Health Equalities: Are we there yet?

1. Health Equalities: Are we there yet? Evelyn Asante-Mensah Interim Chief Executive

2. How things have changed HIV in black communities in the 80s and early 90’s A hidden issue Raising the issues and facing A mountain of prejudice

3. A changing policy scene We have seen big changes The Human Rights Act The Public Sector Equality Duty The Equality Delivery System But is that now all under threat? ...

4. The bigger picture …. Seeing the bigger picture is recognising this is all about Human Rights And the principles behind them Freedom Respect Equality Dignity Autonomy

5. The impact of austerity…. Unemployment, unstable jobs, zero-hours Poor housing, fuel poverty 4 million not properly fed … more food banks With impacts on health and wellbeing

6. The personal stories… Patient refugee, fleeing violence from another city, staying in a temporary voluntary sector night shelter (winter initiative) every night last week, presented looking for mental health support and medication. Previously on antidepressants, no money, all worldly goods with him in a small bag, winter initiative closing at end of week and no idea where to go now. Signposted to State homeless centre but as no local connection unlikely to be housed for more than 28 days, given basic food and toiletries from health centre stock, very distressed/sobbing.

7. The personal stories… Woman, mid 40s, with chronic depression and multiple previous suicide attempts. She also suffers from angina and has had a previous MI. She has recently been deemed fit for work, but is appealing this decision. Money is extremely tight, and she and her boyfriend are currently surviving on his benefits alone. She has suffered from physical, sexual and emotional abuse all her life and her current relationship is no exception. She wants to visit her daughter (whose young child has recently been removed from her care), but can’t afford the coach fare – she is waiting for her daughter to pay it as her partner refuses to. The daughter in turn is waiting for her own benefits to come through. Another daughter is homeless.

8. The personal stories… The Tuesday started with half an hour on the phone to give the police the relevant medical information for two of our patients who had been found dead in their homes the previous day. Separate incidents – both in their thirties and both with drug paraphernalia around – one with a tourniquet still on his arm the other recently self discharged from hospital with cirrhosis. I think we get inured at times to these deaths of young people, but two on the same day... This week I have felt particularly hard hit and sad. For them, for their families and friends, and for all our young folk. Where are our priorities?

9. The State of Health…. We know the evidence … known it for 25 years We know some of the solutions … or our communities do Now we need to find a way to get the solutions in place Over to you – any questions?

10. Following up on equality For more information about BHA, our work with the British Institute of Human Rights and our magazine, Health Equalities Contact us at info@theBHA.org.uk www.theBHA.org.uk