Equity in health care, defined as equal opportunity for all individuals to achieve their full health potential, regardless of their diverse socio-economic and demographic circumstances, remains an ideal yet to be fully realised in the UK. As healthcare providers who are intimately involved in patient care, nurses are at the frontline of this struggle for healthcare equity.
Socio-economic disparities are one of the most fundamental challenges to healthcare equity, encapsulated by the concept of the social determinants of health. This term refers to aspects of an individual's life such as income, level of education and employment, which all influence health outcomes. Unfortunately, those from lower socio-economic backgrounds often face barriers to healthcare access, contributing to health inequities (Marmot, 2020). This issue presents a substantial challenge for nurses. They witness first hand the impact of these socio-economic barriers, which affect patients' ability to access timely healthcare services and follow through with prescribed treatments, thereby affecting overall health outcomes.
It is widely recognised that ethnic minorities in the UK frequently experience poorer health outcomes and face higher barriers to healthcare access. Nurses, therefore, encounter an additional layer of complexity in providing care. Language barriers and cultural differences between healthcare providers and patients can lead to misunderstandings, miscommunication and, ultimately, suboptimal patient outcomes. Furthermore, a lack of ethnic diversity within the nursing workforce contributes to these communication challenges and hampers the establishment of culturally competent care (Szczepura, 2005).
The issue of diversity and representation within the nursing workforce is an essential aspect of this discussion. Evidence suggests that a diverse nursing workforce, reflective of the population it serves, can enhance patient-nurse communication, improving patient experiences and outcomes (Green et al, 2007). Thus, actively promoting diversity and cultural competency within the nursing profession must be a key strategy towards achieving healthcare equity.
Geographic health inequities also present a significant challenge within the UK. There exist stark disparities in health outcomes across different regions, with more deprived areas, such as parts of the North East of England, enduring poorer health outcomes (Bennett et al, 2018). Nurses working in these disadvantaged areas must grapple with higher patient demands and fewer resources, further straining their ability to provide effective care.
Lastly, the role of healthcare policies and austerity measures in exacerbating healthcare inequities cannot be overlooked. Reductions in public spending on health and social care services due to austerity measures have reportedly negatively affected access to care, hitting hardest those most disadvantaged (Loopstra et al, 2015). These policy decisions often increase the workloads of nurses and complicate their efforts in delivering high-quality, equitable care.
Confronting these challenges necessitates multi-dimensional and robust strategies. Such strategies should include proactive efforts to increase diversity within the nursing workforce, targeted investment in nursing education with an emphasis on the social determinants of health, and engaging nurses in policy discussions (West et al, 2014).
The journey towards achieving healthcare equity in the UK is a multifaceted challenge with profound implications for nurses. Tackling these issues requires a holistic and integrated approach that acknowledges the impact of socio-economic conditions on health outcomes, promotes diversity within the nursing profession, and recognises the central role that nurses play in delivering equitable health care. Only through such a comprehensive strategy can we hope to make strides in promoting equity within the UK's healthcare system.