Abstract
In the United Kingdom (UK), the provision of health care is established on the principle of access of care for all - free at the point of delivery. The UK hosts a multi-ethnic population and thus to ensure equality of access health policies must take into account the needs of people from all ethnic backgrounds. The purpose of this study is to identify the aspects of ethnicity that need to be accounted for when forming health policy in order to provide health care that is accessible to all, regardless of ethnic background. In the UK, minority ethnic groups see a higher incidence of diseases such as diabetes, coronary heart disease and haemoglobinopathies, compared to the national average; furthermore the incidence of diabetes is highest in the British Bangladeshi population. Thus the researcher has chosen to use the British Bangladeshi population and diabetes management as a vehicle to explore and identify the aspects of ethnicity that are not only pertinent to the delivery of appropriate diabetes care but should also play a vital role in shaping policies that govern the delivery of all health care. Using diabetes as the vehicle for this research, the methodology for this study is comprised of two phases: a national exploratory survey and a single case study. The purpose of the exploratory survey is to study current policies on diabetes management and assess their applicability to people from ethnic minority groups. The findings from the exploratory survey indicate that there is a lack of diabetes policies in the current health care system that account for the needs of ethnic minority people. With this lack apparent a single case study was conducted using British Bangladeshi people and diabetes management as a vehicle, to explore and identify the aspects of ethnicity that need to be reflected in diabetes policy. A single case study was the apposite methodology for this phase of the research as the setting for the case study was unique in that it was a recognised centre for excellence in primary care that served a large British Bangladeshi population. The study identified communication, tradition, religion, professional and patient education to be the aspects of ethnicity pertinent to the delivery of appropriate diabetes care. These components of ethnicity must inform diabetes policy to ensure diabetes care that accommodates the needs of minority ethnic people. Having used diabetes as a vehicle for this study, the researcher further applies these aspects of ethnicity to the observed patient’s journey to develop a schema for the inclusion of ethnicity into other health policies. Whilst this schema is constructed from a single case study, the researcher proposes that it be applied to other minority ethnic groups for the inclusion of ethnicity into all health policy. The schema presented at the conclusion of this research may be used as a tool to identify the components of ethnicity for other ethnic groups which if reflected in all health policies would ensure a health service that addresses the needs of each patient as an individual.