People’s Health Trust has today launched a major new programme, which aims to help local people experiencing discrimination – including racism, homophobia and transphobia, ablism, misogyny, and agism – to take action and secure positive change that will benefit their health.
The programme launches at a time when many communities affected by discrimination feel they live in an increasingly hostile environment amid rises in hate crime, racism, and xenophobia – both at a community and national level.
Discrimination is a profound social injustice and it fundamentally affects people’s physical and mental health. It is a driver of chronic stress, which has significant consequences for people’s mental health and physical health, including accelerating biological ageing and premature death. This programme aims to tackle this head on, creating opportunities for local people to challenge the practices, behaviour and structural conditions that result in this unfair treatment.
Working initially in six towns and cities in England, local people will share their experiences of discrimination and develop an action plan for tackling it. Through this work, they will engage with the places, people and institutions that are contributing to this harm with the goal of fundamentally change this for the better. This may include widening people’s participation in decision-making and services, to ensure that marginalised groups have a seat at the table, are heard and included, biases are reduced, accountability is stronger, and representation is increased. It may also involve working together with different agencies, stakeholders, and across sectors to collaborate on things like inclusion, accessibility, and tackling discrimination and hate crime.
The programme will be evaluated by academics from the Universities of Sheffield, Exeter and Lancaster, as part of the world-leading School for Public Health Research, funded by the National Institute for Health and Care Research – with a particular focus on measuring any health benefits for local people in participating in the collective campaigning.
Discrimination, whether experienced day to day or over a lifetime, seriously harms people’s health – meaning they live longer in poor health and die younger than they otherwise would. Some groups of people are more likely to experience discrimination than others, particularly people from racially minoritised communities, people seeking asylum and refugees, older people, women, LGBTQ+ people, and people with health conditions and disabilities.
This is compounded by poverty, which these groups are also more likely to experience than others, and this multiplier effect has severe consequences for healthy and overall life expectancy. It also impacts on their ability to secure strong foundations in the building blocks of health, such as good work, a safe and secure home, a good education, access to nature, and access to public services including healthcare.
The health impacts of discrimination
- Racial discrimination is reported to cause severe stress and has the deepest evidence base surrounding forms of discrimination and impacts upon health. Experienced over time, stress responses caused by racial discrimination increase the likelihood of premature death as well as several leading causes of death and disability including heart diseases, diabetes, obesity and high blood pressure.
- LGBTQ+ discrimination is associated with increased psychological distress, is strongly linked with a much higher likelihood of attempting suicide, reduced relationship quality, ineffective coping mechanisms and lower levels of self-esteem.
- Ageism is associated with physical and mental illness, poorer social relationships, much lower wellbeing, riskier health behaviours, such as through alcohol, tobacco and diet, a worse quality of life and premature death.
- Disability discrimination is associated with increased rates of depression, psychological distress, poorer mental functioning, lower life satisfaction and a higher likelihood of poor self-rated health. Disabled people tend to live in poorer health than non-disabled people and face significant challenges accessing public services and decent employment.
- Sexism and misogyny have consistently negative effects on women’s health, which are particularly in evidence as a result of structural issues such as the gender wage gap, missed/misdiagnosis of health conditions, the stress of caring responsibilities, and attitudes and behaviours to women in the workplace, social and public spaces. There remain significant evidence gaps around the direct health impacts of sex-based discrimination.
- People who report more than one type of discrimination (for example, racism, sexism, misogyny, ableism, transphobia and homophobia) are much more likely to have mental health problems including symptoms of depression.
Evidence shows that some key ingredients are needed to tackle discrimination, including valuing people’s experience, particularly community-led and community empowerment work which takes a broad approach to engagement, and widening people’s participation in decision-making and services, to ensure that marginalised groups have a seat at the table, are heard and included, biases are reduced, accountability is stronger, and representation is increased. All partners funded through Discrimination and Health priority will seek to include these features in their work.
John Hume, CEO of the People’s Health Trust, said:
“We know that discrimination gets under the skin and that it causes serious stress responses and has a damaging effect on health. Through this work we are trying to understand what can change to reduce or mitigate the harm by focussing not on the individual but on the institutions and systems which contribute to the discrimination and also have the power to make a real difference to the health of generations of people.”
The NIHR School for Public Health Research evaluation team said:
"Our evaluation of this vital programme will focus on understanding how community-led action against discrimination can translate into tangible health benefits for individuals and groups. We are particularly interested in how empowering marginalised communities to challenge systemic injustices can improve health and well-being, contributing to a more equitable and healthier society."
Thanks to the support of People’s Health Trust funding, we will be able to expose and address the deep-rooted discrimination and health inequality affecting women from disadvantaged communities as well as marginalised groups in the County Durham area.
This funding is directly contributing to the formation of a peer-led lived experience group-made up of survivors of domestic and sexual abuse who are now going to be working alongside local police to improve responses to mental health and discrimination. This is not just progress, it is a transformative shift led by those who’ve lived it while amplifying the voices of those most affected by health inequalities. Together we are not only raising awareness we are hoping to make changes
Linda Kirk
Founder of the Just for Women Centre in County Durham, which is delivering one of the local Discrimination and Health projects
Discrimination and Health partners
Bristol Women’s Voice
This project is led by older women aged 55+ living in Bristol who are facing age and gender discrimination and experiencing financial disadvantage. They will come together monthly to identify and understand the prevalence and impact of everyday and systemic ageism and sexism on their health and wellbeing. They will also take social action aimed at reducing societal and institutional discrimination and its harm through influencing decision-makers and challenging stereotypes. As well as social action projects there will be training to upskill and support older women to deliver social action and an advisory group, which a local group, Bristol Older People’s Forum, will be part of.
Leeds Muslim Youth Forum
This project brings together people from racialised communities in the Harehills and Gipton wards in Leeds to document their experience of discrimination and engage key stakeholders. Participants include refugees and those seeking asylum. These communities are facing significant socio-economic disadvantage and societal discrimination such as xenophobia, Islamophobia and racism which lead to chronic stress, poor mental health outcomes and physical health issues. People will be trained and act as community ambassadors to ensure that all communities are involved in the project and will be led by a steering group. The project aims to highlight the impact of discrimination on the health of the community, co-design solutions and influence policy change.
Just for Women Centre CIC
This project in Stanley, County Durham, is led by and for women, including those seeking asylum and refugees, who are experiencing every day and institutional discrimination with a particular focus on those facing multiple and intersecting forms of disadvantage including gender, socio-economic status and race. Through facilitated workshops and discussion groups they will explore how discrimination manifests in their lives and use this learning to develop advocacy work and policy recommendations with the aim of influencing local services and reducing the health impacts of discrimination.
Support Northamptonshire
This project works with older people from racialised communities experiencing financial disadvantage in Wellingborough, Corby and Northampton. These communities experience discrimination within public health services and face intersecting challenges such as long-term health conditions. The project develops support plans for participants and documents their lived experience to understand the impact of everyday and systemic discrimination on the health of Asian, Black African and African-Caribbean communities and look at ways in which the prevalence and impact of this harm can be reduced at an individual, societal and institutional level. There will be a project steering group who will shape development and delivery.
English for Action
This project works with migrant women, mainly from the Bangladesh community and other migrant communities including Sudanese, Iraqi, Afghani and Somali in Bow, in the London Borough of Tower Hamlets. These women are experiencing marginalisation and social and economic disadvantage alongside compounded discrimination: racism, xenophobia, Islamophobia, sexism, misogyny, and exclusion from services and civic life, plus language barriers and illiteracy. They also face intersecting challenges such as long-term health issues. Trained Volunteer Facilitators will co-facilitate discussions and conduct a listening campaign to better understand the broader local context. A steering group of volunteers will use collated feedback to shape the project. Participants will explore their experiences of discrimination and collectively identify important issues to act on, with the aim of influencing changes in practice that reduce the discrimination experienced by participants.
MindOut
This project, will evidence how LGBT+ people are disproportionately impacted by poor mental health due to stigma, discrimination, and a lack of understanding around the complex and specific needs of this community. It focuses on mental health activities and peer support for individuals identifying as LGBT+ and other marginalised characteristics, including those facing housing uncertainty, low income households and the unemployed; socially isolated and older people. The work will draw on the existing and future intelligence gathered from MindOut’s LGBT+ mental health services in Sussex to understand how discrimination affects the health of LGBT+ people. This evidence will inform MindOut’s influencing and partnership work to address the social determinants of health, including employment, housing and social isolation and improve health outcomes for marginalised LGBT+ communities.
National Institute for Health and Social Care
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research.
We do this by:
- funding high quality, timely research that benefits the NHS, public health and social care
- investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services
- partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research
- attracting, training and supporting the best researchers to tackle complex health and social care challenges
- collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system
- funding applied global health research and training to meet the needs of the poorest people in low and middle income countries
NIHR is funded by the Department of Health and Social Care.
Our work in low and middle income countries is principally funded through UK international development funding from the UK government.