Health issues and access to services

Health issues

Minority ethnic groups in general have lower mortality than the general population, but may have specific health problems, such as heart disease and diabetes among South Asians (ScotPHO).

Data on self-reported health by ethnic group from the 2011 census are available on the Scottish Government website. Other sources of data on health and ethnicity are listed on the ScotPHO website.

The NHS Health Scotland Dimensions of Diversity report shows that asylum seekers suffer particularly from mental health problems on arrival. These are compounded by the pressures of asylum seeking status, enforced inactivity and isolation from the mainstream of society. Language is an additional barrier to inclusion.

Research with asylum seekers and refugees representing 26 different nationalities in Glasgow by NHS Greater Glasgow and Clyde in 2005 revealed these groups experience a multitude of problems which prevent them from promoting their physical and mental health and wellbeing. The complexity of seeking asylum, poor living conditions, lack of money, language barriers, racism and lack of control over their future appear to manifest themselves in mental health problems. These problems also make asylum seekers and refugees vulnerable to developing other health related problems e.g. drug and alcohol misuse. The research recommended that it is important that service providers address practical problems facing asylum seekers and refugees through providing a much more holistic and needs led approach.

Gypsies/Travellers have some of the poorest health outcomes in Scotland. The Health Protection Agency in England has conducted a mapping exercise of Primary Care Trusts to explore what is known about local Gypsy Traveller populations, estimate immunizations rates and describe current services to increase immunization as well as to address wider health issues.  It was found that there is an ongoing need to improve knowledge of population numbers and the provision of and access to services that are culturally sensitive and responsive to the needs of Gypsy Traveller communities.  Immunization services are only one component of a wider strategy for improving the health of Gypsy Travellers through effective health and social care interventions.

Accessing services

Ethnic minorities can face greater difficulties when trying to access services, for example due to a lack of knowledge about existing services and differences in language and cultural expectations.  For example:

Scottish Government research on migration (2009) identified that GP registration among economic migrants in Scotland was low and their use of services limited, with some reporting a suggested preference to return to their home country for treatments. The report suggested that migrants made few demands on health services because they were, on average, younger, in employment and without children. It also suggested that migrants needs for health services will change as they decide to settle and to raise children in Scotland. 

Bansal et al (2013) identified inequalities in the way mental health services are used by different ethnic groups. This study, which is the first of its kind in Scotland, looked at hospital admissions for psychiatric disorders, mood disorders such as depression and psychotic disorders such as schizophrenia between 2001 and 2008. The research found that South Asian and Chinese people, in particular, were often very late into the system and that in most minority groups people who went to hospital were shown to be significantly more likely to be treated under the Mental Health Act.


Updated July 2015

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