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Exploring the Disparity of Covid-19 with the Crawley BAME Community

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Exploring the Disparity of Covid-19 with the Crawley BAME Community Exploring the disparity of Covid-19 with the Crawley BAME Community (North, South, East) August 2020 1 For everyone, for 80 years We are Citizens Advice We can all face problems which seem complicated or intimidating. At Citizens Advice, we believe no one should face these problems without good quality independent advice. Our goal is to provide free, independent, confidential and impartial advice to everyone on their rights and responsibilities, so they can move forward and thrive. We want every voice to be heard and to improve the policies and practices that affect people’s lives. Citizens Advice in West Sussex (North, South, East) is an independent local charity, a member of the Citizens Advice Network. 2 Contents Executive Summary Page 3 Methodology Page 5 What 3 things will Demographics Page 6 “ you do to make a Results and key themes Page 9 difference; in the short, Conclusion & suggestions Page 22 medium and long term?” Appendices Page 24 Member of the community We are grateful for the support of Crawley residents in sharing their stories so openly. For the support of local community groups, the District Council, Public Health West Sussex, GP practices and others who helped to facilitate this important piece of community engagement. Including our friends at Diverse Crawley, Gatwick Detainees Welfare Group, Refugees Welcome Crawley and the Sangam Womens Group. 3 Executive Summary Sussex, with 20.1% of people identifying a new structure coped better. as non-white. But the BAME population New connections were made, with one itself is diverse this will present different community leader explaining attendance The coronavirus pandemic has had a lived experiences. at his Temple had increased because of devastating impact across society, but Interventions cannot be generic; instead video platforms. However not everyone the disparity of Covid-19 for the BAME we must recognise what is common was aware of the support and activities community revisits the upstream across groups while treating people as available. This is a reminder of the links and wider socio economic individuals and finding local solutions. importance of ongoing awareness determinants for health outcomes i. raising, particularly for people who are Early on, the relevance of the local This is an opportunity to build on context could be seen. For example, not a part of established local groups. existing work and to achieve real whilst having high Covid-19 incidence for There were positive views expressed change. West Sussex, Crawley was still lower than about the NHS, although different The recent Runnymede Trust report ii the average in England. This means practices can be seen across the District. identified 1 in 20 (5%) BAME people many people did not have direct Improving access to appointments and having been hospitalised with the virus, experience of Covid-19. Other factors removing language and communication compared with 1 in 100 (1%) white include the proximity of Crawley to barriers will bring greater equity. people. It is vital we all work together to London, the impact of Gatwick Airport, Emerging needs for newly arrived find solutions. This piece , funded by and transport choices. migrants need to be reflected in future Sussex Partnership NHS Foundation, For 18-25 year olds, worry about money strategies, for example an increase in reinforced much of what we know. and jobs is high, as well as hate crime. Arabic as a first language. Through the Crawley BAME community Crawley has been identified as at risk of these are framed in a local context with The impact of cancelled NHS being the most financially impacted area community led solutions which may appointments is an important message in the country, addressing socio reduce disparity of Covid-19. for us all. Social distancing has removed economic factors will be particularly connections but not the problems: a Some members of the BAME community important for Crawley’s BAME residents. number reported ongoing pain and expressed frustration at more research The Low Commission report on the increased worry. Some had life changing with little evidence of change. impact of advice on health outcomes will events but no access to support, for play an important part in this. example two women experienced We must all play our part in taking up the miscarriage. We must begin the challenge set for us to bring about real There were positives: in particular for recovery to meet both the needs of the step change. families who found improved quality coming months but also the unmet needs as a result of “lock down”. Crawley is the most diverse area in West time; others who identified with a community spirit. People who could find 4 Recommendations: Improved awareness across all to prevent widening health and ethnicities and cultures will help social inequalities. 1. Engagement must be ongoing, remove barriers. taking existing work and reaching 7. Lessons should be shared about people who don’t always engage, 4. Linking interventions and key how people connected, created Engagement needs to be part of messages to motivations people structure and coped through continuous improvement as well as will respond to, rather than a lockdown. People will need to service and product design. one size fits all approach, may be continue social distancing for the Including reaching second+ more effective. Lived foreseeable future. New ways of generation and people with experiences influence how a sharing, such as social media and disabilities. Ensuring the diversity of person will respond to key printed leaflets will reach more the BAME community is reflected in messages. Work should be user- people, alongside capacity building interventions, so they work. led and informed by the needs and for organisations, community and interests of the target audiences. faith groups to continue to connect. 2. Deliverables are needed to build trust with the BAME community 5. Developing and sharing the This is an opportunity to build on so actions are visible and evidence base on downstream what we know and work experienced. Confidence will causes. For example the role of underway and address the gaps depend on genuine change as a Vitamin D or underlying health and try new interventions. result of this work. Organisations conditions. In the words of one member of the should create a “road map” with community: goals and timeframes to be shared 6. Wider socioeconomic and reviewed using quick local determinants must be addressed to prevent ongoing actions to demonstrate change. Survey after survey and nothing disparity in Covid-19 and other “ happens. Then the same survey is 3. Interventions and information reduced health outcomes. Covid- regurgitated a few years later. Waste must be accessible and equitable, 19 has and will continue to have an a lot of effort and time, bet nothing tackling both language and impact on health, with people’s will come out of this and there will be communication barriers. Images, finances driving the level of risk a wash and not see any good plain language and easy read they may be exposed to; for outcomes from that. through a range of channels will help example having to work, use public deliver key messages whilst aiding transport, or not using online That’s my challenge to you.” digital and in-person translation. shopping. Early support with issues outside of health are needed 5 Methodology 214 comprehensive surveys Engagement took place over 4 weeks between July and August 2020 just before lockdown eased, using quantitative and qualitative methods. 22 semi-structured interviews The lockdown necessitated digital channels as our primary route, although in person interviews did take place. This created 8 in-depth interviews limitations and reduced the capacity to reach high numbers and some who are digitally excluded or people with limited English. 3 Focus groups Efforts included using interpreters, using members of the community, and translated printed leaflets. A focus on capturing personal statements from the survey and increased interviews was used to improve validity. A larger response came from working age people and from Asian communities, compared Qualitative with the 2011 Census. 214 people took part which equates to 1-1 semi-structured interviews using the survey structure an approximate 6% of the local BAME population, although with additional free text and exploration of themes. A boost taking into account population growth, it is likely the reach is sample was used to improve representation, for example newly smaller. arrived migrants. It is recommended future engagement use a blended approach In-depth interviews taking ethnographical principles, and include face to face locations and generic channels. exploring culture and lifestyle, values and experiences in the home setting, via video calling. Demographic profiles identified to represent Crawley’s diversity. Quantitative Focus Groups to explore and test emerging themes, with Online and printed surveys were shared via QR codes, links one online open style forum. through the Crawley network, social media, and distributed by hand. Awareness was raised through flyers, word of mouth, An advisory group was formed, with professionals working digitally and social media, including paid for boosts. Questions in the area and mixed BAME backgrounds, to provide input and were aligned to the other NHS commissioned partners to feedback throughout the project and report writing. provide a consistent data comparison. __________________________________________ 6 Demographics 60% of respondents were women compared with 51% overall in Crawley Crawley is the most diverse area in West Sussex, with 20.1% of the population describing themselves as from a non-White background. Our participant group is reflective but not fully The average age in Crawley is 37 years, a representative of the local demographics, due to the relatively higher proportion of people over this age small sample size surveyed: 214 respondents of a BAME answered this survey population of approximately 3472 (2011 Census).
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