3 December 2020

Pemberton Lecture 2020: A Review

Yvonne Coghill’s 2020 Pemberton lecture, entitled ‘Why race equality in our NHS is important’ provided a balance between scientific evidence and personal experience to demonstrate the impact of race inequalities on people’s life experience.

Whilst focussing primarily on the NHS, she also provided an alarming picture of the inequalities in life experience and opportunities between white people and people from different ethnic backgrounds in all areas of life.

She explained the concept of racism as an organised and sophisticated system that categorises people as inferior based on skin colour and race; one that historically has proved very difficult to dismantle. Systemic racism and discrimination is a global challenge that has led to people who are not white being disadvantaged in many aspects of life, including health, wealth, housing and education. The impact of discrimination is pervasive and affects every aspect of life; feeling ‘other’, worrying whether you will be accepted, what people will think about you and having to work harder to achieve the same levels of acceptance that white people take for granted. These worries, along with the impact of constant micro-aggressions and stressors can lead to heightened vigilance, chronic stress and ‘biological weathering’. Indeed, evidence shows racial differences in telomere length that demonstrate accelerated aging, leading to significantly lower life-expectancy for black women compared to their white counterparts. As Yvonne explained “biological age doesn’t only affect how long you have been alive, but captures what you have been through, and your experiences”.

Along with alarming statistics from the NHS Workforce Race Equality Standard (WRES) data on the different experiences of people from black and minority ethnic backgrounds compared to white people (e.g. higher levels of discrimination, less likely to be appointed from shortlisting, significantly under-represented at higher pay bands), Yvonne also presented the ‘Business Case’ for why reducing inequalities makes sense for everyone, not just people from ethnic minority backgrounds. She presented data demonstrating how the implications of racism mean that staff who are not white were less likely to report problems relating to patient safety for fear of being victimised by management, and research has shown a clear link between how staff are treated and quality of patient care.  The data also reveal telling differences between different non-white ethnicities, which is one reason it can be misleading to rely simply on a “BAME” grouping, and why it is important to consider the experiences of all ethnic groups separately as well.

7 A's of Authentic Allyship

Finally, to address how we can improve this current situation, Yvonne presented her ‘7 ‘A’s of authentic allyship’, encouraging white people to stand up and fight structural racism. There is a lot of work to be done to reduce race inequalities. It is not enough for white people to stand by and feel that we are not doing any harm, we need to become anti-racist and help to dismantle the structural inequalities that enable these inequalities to be perpetuated.

This review was written by Dr Fiona Sampson and Professor Jeremy Dawson