Dr Nik Kotecha, CEO of Morningside Pharmaceuticals, and Professor Kamlesh Khunti, director of the Centre for BME Health, explain how the Midlands can be an engine to help address health inequalities.
This World Health Day, we were all encouraged to play our part to build a fairer, healthier world - one where all people are equitably able to access quality health services, when and where they need them. In a year when COVID-19 has exposed and exacerbated health inequalities across the UK and globally, this is more pressing than ever.
The Midlands is home to one of the most diverse populations in the country, and falls behind the UK average in terms of life expectancy. The effects of the pandemic have been felt deepest in many of our communities. Just over a year ago, we first highlighted the link between ethnic minorities and higher rates of severe disease from COVID-19, and considerable research has been published since. Data to May 2020 showed 25% of patients needing intensive care support were of black or Asian background. And there are many reasons for this, often including social factors, such as multigenerational housing and cultural barriers, the increased likelihood of being a key worker or of pre-existing chronic conditions such as diabetes. Key public health messaging has also not been tailored sufficiently for many of our communities and misinformation has been rife.
Today, as vaccines get rolled out with pace, these inequalities have been highlighted further, with reports that vaccine uptake is still varying dramatically among different communities. The latest figures show that just 58.8% people identifying as black African have had the vaccine and in people identifying as black Caribbean it’s just 68.7%. Across Bangladeshi and Pakistani communities, vaccine uptake is 72.7% and 74.0% respectively. These figures are stark, and low, compared to a rate of 91.3% in those identifying as white. The Government talks extensively about levelling up the economy with a focus on regions like the Midlands. If we are to do this, tackling health inequalities must play a central role as we recover and rebuild.
Behind this levelling up intent is an incredible opportunity for our region. Alongside our diverse population, we have Europe’s second-largest clinical trials cluster and are home to almost 1,000 medtech businesses. Our newly established Midlands Engine Health partnership is engaging public, industry and academic partners from across our health and life sciences sector -- bringing regional leadership to maximise opportunities for investment and innovation. Our expertise is already helping to drive research that will not only help to address inequalities in the Midlands, but also through innovations and discoveries that can improve healthcare across the U.K. and globally.
The discovery that Dexamethasone and other drugs could be repurposed as medicines for COVID-19 present transformational opportunities. Such low-cost, readily available drugs, made here in the Midlands, will be critical - saving lives at home and in developing countries, as they wait for vaccines. The Midlands is a region of globally connected firms - an exporting powerhouse; strengths which will amplify the role we can play as the world recovers from the pandemic. Our international role can be amplified further with targeted support from government to help more firms to grow and to stay U.K. based. Stripping away red tape and bureaucracy, making research and development investment accessible to small and medium sized firms for instance, will have a double benefit - economic growth and acceleration of the UK’s role in global health solutions.
The Midlands already leads in clinical trials. A key area for action we must focus on, to reduce health inequalities for future generations is to engage more diverse populations in our clinical research, something that the government has recently recognised. Our work to engage representative population trials has been invaluable in understanding and reacting quickly to the impact of COVID-19 - yet our work has just begun. Meaningful future impact means significantly boosting clinical research capacity and actively reaching out to seldom-heard communities, through community and faith leaders, or even through well-known figures like Lenny Henry, last week. Again, the Midlands is well-placed to take the lead, and our Centre for Black and Minority Ethnic Health in Leicester has already developed powerful insights, and can offer the training and infrastructure that will help improve the breadth, scale and impact of representative research, benefiting communities here in the UK and around the world.
Successful community engagement is about landing the right message, in the right way - and through trusted voices. And it is only by involving and understanding the health needs of ethnic minorities that we can do this and better serve the healthcare needs of everyone.
Although the COVID-19 pandemic has highlighted health inequalities, we have to remember that they are by no means confined to this disease – and post-pandemic, our work has to continue, indeed, it must accelerate. In the Midlands, we have been doing pioneering work in disease areas that disproportionally affect people due to their socioeconomic status and ethnicity for many years, such as diabetes, cardiovascular disease, inflammatory diseases, liver disease, cancers and respiratory conditions. While it was reassuring to see the government recognise our work in its recent vision on health research including our centre, we need to see tangible investment in our centres of excellence and our small businesses. We need a commitment to onshoring related manufacturing as we seek to build secure and resilient supply chains, if we are to create real change. Research with ethnic minority groups, for example, requires more money for service tailoring, language translations and bilingual workers, and it takes more time.
The pandemic has shown that the UK can be a leader in health tech and life sciences, from the Oxford-AstraZeneca vaccine to genomic sequencing and drug repurposing discoveries. At the heart of that, the Midlands Engine is leading the way to reduce health inequalities. Investment now in the Midlands proven health capabilities must be a priority, if we are truly committed to levelling up health inequalities, for every community - at home and across the globe.
