C R CENTRE FOR RESEARCH IN PRIMARY CARE P C A Health Needs Assessment of Black and Minority Ethnic Children’s Needs Report prepared for: Leeds Children & Families Modernisation Team and Leeds Health Action Zone By: Barnardo’s, the Centre for Research in Primary Care, and the Centre for Disability Studies (University of Leeds) JUNE 2002 This report is available online at: www.leeds.ac.uk/disability-studies/projects/leedshna.htm A Health Needs Assessment of Black and Minority Ethnic Children's Needs A report prepared for the Leeds Children & Families Modernisation Team and Leeds Health Action Zone by Barnardo’s, the Centre for Research in Primary Care, and the Centre for Disability Studies (University of Leeds) JUNE 2002 This full report and an executive summary are available online at: www.leeds.ac.uk/disability-studies/projects/leedshna.htm Acknowledgements The presentation of this report arises from the contribution of many people. We would particularly like to thank all of the young people, parents and professionals who contributed their views and experiences during the research process. The process was made possible by the active co-operation of staff within NHS Leeds, Education Leeds, and Leeds City Council. The writing and editing of the report was also a collective effort by members of the research team. Specific credit is therefore due to: Karl Atkin Ikhlaq Din Ali jan Haider Hanif Ismail Samantha Jagusz Di McNeish Mark Priestley Susan Rautenberg Angie Ryan Darshan Sachdev Sonali Shah Health Needs Assessment: minority ethnic children in Leeds (June 2002) Contents List of Figures.............................................................................................................2 List of Tables..............................................................................................................3 1. Introduction ...............................................................................................................4 Health needs assessment...........................................................................................4 Determinants of health..............................................................................................5 Health inequalities......................................................................................................6 Racism and health ......................................................................................................8 2. Nature of the population.........................................................................................10 The national picture.................................................................................................10 The situation in Leeds..............................................................................................11 Variations between wards .......................................................................................14 3. Specific Health Issues...............................................................................................18 Poverty and environmental indicators.....................................................................18 Reported health and illness......................................................................................20 Disability, impairment and chronic illness ...............................................................25 4. Use of Services.........................................................................................................27 Primary care .............................................................................................................27 Hospital services......................................................................................................31 Ethnic monitoring.....................................................................................................34 Experiencing services...............................................................................................35 5. Background to organisational concerns ..................................................................40 Type of organisation................................................................................................40 Involvement with minority ethnic children..............................................................41 Contribution to services..........................................................................................44 6. The views of key informants....................................................................................46 Communication........................................................................................................46 Access to services....................................................................................................48 Staff composition and cultural competence ............................................................49 Information pooling and co-ordination....................................................................51 Poverty and social exclusion....................................................................................51 Specific health concerns...........................................................................................52 Disability...................................................................................................................53 7. Views of Parents ......................................................................................................55 Health beliefs and practices.....................................................................................55 1 Health Needs Assessment: minority ethnic children in Leeds (June 2002) Health services and practitioners............................................................................59 8. Views of young people.............................................................................................64 Experiences of health services and practitioners....................................................64 Access to health information and education...........................................................66 Poverty, social exclusion and health........................................................................67 The relevance of ethnicity, culture and religion......................................................68 9. Report summary ......................................................................................................69 References....................................................................................................................73 APPENDIX A: Numbers of Children in Leeds Primary Schools by reported ethnicity and location of school Ward (source: Education Leeds, 2000-2001).........................77 APPENDIX B: Topic Guide for Parent Interviews......................................................79 APPENDIX C: Topic Guide For Children...................................................................80 List of Figures Figure 1: Minority ethnic children in the national population (source: 1991 census).10 Figure 2: Numbers of children from minority ethnic communities (source: 1991 Census) ................................................................................................................11 Figure 3: % pupils in Leeds Schools by ethnicity (source: Education Leeds)...............13 Figure 4: Under 5s in Harehills Ward (source: 1991 census).....................................16 Figure 5: Under 5s in Chapel Allerton Ward (source: 1991 Census) ........................16 Figure 6: Under 5s in University Ward (source: 1991 census)...................................16 Figure 7: SDQ scores for children of different ethnic groups (source: Health Survey for England)..........................................................................................................21 Figure 8: Probability of having ever smoked (source: Health Survey for England).....22 Figure 9: Probability of having ever drank (source: Health Survey for England) ........23 Figure 10: Likelihood of reported major accidents (source: Health Survey for England)................................................................................................................24 Figure 11: Likelihood of reported minor accidents (source: Health Survey for England)................................................................................................................24 Figure 12: % children visiting GP in past two weeks (source: Health Survey for England)................................................................................................................27 Figure 13: % children taking prescribed medicines (source: Health Survey for England)................................................................................................................28 Figure 14: % children ever visited dentist (source: Health Survey for England).........29 Figure 15: % presenting with dental problems at last visit (source: Health Survey for England)................................................................................................................30 Figure 16: % visiting hospital as outpatients in the past year (source: Health Survey for England)..........................................................................................................32 2 Health Needs Assessment: minority ethnic children in Leeds (June 2002) Figure 17: % visited hospital as day patients in the past year (source: Health Survey for England)..........................................................................................................32