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Equality, diversity and inclusion in health and social care research: COVID-19 and beyond

Equality, diversity and inclusion in health and social care research: COVID-19 and beyond

01 June 2020

Rebecca Barnes, Senior Research Adviser in Qualitative Methods and Chris Newby, Senior Adviser in Medical Statistics, RDS East Midlands

As the COVID-19 pandemic and its effects on everyday life, health and the economy continue to unfold, writer Damian Barr said, ‘We are not all in the same boat. We are all in the same storm. Some are on super-yachts. Some have just the one oar(@Damian_Barr). All of us have been affected by COVID-19 and being in lockdown. However, the impacts will differ according to gender, age, ethnicity, disability, socio-economic status, and physical and mental health prior to the pandemic, to name just a few factors.

Emerging statistics show this starkly: Professor Kamlesh Khunti and colleagues highlight data from the Intensive Care National Audit and Research Centre which shows that a third of COVID-19 patients admitted to critical care are from ethnic minorities. They point out that this is indisputably disproportionate to the 13% of the UK population that they comprise. They have called for further analysis of ethnic disparities and this will hopefully be delivered through the recent NIHR call for studies focusing on the relationship between COVID-19 and ethnicity.

Government statistics concerning socio-economic status show that the COVID-19 mortality rate was more than double in the most deprived areas of England (55.1 per 100,000) compared to the least deprived areas (25.3 per 100,000). In addition, Global Health 50/50’s international data tracking by sex indicates that men are more likely to experience more severe symptoms and higher mortality rates.

Alongside COVID-19 health and mortality data, living and working in a pandemic gives rise to many other inequalities. For researchers, the gendered impacts of lockdown have already been noticed. Dr. Alessandra Minello’s article in Nature anticipates that in heterosexual couples with children, women are more likely to bear the brunt of childcare, housework, and home-schooling. For female researchers, this restricts opportunities to submit journal articles and grant applications, adversely impacting tenure and promotion prospects.

It is, however, encouraging to see that these deep-seated inequalities – amplified by the COVID-19 pandemic – are receiving airtime. It is timely that the RDS have identified equality, diversity, and inclusion (EDI) as one of its national priorities, to be led by RDS East Midlands. An action plan is being drafted and a pan-regional advisory group will be established to bring together RDS staff, public contributors, and researchers – the three groups that our EDI work will target.

The RDS is ideally placed to support you to develop studies with inclusive research design, such as identifying appropriate research methods for individuals and groups with different communication needs, cultural values, or mistrust of researchers. We can also advise you on whether your patient and public involvement (PPI) reflects your sample population and how to engage with seldom-heard groups. The NIHR has recently released a checklist for completing the new EDI section of the standard application form, and one of our first tasks will be to produce supporting guidance to enable you to make this a strong and comprehensive section of your application. We also want to explore how the RDS can reach out to under-represented groups of researchers.

EDI is often treated as a tick-box exercise or an optional extra, and it raises issues that can sometimes feel challenging or uncomfortable to acknowledge. Achieving EDI requires ongoing reflection and scrutiny. However, you are not expected to have all of the answers yourself, but rather to be open to seeing your research problem and research design from multiple, diverse perspectives. This is essential if we are to understand and address the needs of groups who are most under-served and to conduct robust and transformative research. Remember the RDS is here to support you with your applications so get in touch with your local team and we'll help ensure you have meaningful EDI in your plans.

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