Research

Tackling Inequalities and Discrimination Experiences in Health Services (TIDES) Study

The Tackling Inequalities and Discrimination Experiences in health Services (TIDES) study investigates how discrimination experienced by both patients and healthcare practitioners may generate and perpetuate inequalities in health service use. Using questionnaires and in-depth interviews, the study aims to (1) highlight ways in which healthcare practitioners can help reduce discrimination experiences and (2) develop an intervention framework to reduce discrimination in healthcare settings. The TIDES study is funded by the Wellcome Trust.

Further information about TIDES.

 

South East London Communtiy Health (SELCoH) Study Phase 2

The second phase of the South East London Communtiy Health (SELCoH) study, aimed to examine the roles of historical social context and policy in shaping observed patterns of health inequalities; to investigate the differences in anticipated and perceived experiences of discrimination; and to investigate the contribution of discrimination to inequalities in social functioning, common mental disorders, physical functioning, and health service use.

The first paper from this study, ‘Discrimination and common mental disorder among migrant and ethnic groups: findings from a South East London Community sample, has now been published.

Other papers form Phase 2 include, ‘Mental health among UK inner city non-heterosexuals: the role of risk factors, protective factors and place’.

Further publications from Phase 2 are forthcoming. For a full list of SELCoH publications please see the SELCoH website

 

Research from our partners

The impact of co-located welfare advice in general practice

Social problems and health are closely linked. One fifth of GP consultation time is spent supporting patients’ social needs such as housing, access to welfare benefits, debt and relationship problems. GPs report both that their time pressures and patients’ health is being made worse by increasing financial strain and welfare reforms. People with poor mental and physical health may find it harder than others to access support and advice for social problems. Placing welfare advice services in GP practices (co-location) is one approach to supporting people whose health is affecting, or affected by, such difficulties. These services are also hoped to ease pressures on practices.

CLAHRC North Thames researchers at UCL carried out a study to assess whether co-located welfare advice could impact mental health, well-being and financial strain. The study found a significant reduction in common mental disorder among those receiving advice compared to controls, after three months. This difference was particularly large among females and Black or Black British advice recipients (63% and 91% bigger reduction in poor mental health respectively). Those with a positive outcome of advice (e.g., if advice led to improvements in income or housing circumstances) experienced improved mental well-being. The advice group overall also experienced a significant reduction in feelings of financial strain over time relative to controls. This was supported by our findings that the advice group received £15 on average per person, for every £1 spent by commissioners. Nearly half of advice recipients would not have sought advice, or would have turned to their GP had the service not been there.

However, co-location alone is not enough for successful implementation. We identified key barriers and facilitators to implementation and suggest several factors amenable to change that could enhance the potential for co-location to influence outcomes for patients and GP practices.

Summary findings are available here: CLAHRC BITE

Links to the published papers:

(1) Impact of co-located welfare advice in healthcare settings: prospective quasi-experimental controlled study

(2) Co-located welfare advice in general practice: A realist qualitative study

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