenatal testing. On the other hand there is evidence to suggest higher levels of breastfeeding in BME communities. Earlier national research suggests maternal mortality rates being higher than the general population, a lower uptake of cancer screening services and also elevated rates for stillbirth and neonatal issues in Gypsy and Traveller communities.
- Children & Young People from BME communities again have a variation in health outcomes – sometimes better than the general population and at times worse.
- Older People numbers for both BME groups and the general population are growing. Expectations that families continue to care for their elders are being challenged and the health of all elders could be compromised. Local data is limited on this aspect.
- Irish Travellers & Gypsies, although local numbers are low, they could be significantly more likely to have a long-term illness, health problems or disabilities with access and use of health services being worse than the general population. Cultural pride and other barriers often prevent better access or increase late presentation and so more acute use of services.
- Palliative Care services for BME elders, as suggested by earlier research, are possibly not being accessed as extensively because of language difficulties and lack of provision awareness. Recent national insight suggests an increasingly important need to improve communication, training and awareness of patient and family needs in light of the ageing BME and general population.
- Disabilities and health of BME communities has a range of differences to general population with wider and more pronounced negative outcomes and inequalities according to recent research. For example, Learning Disability services are disproportionately accessed less by BME residents, specific affects eye and deaf BME residents with Census 2011 highlighting greater locally self-reported health problems for the Irish community
- Local services are accessed by a lower proportion of BME residents compared to population estimates. There is a need to develop improvements in recording BME status to improve data accuracy and subsequent analysis.
Download latest Chapter 13: BME Groups (Warning - large document)
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Gypsy and Traveller Accommodation Needs Assessment (2014)
This was commissioned to identify the needs of Gypsies and Travellers and Travelling Showpeople (referred to hereafter as “Travellers”) from across the area. The overall objective of the research was to provide a robust evidence base to inform future reviews of Local Plans and housing strategies. Access report here
Dementia does not discriminate - The experience of Black, Asian and minority ethnic communities (All-Party Parliamentary Group on Dementia, 2013)
Gypsy, Traveller and Roma: experts by experience (December 2014)
This report by The National Federation of Gypsy Liaison Groups and Anglia Ruskin University has found that nearly 9 in 10 children and young people from a Gypsy, Roma or Traveller background have suffered racial abuse and nearly two thirds have also been bullied or physically attacked. It also found the infant mortality rate of Gypsies and Travellers is three times higher than the national average.
Access the report here
Range of factsheets provided by the Federation of Irish Societies (FIS) on Irish population key health issues (August 2012)
The Federation of Irish Societies has also produced research on
Key information sources for you to consider:
NHS Outcomes Framework
National Centre for Health Outcomes Development
NHS Information Centre
JSNA other useful sources of information
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