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Knowledge and Library Services Part of the Barts Health Education Academy
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March 2023
Hello and welcome to this edition of Barts Health Knowledge and Library Services' monthly Inclusion and Diversity Evidence Update.
Please let us know how we can improve future updates by providing feedback, and let us know if there are any resources or publications you would like us to feature.
To find out more about the library services available to you, including our highly-regarded literature searching service and desktop document supply service, please visit our WeShare page.
Feel free to cascade this update to any colleagues who might be interested.
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From King's College London:
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From Harvard Business Review:
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From PIF member Cancer Research UK and NHS Digital:
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From News Medical Life Sciences:
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From VCSE Health & Wellbeing Alliance:
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From Obesity Health Alliance:
- Dietary and Health Inequalities Obesity Health Alliance Position Statement
The Obesity Health Alliance (OHA) is a coalition of 50 health organisations including the British Heart Foundation, Cancer Research UK, Diabetes UK, the British Medical Association and medical royal colleges. This document outlines the known evidence base for the relationship between overweight and obesity and health inequalities, and the recommendations supported by the OHA to address health inequalities through action to reduce the prevalence of obesity.
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From the Royal College of Obstetricians and Gynaecologists:
- RCOG policy position; Pelvic floor health
"RCOG policy positions set out our views and recommendations on the key areas for change across NHS and Government policy to improve women’s health and care. They are made available on our website so that women, RCOG Members and Fellows, other healthcare professionals and wider stakeholders working in women’s health can also view them. If you are interested to hear more about our policy work, you can email policy@rcog.org.uk.
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From the Department of Health and Social Care:
- England Rare Diseases Action Plan 2023: main report [Policy paper published 28 February 2023]
"In January 2021, we published the UK Rare Diseases Framework, a national vision to improve the lives of the approximately 3.5 million people in the UK living with a rare disease. England’s first Rare Diseases Action Plan followed in 2022, transforming the priorities of the framework into concrete actions."
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From the British Dental Journal: Ethnic inequalities in child oral health behaviours among five- and eight-year-old children from England, Wales and Northern Ireland
"Aim: To examine whether there are ethnic inequalities in child oral health behaviours and the role of parental socioeconomic status (SES) in explaining them.
Results: Children of Asian ethnicity were less likely to start brushing early in life (odds ratio [OR]: 0.25; 95% confidence interval [CI]: 0.15-0.43), brush regularly (OR: 0.56; 95% CI: 0.32-0.97) and have a check-up last year (OR: 0.28; 95% CI: 0.16-0.49) than those of white ethnicity. Children of Black ethnicity were less likely to have a check-up last year (OR: 0.39; 95% CI 0.17-0.89) than those of white ethnicity. Children of other ethnicity were less likely to start brushing early in life (OR: 0.41; 95% CI: 0.23-0.77) and brush regularly (OR: 0.45; 95% CI: 0.23-0.87) than children of white ethnicity. Inequalities in toothbrushing frequency and regular dental attendance between children of Black and white ethnicity were fully attenuated after adjustment for parental SES."
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From Epidemiology & Infection: Socioeconomic and ethnic inequalities in incidence and severity of enteric fever in England 2015–2019: analysis of a national enhanced surveillance system
"There is limited research on whether inequalities exist among individuals from different ethnicities and deprivation status among enteric fever cases. The aim of the study was to investigate the association between the enteric fever incidence rates, ethnicity and deprivation for enteric fever cases in England. Additionally, it was assessed if ethnicity and deprivation were associated with symptom severity, hospital admission and absence from school/work using logistic regression models. Incidence rates were higher in the two most deprived index of multiple deprivation quintiles and those of Pakistani ethnicity (9.89, 95% CI 9.08–10.75) followed by Indian (7.81, 95% CI 7.18–8.49) and Bangladeshi (5.68, 95% CI 4.74–6.76) groups: the incidence rate in the White group was 0.07 (95% CI 0.06–0.08). Individuals representing Pakistani (3.00, 95% CI 1.66–5.43), Indian (2.05, 95% CI 1.18–3.54) and Other/Other Asian (3.51, 95% CI 1.52–8.14) ethnicities had significantly higher odds of hospital admission than individuals representing White (British/Other) ethnicity, although all three groups had statistically significantly lower symptom severity scores. Our results show that there are significant ethnic and socioeconomic inequalities in enteric fever incidence that should inform prevention and treatment strategies. Targeted, community-specific public health interventions are needed to impact on overall burden."
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From BMJ Open: Relationship between ethnicity and stage at diagnosis in England: a national analysis of six cancer sites
"Strengths and limitations of this study:
- This study used national-level data and granular ethnicity definition where possible.
- The analysis was adjusted for confounders, including comorbidities, which may impact the timing of an individual’s cancer diagnosis; previous studies do not consistently account for confounding, or cover a range of sites.
- Information on an individual’s education, religion, country of birth and language spoken at home was not available; these characteristics have been shown to have an impact on symptom knowledge and understanding of the healthcare system.
- The requirement of hospital admission in defining Charlson Comorbidity Index score means that comorbidities managed in primary care are not accounted for; individuals with no Hospital Episode Statistics record are more likely to have unknown ethnicity and missing comorbidity."
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From the Journal of Allied Health: Advancing Inclusion of Transgender Identities in Health Professional Education Programs: The Interprofessional Transgender Health Education Day.
"The purpose of this study was to explore the impact of an Interprofessional Transgender Health Education Day (ITHED) on student knowledge and values where transgender and gender-diverse educators were positioned as the principal educators. The aims were to: 1)evaluate the impact of participation in the ITHED on total and subscale scores of the Transgender Knowledge' Attitudes and Beliefs (T-KAB)38 scale' 2) evaluate the relationship between past transgender health training' clinical experience' or personal relationships with the transgender community on T-KAB scores' and 3) describe student perceptions regarding the value of learning about transgender health directly from transgender and gender-diverse educators."
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From the International Journal of Environemental Research and Public Health: Understanding How School-Based Interventions Can Tackle LGBTQ+ Youth Mental Health Inequality: A Realist Approach.
"Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health in comparison with their cisgender heterosexual peers. The school environment is a major risk factor and is consistently associated with negative mental health outcomes for LGBTQ+ young people. The aim of this UK study was to develop a programme theory that explained how, why, for whom, and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ young people, through participation with key stakeholders. "
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From Cureus: Racial Differences in Perceived Risk and Sunscreen Usage
"Although White individuals have higher incidence of melanoma, clinical outcomes are worse among patients with skin of color. This disparity arises from delayed diagnoses and treatment that are largely due to clinical and sociodemographic factors. Investigating this discrepancy is crucial to decrease melanoma-related mortality rates in minority communities. A survey was used to investigate the presence of racial disparities in perceived sun exposure risks and behaviors."
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From medRxiv: Ethnic differences in the indirect impacts of the COVID-19 pandemic on clinical monitoring and hospitalisations for non-COVID conditions in England: An observational cohort study using OpenSAFELY [pre-print - not peer-reviewed]
"This is one of the largest studies to describe how the pandemic impacted ethnic differences in clinical monitoring at primary care and hospital admissions for non-COVID conditions (across four disease areas: cardiovascular disease, diabetes mellitus, respiratory disease and mental health) in England. A study population of nearly 15 million people, allowed the examination of five ethnic groups, and data until April 2022 allowed the evaluation of impacts for a longer period than previous studies."
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From the Journal of Religion and Health: Religion/Spirituality and Gender-Differentiated Trajectories of Depressive Symptoms Age 13-34
"Studies examining religion/spirituality (R/S) and depressive symptoms report divergent fndings, often depending on the types of variables considered. This study assessed whether subjective and experiential R/S variables were associated with increased depressive symptom burden from adolescence to young adulthood. Variations by gender were also assessed. Using group-based trajectory modeling with a cohort-sequential design, four distinct symptom trajectories were identified for women and five for men. 27.4% of women and 10.2% of men were classified on peak trajectory groups. Religious attendance was protective for men and women. Prayer was protective for women but linked to risk for men. Born-again and life changing spiritual experiences, along with belief in supernatural leading and angelic protection, were broadly associated with increased classification on elevated
symptom trajectories. In one exception, belief in supernatural leading was associated among some men with decreased risk of depressive symptoms during adolescence. Researchers must take a variety of R/S variables into account when assessing
depressive symptoms, not simply religious attendance, prayer frequency, or afiliation as is commonly practiced. Religion and spirituality are multidimensional and in some cases may operate differently for men than women vis-à-vis mental well-being."
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From the International Journal of Environmental Research and Public Health: Analysis of the Barriers and Motives for Practicing Physical Activity and Sport for People with a Disability: Differences According to Gender and Type of Disability
"The aim of the study was to analyse the perception of the barriers and motives for the practice of physical activity (PA) in people with a disability, according to gender and type of disability. The participants in this investigation were 103 people with a disability (33.25 ± 11.86 years) who were habitual users of PA or sports programmes. They completed the questionnaire Motives and Barriers for Physical Activity and Sport (MBAFD). The results showed that personal barriers were more important than environmental ones and that the most outstanding motives were those related to leisure, enjoyment or social aspects. Regarding gender, women perceived more barriers than men. For the people with physical (PD) and intellectual (ID) disabilities, the most common barriers were of an intrinsic nature, and for those with a visual disability (VD), barriers of an environmental nature. With respect to the motives, people with PD gave higher scores to the items related to aspects of physical improvement and rehabilitation. In contrast, people with ID and VD placed more importance on reasons of leisure, enjoyment and social relations. Knowledge of these findings can be a tool to help increase the provision of PA for people with a disability."
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From the Journal of Intellectual Disability Research: Intellectual disabilities moderate sex/gender differences in autism spectrum disorder: a systematic review and meta-analysis
"Background
Girls/women with autism spectrum disorder (ASD) are suggested to exhibit different symptom profiles than boys/men with ASD. Accumulating evidence suggests that intellectual disability (ID) may affect sex/gender differences in ASD. However, a systematic review and meta-analysis on this topic is missing.
Methods
Two databases (MEDLINE and PsycINFO) were used to search for studies reporting sex/gender differences (girls/women versus boys/men) in social communication and interaction, restrictive and repetitive behaviour and interests (RRBIs), sensory processing, and linguistic and motor abilities in ASD. The final sample consisted of 79 studies. The meta-analysis was performed with Review Manager using a random-effects model. Participants with ASD without and with ID were analysed as separate subgroups, and the effects in these two subgroups were also compared with each other..."
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From Emotion: Mind the gap! Stereotype exposure discourages women from expressing the anger they feel about gender inequality
"This work examines strategic factors that impact women’s intention to express anger. Research suggests that women express anger to a lesser extent than they experience it (Hyers, 2007; Swim et al., 2010), and we focus on the role of gender stereotypes in this phenomenon. We differentiate two “routes” by which gender stereotypes can lead women to avoid expressions of anger. "
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New title available in our collection:
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Read our latest Covid-19 Evidence Update (published February 2023) here.
Read our latest Staff Wellbeing Evidence Update (published March 2023) here.
Read our latest Safer Surgery Evidence Update (published March 2023) here.
Read our latest Research from Barts Health Authors (published February 2023) here.
Read our latest Leadership Evidence Update (published February 2023) here.
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Happy to help.
If you require the full text of any of the articles mentioned above, or any other assistance, please email bartshealth.library@nhs.net
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