Editorial

Citation

(2011), "Editorial", Ethnicity and Inequalities in Health and Social Care, Vol. 4 No. 1. https://doi.org/10.1108/eihsc.2011.54504aaa.002

Editorial

Article Type: Editorial From: Ethnicity and Inequalities in Health and Social Care, Volume 4, Issue 1

Welcome to the first issue under the new emblem of Emerald Group Publishing. We have seen a transition from Pier Professional to Emerald in a time of national and international upheaval.

Locally we have seen burning and looting in London and other English cities, which was described in various ways such as disturbances, riots, uprisings or pure evil and criminal behaviour. We even witnessed an analysis by the historian David Starkey, which framed the problem as white people becoming black.

On the global stage the so-called Arab Spring has dominated international affairs in the media, as governments in Tunisia, Egypt and Libya were faced with effervescing emotions and active opposition to regimes under which nations lived for years. In Europe, the financial stability that had provided the foundation for advances in many spheres, including health and social care, became vulnerable with the fragility of the euro.

These events speak to a number of issues. Events are experienced from a particular perspective, which is held on to as the truth, unless there is effective challenge to the default worldview held and articulated by each person. Further, the events tell of an uncertainty about the future. Environments and modes of being that were once the norm were thrown into disarray, leaving citizens and those in government grappling for frameworks to name and survive new realities. A third consistent theme is the questioning of right and wrong. Debates raged and continue, about absolute or relative definitions of good and evil. All this influences current thinking against a backdrop of the tenth anniversary of the September 11th terrorist attacks.

This issue of the journal neatly speaks to all the issues raised by these national and international events.

The paper on “Migrant women in Austria” brings into focus the cost in human misery, poor health and death when services are inflexible in the face of difference. The paper exposes the challenges encountered when there is a collision of experiences, cultures and expectations. Economic factors affect the ability of services to be responsive but the paper also points to cultural barriers. “Cultural” in the sense of the expectation of services that patients will fit into the status quo. Perhaps, a market economy would turn patients into customers and as a consequence service providers would see their needs, wishes and demands as critical to determining the nature of their interventions. Maybe not. The upheaval in the NHS brings all these questions into focus.

The paper “Faith in one city” crystallises the point that some parts of the UK are so diverse that it is a fallacy to speak of a white majority population with a familiar mono-culture. The paper also brings to mind the extent to which all communities emerge as seekers of meaning. Hedonistic pursuits of immediate pleasure and self-interest, with no moral reference point is not the norm. Diverse communities join in searching for meaning and peace. September 11th attacks are remembered by all but celebrated by none.

The Gavrielides paper on “Human rights in health and social care” illustrates that consensus is not easily achieved on issues of human rights. Different perspectives come to the fore. The failure of services to appreciate the utility of current legislation puts its future at risk, just as much as those who speak out in opposition to the incorporation of the European Convention of Human Rights into domestic legislation.

The final paper in this issue considers the “Unmet needs and antisocial personality disorder among Black African and Caribbean service users with severe mental illness”. The research identifies a previously under-researched sub-group of psychiatric inpatients with a high proportion of unmet health and social needs. Antisocial personality disorder was associated with lower qualifications and a greater risk of homelessness and substance misuse. Unmet need was associated with lower qualifications and substance misuse. In a stepwise linear regression model alcohol dependence and drug misuse were the most significant predictors of unmet need.

Overall, the papers in this issue not only inform but they also challenge. They challenge practitioners, managers and leaders of organisations to reach for more sophisticated analyses of problems. The papers are strong in their presentation of potential solutions, sometimes developed in unfamiliar settings but using concepts that are familiar across the world. The national and international events cited earlier highlight the commonality of the human desire for self-respect, well-being and dignity. These papers draw us into health and social care and ask similar questions. The one which remains unspoken but lingers is “whose responsibility is it to make positive change?”