THREAD on @RoySocMed ONP51: Health inequalities: what can healthcare professionals do?"

1/

Dr Chad Hockey talks about how the original game of monopoly which originally had wealth distribution that is no longer part of the game

bbc.com/worklife/artic…
2/

🗣️ "The poverty of our century is unlike that of any other. It is not...the result of natural scarcity, but of a set of priorities imposed upon the rest of the world by the rich. Consequently, the modern poor are not pitied … but written off as trash.” John Berger
3/

Healthcare provision is based on the fact that we all have the same healthcare needs but this is not the case.
4/

Inverse care is an issue of resilience to maintain your day-to day activities.

The community often does not belong to the people that live in them:
5/

Join the NW London Deep End scheme: eventbrite.co.uk/e/deep-end-nw-…
6/

@benomsam @CommVoicesNWL

We should be campaigning for time and space to change how health and social care is funding rather than tokenistic pots of money.

(Sorry tech issues so missed much of this!)
7/

Michelle Gavin from @GypsyTravellers speaks about huge health inequalities
8/

Huge health inequalities in gypsy and traveller communities in suicide, anxiety, depression and child mortality.

gypsy-traveller.org/wp-content/upl…
9/

What can we do to improve health inequalities at your healthcare institution?
10/

April Wareham from "Working with Everyone"

🗣️ Do we really put ourselves in other people's shoes and non-healthcare priorities/circumstances?

Our society has societal norms which assume sufficient money/housing/IT skills/literacy.

Many people are just doing their best.
11/

Not everyone has a smartphone/printer/computer that works.

💡Things that helped:

People were seen as people rather than being judged as stereotypes

Listening actively
12/

@rachelpower222 from @PatientsAssoc presents results of recent survey:

People of disabilities and long term conditions felt left behind during lockdown.

Difficult to access secondary care appointments:
13/

Why were people worried about accessing healthcare services? Did we ask?

How can we help? How do we engage with marginalised populations? Tech won't be the answer!
14/

Panel discussion: Why do health inequalities still exist?

➡️ We can make healthcare better but healthcare inequalities are much bigger than healthcare...is there a lack of political will?

➡️ Do we value wellbeing or money in society?
15/

➡️ Do we look at disease in people or people with disease?

➡️ Tribalism between different groups, CCG/secondary care/social care - multiple managed hierarchies

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More from @DipeshGopal

13 Sep
1/

🧵

THREAD about why race is in the @NICEComms hypertension (blood pressure) guidelines and why it should go: nice.org.uk/guidance/ng136

@MedCrisis and I read #AngelaSaini's book "Superior" and were horrified at the inclusion of race without clear scientific basis:

#FOAMed
2/

The @NICEComms specifically implies that Black people are inherently different (assumption: biological/genetic) compared to White people.

Why? @DoctorMayJay

Suggestions: Black people are inherent salt retainers due to salt deficiency, etc: ncbi.nlm.nih.gov/pmc/articles/P…
3a/

This article from @American_Heart is a long reach arguing that there are inherent genetic differences between Black people and White people citing small genetic studies: ahajournals.org/doi/full/10.11…
Read 14 tweets
3 Sep
Thank you to the @bmj_latest for hosting the
#BMJCovid

@PaulGarnerWoof: #LongCovid was way long than the 2 weeks

blogs.bmj.com/bmj/2020/06/23…
@Dr2NisreenAlwan - "why aren't we measuring #LongCovid?"

#LongCovid - often has a wide range of symptoms: body ache, chest pressure, tiredness, rash. The symptoms do not completely go - relapsing and remitting. #BMJCovid

Read her article here: blogs.bmj.com/bmj/2020/07/28…
@trishgreenhalgh - "you do not necessarily need a positive test to have #LongCovid"

Let's not get too caught up with this - we weren't testing at the beginning of the pandemic. #BMJCovid

How do we manage #LongCovid. Great patient resources here: bmj.com/content/370/bm…
Read 14 tweets
26 Jul
🧵THREAD on Hardouin et al (2020) #MedBikini article #MedTwitter

1/

Editors' response:

Unconscious bias = implicit bias
Conscious bias = explicit, intentional

So in this is essentially misogyny and conflicts with human rights to free speech/private life. Image
2/

Methodological concerns: unspecified definition of 'controversial'. There needs to a validated definition.

🗣️ "Controversial political and religious comments were
...directed toward...faith.

Controversial social comments...on abortion and gun control."
3/

Moral concerns: clinicians performed searches on social media to conduct their research.

To be fair this is what patients could/would do. I'm not condoning this methodology.

I've had patients tell me that "I'm established" when I first met them from Googling me. 😳
Read 15 tweets
28 Jun
1a/

THREAD 🧵 on why #BlackLivesMatter

This week I presented to my GP practice about this topic covering:

Socio-economic/health differences
Genetics/Race science
History @DavidOlusoga
Being anti-racist/education
@jhalakprize

🔗: youtube.com/watch?v=0SQJz3…
1b/

It's designed to start conversations and be concise. You have to put the work in to work on yourselves to be anti-racist.

Please feel free to distribute.

If there are parts that are wrong, I am happy to amend/take down. @MelaninMedics @olamide_dada @KhadijaOwusu
1c/

Please circulate if it resonates @Dr_Ayan @OrthopodReg @yvonnecoghill1 @trishgreenhalgh @AmeenKam @omaromalleykhan @aftertheletters @RoshanaMN @parthaskar @JohnBoyega @SoniaAdesara @raceandhealth

Also call me out if I've got stuff wrong too/can be better.
Read 42 tweets
6 Jun
1/

🧵 THREAD on "Black" by @Santandave1.

This song tackles overwhelming pain, history, suffering and loss of culture that inter-twines with modern injustices that black people face. #BlackLivesMatter

@MelaninMedics @thermoflynamics @OrthopodReg

🔗:
1/

I will try my best to explain the references in the song but I admit I'm no expert in black history.

Feel free to correct me anywhere.

🗣️ "Black is pain, black is joy, black is evident"
1/

🗣️ "It's workin' twice as hard as the people you know you're better than
' Cause you need to do double what they do so you can level them."

I was told this as a child too. Despite this minorities rarely make leadership positions.

@WRES_team: england.nhs.uk/wp-content/upl…
Read 20 tweets
5 Jun
1/ THREAD summarising @PHE_uk report

More likely to die from #COVIDー19 if you are:

Older
Male
From certain parts, e.g. London, NW
From a deprived background
From a ethnic minority background
A low-skilled (key) worker
A migrant
Living in a care home
Have a medical condition
2/

Data limitations

- most lab confirmed cases were from hospital deaths - most severe cases?
- the case definition/testing of COVID-19 changed through the pandemic

- ethnicity matched from 2011 census

- lack of data on vulnerable groups: migrants, sex workers, homelessness
3/

Appraisal

- no discussion/action plan

- lessons learnt due to led by Equalities Minister (@KemiBadenoch) who had never heard of @MichaelMarmot's @TheMarmotReview until mentioned in Parliament yesterday:

- I’m worried very little will change
Read 40 tweets

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