1. Understanding Diversity & Inequality In Healthcare Dr Bobbie Jacobson Director London Health Observatory The London Health Observatory: monitoring health and health care in the capital, supporting practitioners and Informing decision makers.

2. The Cycle of Invisibility

3. Percentage of people in ethnic categories by borough, London (Source: Census 2001)

4. Diversity: London PCTs with 2 or more minority ethnic groups comprising more than 10% of the population each (2001 census ethnic categories) Hackney (other white, Caribbean, African) Lambeth (Caribbean, African) Lewisham (African, Indian) Brent (Indian, Caribbean) Source: Census 2001

5. Pre-requisites For Effective Action To Reduce Ethnic Differentials in Health Board level commitment/clarity of objectives Trust-wide training programmes in race and diversity Coherent PCT/Acute Trust Commissioning Strategy Complete & high quality data collection Tried and tested analytical tools/methods of adjusting for need. Access to analytical skills Ability to shift resources to areas of un-met need

11. Towards Local Action: Some Questions Focus or breadth? Topics to prioritise:  Big national priorities?  Big local priorities?  Agreed priorities? Admissions or Interventions? Trust - “controlled” topics Topics with statistical validity at Trust/PCT level Specialist or non-specialist?

12. LHO Resources Ethnic Disparities in Health & Healthcare “Diversity Counts” report Toolkit for analysing ethnic differentials in hospital use (in preparation) Ethnic differences in revascularisation in London (in preparation) www.lho.org.uk