Multiculturalism And Healthcare Delivery In Wolverhampton, UK

Impact of Multiculturalism on Healthcare Delivery

According to Ashcroft and Bevir (2018), modern Britain is multicultural. After Second World War, the United Kingdom was experienced an influx of immigration which has rigorously changes its nature. The overall population of UK has changed from one that was overwhelmingly white, ethnically Christian to one that is made up of different cast, creed, cultures and communities extracted from different parts of the world. In the UK, a degree of demographic diversity that would have been marginally imaginable during the previous century now constitutes an inescapable part of the British life. The term “multiculturalism” highlights these demographic changes, the intersecting legal, political and theoretical debates and at the same time promotes culture diversity (Ashcroft and Bevir (2018).

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This change in demography under the multicultural concept changes the overall aspect of the healthcare needs and the pattern of healthcare delivery. Chang, Yang and Kuo (2013) are of the opinion that the pattern of the healthcare delivery under the multicultural set-up must be designed in a culturally sensitive manner in order to reduce the health-inequality while promoting quality of life and well-being. However, a culturally sensitive health care model has different aspects. The following essay aims to highlight the complex factors prevailing in a multi-cultural community and how this factors impacts in the overall process of healthcare delivery.

The essay will also take an initiating in understanding the different cultural requirement of communities residing in UK. At the end the essay will evaluate the impact of leadership on the multi-disciplinary team who to providing care to that deliver community and appraise the attribute of an effective multi-disciplinary healthcare team who are working with culturally diverse population. While discussing the different aspect of the multi-cultural community, the essay will mainly focus on culturally diverse population residing in Wolverhampton. People residing in Wolverhampton are worse in comparison to other parts of England. Wolverhampton is regarded as one of the most deprived district or unitary authority residing in England (Public Health England 2017).

While discussing the role of the multi-disciplinary team, the essay will mainly focus on the roles and responsibility of Healthwatch, an independent consumer champion which was established in order to gather and to represent the views of public (HealthWatch Wolverhampton 2018). Overall, the essay will help to understand the importance of multi-disciplinary in delivering care under a culturally competent manner.

Population Demography of Wolverhampton

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Wolverhampton is a city located in the West Midlands of England. It covers a total area of 26.81 square miles and estimates 256,600 total population, making it only 59th populous city in England. The population density of Wolverhampton is 8,820 per square mile. The inhabitants of Wolverhampton are regarded as Wulfranians. Among the total population, 51% are females and rest are males and the average life-expectancy is more than 60 years (World Population Review 2018). Only 42% of the total population is married with 9.9% co-habit with a member of opposite sex and 0.7% live with a partner who belong from same sec and 29.3% are single and have never has sexual relationships with same or different sex and 8.9% are divorced and separated and 13,025 are widowed (Census United Kingdom 2011).

Population Breakup of Wolverhampton

Race or Ethnic Background

Percentage (%)

Total white population

68

White British

64.5

South Asian

17

Black

7

Chinese

2.5

Mixed Race

5

Understanding Cultural Requirements in Wolverhampton

Wolverhampton and life expectancy

Wolverhampton Government UK (2018) highlighted that life expectancy of both men and women residing in Wolverhampton are lower than the rest of the population residing in other parts of the England. According to Wolverhampton Government UK (2018), the life expectancy of Wolverhampton is men during the tenure of 2012 to 2014 are 77.6 years and that of women is 81.8 years. However, life expectancy of Wolverhampton has increased during the course of time.

30%, nearly 14,900 children in Wolverhampton, come from poor or low income families. It is due to poor family back-up that the healthy life-expectancy of the overall population residing in Wolverhampton is worse in comparison to the rest of the population residing in England (Public Health England 2017). The trend for life expectancy is not improving and the gap between the healthy life expectancy and the overall life expectancy is increasing in males and decreasing slightly in females. Approximately the life expectancy of quarter of male population (26.6%) and female population (28.7%) is characterised by increasing disability (Wolverhampton Government UK 2018)

The complex factors in Wolverhampton, a multi-cultural community

The poor health-related life-expectancy is mainly attributed to health-inequalities in Wolverhampton. This health inequality is reflected both in children health and in adult health. Like each year 26.5% of children are classified under obese category along with increase in alcohol abuse.

In adult also the alcohol related harm is high which leads to 2,078 hospital stay per year. Smoking abuse is also prevalent among the adults that lead to 320 death count per year and this is worse in England. The rate of self-harm is also high which further leads to increase in hospital stay (Public Health England 2017). According to Public Health England (2017), this high level of health inequality in Wolverhampton is mainly dominated by complex factors of multicultural community. These complex factors include different cultural background, different genetic backup and different ethnicity.

Ethnicity

Wolverhampton is infiltrated with people from different ethnic background while the majority of them are Christian and the rest being Sikh, Hindu, Muslim, Buddhist and others (Census United Kingdom 2011).

National Research Council and Committee on Population (2004) are of the opinion that the people in UK who are from different ethnic background other than Christian face challenges in having access to medical care. Moreover, even if they receive care, their care is not equivalent to other others. National Research Council and Committee on Population (2004) further highlighted that the in comparison to White population residing in UK, the Black and the Hispanics and Asian population have poor access to comprehensive health-insurance coverage with Hispanics facing greater barriers in accessing health insurance in comparison to other groups. The poor access of the health-care insurance leads to an increase in the health-inequality and thereby creating barrier healthcare delivery.

Role of Leadership in Multidisciplinary Healthcare Team

National Research Council and Committee on Population (2004) are of the opinion that lack of proper access of the health insurance among the ethnic minority group prevents them from approving to the health-service providers in order to seek help for their complex health-related issues. Wolverhampton NHS Continuing Healthcare and NHS Funded Care have been launched by the government of UK in order to provide statutory health care service among the culturally diverse communities of Wolverhampton. Anyone who is more than 18-year old is eligible for this healthcare funding. However, this funding is not comprehensively used by the people of Wolverhampton. Public Health England (2017) further stated that the majority of the population who are from ethnic minority in UK lack proper financial setup and the same has been also highlighted in the demography of the Wolverhampton.

This poor finical background along with lack of proper access of the healthcare insurance prevent help from visiting to hospital or go for health-related checkups and thus all their health-issues remain unheard and unnoticed leading increase in the gap in the healthy life-expectancy. In relation to different ethnic minority under multicultural context, van der Gaag et al. (2017) stated that the people from ethnic minority visit their general practitioner less frequently in comparison to the non-indigenous people or other ethnic population. The main reason behind this is lack of proper health literacy. Lack of proper healthy literacy creates a gap in the health-related awareness among the ethnic minority population increase health inequality.

This gap in health-related awareness also creates a barrier in comprehensive health delivery. The people who lack proper health awareness are less likely to abide by the healthy-lifestyle and therapy adherence and thus increasing barrier in healthcare delivery. In relation to proper health awareness among the people from ethnic minority, Taylor et al. (2017) stated that people from ethnic minority lack the basic understanding of the importance of diet in diabetic management. This is the reason why there is increase in the tendency of the development of diabetes mellitus.

The lack of the health-related awareness also forces them to incline towards unhealthy lifestyle like smoking of tobacco and drinking of alcohol. According to Public Health England (2017), people residing in Wolverhampton have high level of alcohol and tobacco abuse. This high level of alcohol and tobacco consumption increases the tendency of developing cancer, type 2 diabetes, obesity, smoking and alcohol related deaths and the number of suicide attempts. These factors complicate the healthcare delivery further.

Genetics

The Human Genome Project has celebrated its 25th anniversary on October 1st 2015. Since the advent of the concept of the human genome project the implications of genomics in the domain of health care and nursing have gained prominent significance. This advent of Human Genome Project has invented the concept of personalised medicines (McCormick and Calzone 2016). McCormick and Calzone (2016) highlighted that it is the duty of the nurse manager and other healthcare professional to include genomic competencies into practice. Battista et al.

(2012) argued that in-order to incorporate genetic competencies into practice the first, the foremost requirement is the co-ordination of activities between the different healthcare professionals, and this will be followed by defining of the roles and the responsibilities of the healthcare professionals acting under different discipline. Battista et al. (2012) also highlighted the importance of forging new relationships along with increased sharing of knowledge, expertise and genetic information. This will help to overcome the barrier of the redistribution of roles and responsibilities and lack of preparedness among the non-genetic professionals.  However, under the context of Wolverhampton, it can be said that there is lack of trained healthcare professionals.

This lack of trained healthcare professionals is creating a barrier in procuring care under genetically diverse context. Moreover, the majority of the Asians who are residing in Wolverhampton are genetically predispose towards obesity and non alcoholic fatty-liver disease (Wong and Ahmed 2014). This high level of obesity is the main cause behind high level of mortality in the cardiovascular disease, recorded cases of diabetes, infant mortality due to maternal diabetes, cancer and development of obesity during an early stage in life (Public Health England 2017).

This high prevalence of obesity among the Asian population residing in Wolverhampton demands obesity specific healthcare programs and initiatives. This healthcare initiative includes development and education in management of proper weight control diet. However, Wong and Ahmed (2014) highlighted that under the multicultural context development of diet for preventing obesity must cover the both the cultural and the genetic aspect. Lack of proper workforce or lack of co-ordination among the healthcare professionals creates a barrier in effective designing of the personalised care plan.

Cultural diversity

According main cultural needs of the different communities who are residing in the UK is the use their native language while explaining the therapy plan and the process of care. Chhokar et al. (2013) highlighted that regional and cultural relationships are expressed under the marked linguistic difference. Although, the language has been modified though gradual convergence towards “estuary English”, transformation is done under a less formal way. In Wolverhampton, though majority of the population speaks language but the popularity of the other regional language is also significant (Census United Kingdom 2011). This creates a difference in the speech pattern and the dialect. Under this difference in this speech, the communities who are different cultural background for example, Urdu peaking people mainly prefers to converse in their mother tongue or at times fail to understand the complex medical terms or instructions orated in English. This creates a barrier towards comprehensive implementation of healthcare services (Chhokar et al. 2013).

In relation to the Muslim communities or the Urdu speaking community, Attum and Shamoon (2018) highlighted that delivering high-quality care to patient who are from the Muslim faith demands a proper understanding of the differences in their cultural and spiritual values. This difference includes diet, privacy, ideas of modesty, restrictions in alcohol intake and touch restriction. In UK, the Muslims represent a significant portion of the society and is highlighted as the fastest growing religion in the world. It is likely that the healthcare professionals will care for a Muslim service user during his or her entire tenure. The faith of the Muslim communities is guided by several ethnic differences and diverse views in the domain of healthcare and illness. As a result, procuring care for the Muslim patients impose significant challenges for the majority of the non-Muslim healthcare providers.

The faith of Islam influence family dynamics, decision-making, health care practices, associated risks and the use of healthcare services. Thus, barrier in delivering comprehensive healthcare to the Muslim communities demands proper understanding of the Islamic beliefs under the perspective of the religious implications, traditional use of medicine, diet plan and other privacy concerns (Attum and Shamoon 2018). Apart from the Muslims, Hindus also encompass a significant portion of population in Wolverhampton. This population mainly believes in reincarnation and “karma”.  Under the service related issues, modesty and hygiene hold prominent significance.

Women strongly desire to be care by the female healthcare professionals. On the other, they prefer to take bath under free flowing water like shower and are opposed towards taking bath inside enclosed water like bathtub due to hygienic purpose and thus they prefer the use of mugs. Among the Hindus, the married women wear nuptial thread necklace and they refuse to remain the same during their stay in the hospital. Their also had certain dietary constrains at like they are strictly against beef which is opposed to Muslim communities.

Moreover, few Hindu communities are strictly vegetarian and devising diet plan for this group of people at the time of health related emergencies becomes extremely difficult (Giger, J.N., 2016). Abrishami (2018) is of the opinion in order to provide culturally appropriate care plan, there is a requirement of the patient-centred care approach which responds to the patients need while reducing the health-related disparity among the diverse patient population from different cultural and ethnic background.

Role of Healthwatch in Wolverhampton in increasing the community health and social care

Healthwatch is an independent consumer champion which was established in order to gather and to represent the views of the public. It plays an important role both locally and at national level in order to make sure that the overall views of the public and the people who make use of the health and the social care services are taken into account (HealthWatch Wolverhampton 2018). Their main aim is to seek out people in order to discuss their health and the social care needs. According to Abrishami (2018) taking opinion of the service users under the domain of the health and the social care needs helps to increase the provision for the development of the person centred care plan and thus upholding the principle of culturally competent care.

The Healthwatch team in Wolverhampton helps people in decision-making system towards utilizing quality local healthcare services. According to Betancourt et al. (2016), helping people in decision-making, through culturally competent initiatives, helps to increase the overall participation in the care plan. It also helps to decrease health inequalities. The team of Healthwatch Wolverhampton is made of local residents. The presence of the local members promotes healthcare awareness. The local residents understand the local dialect and cultural sensitive prevalent among the particular group of population and this helps increase participation in the care plan along with informed decision making. It also helps to eradicate the barrier of language (Truong, Paradies and Priest 2014).

Healthwatch Wolverhampton team also reflect on the diversity of the Wolverhamptom’s population including young adults and children. According to Truong, Paradies and Priest (2014), doing proper survey in the demographic characteristic of a particular population residing in a specific region helps to gather more information about the prevailing health gaps and the health-inequalities. This information assists in drafting health service plan which is compatible to complex multicultural setup. The role of Healthwatch Wolverhampton also promotes effective partnership with different healthcare services and thereby ensuring proper health and wellbeing.

According to Swanberg et al. (2015), effective partnership among the multidisciplinary team helps in increasing the overall aspect of the health and well-being of the population. In order to engage multidisciplinary team under the healthcare service delivery, the Healthwatch Wolverhampton engages in a number of different projects and special investigation. They also organise community engagement and under this program, the community engagement officers travel throughout the different parts of country in order to accumulate views and experiences of the local healthcare service and thereby helping to increase the overall cultural provision of the care plan.

Team of HealthWatch Wolverhampton

The team of HealthWatch Wolverhampton is headed by Liz. She is the newly appointed executive director. Her main role is to ensure that how HealthWatch complies with its statutory functions in order to make sure that the voice of public is heard or is acted upon as strong commitment. She has completed her graduation in Law and also has a post graduation diploma in the same disciple. The community outreach team is headed by Rasham Gill. He mainly performs the financial assessment. He also take initiatives in working for and with adults with learning disability, young people and social worker. His main work is to engage diverse communities of Wolverhampton while gathering their feedback and experiences in the social care in Wolverhampton.

His 3 years experience as a primary school teacher helps him to engage activity with the children in the Wolverhampton society and thereby helping to promote health and social care services. Apart from community, there is also a local HealthWatch manager. Her work is to maintain public and patient engagement towards planning and delivering health and social care within the Wolverhampton area. Her 15 years of work experience with National Health Service help her towards supporting complex and transformational programs.

The chairman of the board of HealthWatch, Sheila Gill has background of community development. She helps in the promotion of health and social care. Other board members include Jane Emery, she mainly looks after health and the social care concerns of women. Dana Tooby provides adult tuition and is older person’s strategist (HealtWatch Wolverhampton 2018).

Importance of multidisciplinary team

Thus we can see that team and the board of HealthWatch are headed by diverse group of people from different background. One is from judicial background, another one is a primary school teacher, financial advisor, adult trainer etc. This diverse population helps to generate partnership with different services. For example, Sheila Gill works as community development. According to Erickson and Andrews (2011), effective partnership among the members of the community can be achieved through community development. Community development helps in improving the well-being of the low-income people through cross-sectional collaboration. This cross-sectional collaboration helps in reducing the health-disparity and thereby helping to promote further health-development.

Dana Tooby helps to promote adult tuition. In relation to the educating the adults, Raphael (2013) are of the opinion that adolescence or the young adult stage is regarded as a transition from childhood to adulthood. Proper education in the early adulthood helps to reduce the alarming healthcare concern like smoking of cigarettes, consumption of alcohol, dietary habits and physical exercise pattern. Proper health education and utilization of proper social service during the early adulthood helps in the development of the healthy lifestyle habits during the middle or late adulthood stages.

This healthy lifestyle helps in reducing the chances of encountering adverse health outcomes. In Wolverhampton, a significant portion of people are the victims of alcohol and tobacco abuse along with high percentage of physical inactivity. So education during the early adulthood stage helps in proper health-awareness and the utilization of the healthcare service. Rasham Gill offers finical assessment for the people who are going to seek healthcare service. This financial assessment helps to highlight the health inequality along with the insurance access to the people residing in Wolverhampton. The proper assessment of the financial capacity of the people residing in Wolverhampton helps in compatible drafting of the health and social care services (Anhang Price et al. 2014).

Importance of leadership of multidisciplinary team of HealthWatch

According to Weaver, Dy and Rosen (2014) multidisciplinary team is headed by professionals from different disciplines who work together to deliver comprehensive care as per the requirement of the patient. Multidisciplinary care can be delivered by range of professionals who are either functioning as a team under the umbrella of a particular organization (HealthWatch) or professionals from different organization. The composition and aim of the multidisciplinary team change with the requirement of the patient, their physical and psychosocial needs (Weaver, Dy and Rosen 2014). Thus the leadership procured by the multidisciplinary team of HealthWatch helps to improve the experience of the health and the social care service users of Wolverhampton.

This leadership style which is followed by the majority of the professionals who are working under the umbrella of HeathWatch is servant leadership. According to Parris and Peachey (2013), the main principle of servant leadership is listening to the concerns of people through effective communication with proper empathy, active listening. This effective communication styles help the multidisciplinary professionals to extract the exact needs and the concerns of the people and thereby helping to redesign the social and the healthcare service accordingly.

This designing of the care as per the needs or the requirements of the healthcare service users promotes the concept of the person-centred care plan (Swanberg et al. 2015). The person-centred care plan helps to increase the health and the social care experience of the people residing in Wolverhampton.

Conclusion

The above essay mainly aimed to highlight the demographic characteristics of Wolverhampton, a city located in the West Midlands of England and is known for its poor healthcare structure. The analysis of the statistical data revealed that the life expectancy of the people living in Wolverhampton is extremely poor in comparison to the other cities in England. The health-related life expectancy is also poor in Wolverhampton. The poor life expectancy is mainly attribute to lack of proper health awareness and lack of access of the healthcare service. This lack of healthcare awareness is the reason behind high rate of alcohol abuse, smoking and other unhealthy lifestyles.

The essay also highlighted lack the prevalence of multicultural communities in Wolverhampton which increases the level of health-equality due to diverse needs to people from the different cultural background. Moreover, differing ethnicity and the genomic backup further increases the overall demand in healthcare along with increasing the need for the personalised care plan.  In order to improve the access of the health and the social care service of the people of Wolverhampton, the professionals of the HealtWatch have special program. Their healthcare program is mainly headed by multidisciplinary team who mainly works for increasing the engagement of the people from Wolverhampton in the health and social care service.

This increase in the overall engagement also helps in devising person centred care plan. The active initiatives of the professionals from Wolverhampton help to increase community engagement and proper healthcare education. Their multidisciplinary team mainly follows servant leadership styles as they actively listen to the needs of the people, reflect on the diversity of Wolverhampton population including children and youth in order to improve the quality of the local services and to increase the partnership of the healthcare service users. Overall it can be concluded the multidisciplinary professionals of the HealthWatch Wolverhampton work in partnership with services but not in opposition in order to improve the health and well-being of the people of Wolverhampton while reducing the health-equality.

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