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Exploring the impacts of organisational structure, policy and practice on the health inequalities of marginalised communities: Illustrative cases from the UK healthcare system

Hui, Ada; Latif, Asam; Hinsliff-Smith, Kathryn; Chen, Timothy

Authors

Ada Hui

Asam Latif

Kathryn Hinsliff-Smith

Timothy Chen



Abstract

This paper explores how organisational structure, policies and practices in healthcare can inadvertently disadvantage marginalised populations (e.g. individuals from ethnic minority backgrounds) and reinforce health inequalities. We draw upon three diverse UK healthcare settings (long term care institutions, high security hospitals and community pharmacies) to illustrate how systemic injustices negatively impact on access to care, treatment and health outcomes. The first case study considers the care of older people within nursing homes; specifically the disempowering effects of this service structure and impacts of choice reduction upon health and their access to health provision. The second case study explores the impact of security restrictions upon patients within high security hospitals, focusing particularly on the maintenance of relationships and support networks outside of the hospital. The third and final case study, draws upon a national community pharmacy medicine management service to illustrate ways in which policies and guidelines inadvertently obstruct patients' engagement with the service within a community setting. We draw upon these settings to highlight inequalities within different contexts and to illustrate the ways in which well intended services can inadvertently disadvantage marginalised communities in multiple ways.

Journal Article Type Article
Publication Date 2020-03
Journal Health Policy
Print ISSN 0168-8510
Electronic ISSN 0168-8510
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 124
Issue 3
Pages 298-302
APA6 Citation Hui, A., Latif, A., Hinsliff-Smith, K., & Chen, T. (2020). Exploring the impacts of organisational structure, policy and practice on the health inequalities of marginalised communities: Illustrative cases from the UK healthcare system. Health Policy, 124(3), 298-302. https://doi.org/10.1016/j.healthpol.2020.01.003
DOI https://doi.org/10.1016/j.healthpol.2020.01.003
Keywords Health Policy
Publisher URL https://www.sciencedirect.com/science/article/pii/S0168851020300063?via%3Dihub
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