Addressing health inequity in the UK: people who are homeless, from ethnic minority groups or LGBTQ+ communities
In this article, the second of two, Vanessa Heaslip et al explores health inequity in three groups: people who are homeless, individuals from LGBTQ+ groups and ethnic minority communities
Practice nurses who work in GP practices as part of the multidisciplinary team have a key role in the assessment, screening and treatment of people throughout their lives. This article, the second in the series of two, will build on the practice nurse's understanding of health inequity in three particular communities: people who are homeless, individuals from LGBTQ+ groups and ethnic minority communities. The article will also explore the role practice nurses can play in addressing poor health outcomes for individuals in these communities. This article will explore inequity in these groups by looking at four main areas: health status, access to care, quality, and experience of care and behavioural risk factors.
This is the second article in a series on addressing health inequity in the UK; in the last article (Heaslip et al, 2022) we presented an overview of health inequity and health access in the UK, explored the difference between inequality and inequity and presented key national and international policies working to address health inequity. This paper builds on this by considering three particular communities: people who are homeless, individuals from LGBTQ+ groups and ethnic minority communities, as well as how practice nurses can have a key role in addressing poor health outcomes for individuals in these communities.
The World Health Organization (WHO) defines health as:
‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’.
(WHO, 2006; 1)
Furthermore, the constitution notes that health is a collective, not a purely individualistic, responsibility and that the highest attainable standard of health is a fundamental human right, irrespective of race, religion, political belief or socioeconomic condition (WHO, 2006). Indeed, this assertion of treating people equally is also endorsed in the Nursing and Midwifery Council (NMC, 2018) Code. Practice nurses who work in GP practices as part of the multidisciplinary team have a key role in the assessment, screening and treatment of people throughout their lives; in addition to providing nursing treatments, they are also involved in the management of long-term care (Queen's Nursing Institute, 2016) and health promotion through the ‘Making Every Contact Count’ initiative (Public Health England, 2016). The most recent initiative has been the publication of the Core Capabilities Framework for Advanced Clinical Practice (Nurses) Working in General Practice/Primary Care in England (NHS, 2020). This framework offers real opportunities for practice nurses to address health inequities experienced by communities through the key competencies (Table 1). However, in order for this to be maximised, practice nurses require support and time to enable them to implement community- and population-based initiatives, which are needed to address health inequity and disparity.
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