1. Diversity
Map 3: The distribution of people from Black and minority ethnic groups
Understanding the diversity of our local population will help to inform the decisions of
commissioners on shaping future health and well-being servicesi
. Some examples of using
diversity monitoring information:
• 7% of Barnet residents are from African and Caribbean communities there will be a
greater genetic disposition towards sickle-cell anaemia. Death rates and complications
from diabetes is higher amongst and from its complications is higher amongst people
from Asian and African-Caribbean ethnic originii
.
• Similarly, high blood pressure and one of its most important complications – stroke – is
more common amongst people of Black ethnic originiii,iv
with higher morbidity rates if
blood pressure is not controlled wellv
.
• Our large Asian and Mediterranean (Greek and Turkish heritage) communities may be
more pre-disposed to being diagnosed with thalassaemia.
• Schizophrenia is diagnosed more commonly in people of African Caribbean origin than
in people from other ethnic groups.vi
Edgware
Hale
Burnt
Oak
Colindale
West
Hendon
Golders
Green Childs
Hill
Hendon
Garden
Suburb
Finchley
Church
End
East
Finchley
Mill Hill
Totteridge
West
Finchley
Woodhouse
Coppetts
Underhill Oakley
Brunswick
Park
East
Barnet
High Barnet
Proportion of ward
population from
Black and minority
ethnic groups (%)
>29
27 – 29
26 – 27
21 – 26
11 – 21
Edgware
Hale
Burnt
Oak
Colindale
West
Hendon
Golders
Green Childs
Hill
Hendon
Garden
Suburb
Finchley
Church
End
East
Finchley
Mill Hill
Totteridge
West
Finchley
West
Finchley
WoodhouseWoodhouse
Coppetts
Underhill Oakley
Brunswick
Park
East
Barnet
High Barnet
Proportion of ward
population from
Black and minority
ethnic groups (%)
>29
27 – 29
26 – 27
21 – 26
11 – 21
Proportion of ward
population from
Black and minority
ethnic groups (%)
>29
27 – 29
26 – 27
21 – 26
11 – 21
2. • Rates of suicide and deliberate self-harm are higher among young Asian women
compared to other communities.vii
The reasons to explain this behaviour are complex,
but highlight the need to develop flexible and culturally sensitive services.
• Developing cancer screening programmes is another area of challenge. Breast cancer
diagnosis amongst south Asian women is relatively low in their countries of origin,
though their rates increase when they emigrate to western European countries.
Reluctance to self-screen is high within this community, coupled with a belief that they
are not at risk means that when they do present themselves, symptoms of disease are
more advanced. Understanding this behaviour must inform health awareness
campaigns.
• Barnet’s large Jewish community has a large Ashkenazi sub-group who are known to
be genetically pre-disposed towards breast cancer. However, the lack of faith
monitoring means that it is difficult to develop targeted screening campaigns by the
public bodies and relies on a high level of awareness within the community. Breast
cancer often presents itself in women aged under 40 years within this community.
• It is difficult to quantify the size and breadth of our refugee and asylum seeking
communities. Applications to the Homeless Person’s Unit are mainly from people
identifying themselves as ‘White Other’. Preferred languages to be communicated with
include Eastern European and Balkan states. Applications are also received from Farsi
and Afghani speaking communities in Barnet. But it must be accepted that many
refugee and asylum seeking people live in the private rented sector and fall below the
radar of public authorities. Health conditions for refugee and asylum seekers are often
complicated by their journey to England and their experiences of officialdom both in
their countries of origin and here. Many are not registered with local GPs, and it must
be acknowledged that many GPs are not clear about their obligations about providing
healthcare services to these groups of people.
Monitoring diversity
Diversity monitoring emerged from the Race Relations Amendment Act 2000 duty placed on
public authorities to collect ethnicity data about its workforce. However, most public authorities
have widened the scope to collect a range of diversity data relating to both employment
practice and service delivery.
Where possible, data is collected information on age, disability, ethnicity, faith/belief, gender
and sexual orientation by asking people to answer questions based on individual self-
identification.
Sometimes, people do not wish to share information about themselves. We accept this, but
want to encourage people participating in consultations or surveys that sharing diversity
information is as important as finding out people’s opinions on the services received by the
primary care trust or local authority.
3. i
Dundas R, Morgan M, Redfern J, Lemic-Stojcevic N, Woolfe C. Ethnic differences in behavioural risk
factors for stroke: implications for health promotion. Ethnicity & Health 2001; 6: 95-103
ii
Balarajan R. Ethnicity and variations in the nation’s health; Health Trends. 1996; 27: 114-9
iii
Lane D. Beevers DG. Lip GY. Ethnic differences in blood pressure and the prevalence of hypertension in
England. J Human Hypertension 2002; 16:267-73
iv
Stewart JA, Dundas R,Howard RS, Rudd AG, Woolfe CDA. Ethnic differences in incidence of stroke:
prospective study with stroke register. Br Med J 1999; 318: 9167-71
v
Lemic-Stojcevic N, Dundas R, Jenkins S, Rudd A, Woolfe C. Preventable risk factors for coronary heart
disease and stroke amongst ethnic groups in London. Ethnicity & Health 2001; 6: 87-94
vi
Cochrane R & Sashidharan. Mental health and ethnic minorities: A review of literature and implications for
services in Ahmad W, Sheldon T, Stuart O; Ethnicity and Health. NHS Centre for Review and
Dissemination, Social Policy Unit. Leeds, 1996
vii
Bahl, V. Mental illness: a national perspective. In Ethnicity: an Agenda for Mental Health. Bhugra, D and
Bahl, V. Gaskell, London, 1999.