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Health inequality: Tobacco use and racial bias in oximetry under review by DHSC

by Jess Hacker
4 February 2022

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The DHSC has launched two distinct independent reviews into ‘significant’ inequalities in health, to support its incoming Health Disparities White Paper.

The reviews will consider the potential racial bias in the design and use of some medical devices, and evaluate the best approach to tackling disparities associated with tobacco use.

The former comes after an NHS Race and Health Observatory rapid review suggested that darker-skinned patients are at greater risk of inaccurate results from oximeters due to a tendency to present higher levels of oxygen in their blood.

The DHSC said the new review will identify ‘systematic inequalities’ in registered medical devices used by the NHS, and will improve the quality and availability of those devices.

It will also consider what systems need to be put in place to futureproof emerging technologies against ethnic bias.

Professor Dame Margaret Whitehead, professor of public health at the University of Liverpool, will lead the review, which was first proposed in November, to be published within the next 18 months.

Professor Dame Whitehead said: ‘There are growing concerns about the potential for racial bias in the design and use of some medical devices commonly used in the NHS, and that the treatment of patients from some ethnic groups may be less effective as a result.’

Meanwhile, the review into tobacco use will help determine the most impactful interventions to reduce the uptake of smoking and to support smoking cessation.

Tobacco is one of the largest drivers of health disparities and is the single largest cause of preventable mortality.

Smoking brings a disproportionate burden on more disadvantaged families, with extremely high rates in Manchester (20.8%) and Blackpool (19.8%), compared to areas like compared to Wokingham (5.5%).

It will be led by Javed Khan OBE, former CEO of children’s charity Barnardo’s, to be published by April.

Both reviews will inform the Office for Health Improvement and Disparities’ white paper on health inequalities.

This will assess service access and experiences using those services, alongside wider causes of ill health.

The Covid-19 pandemic is understood to have exacerbated health inequalities, with a study last year identifying the widespread use of virtual consultations in general practice as a key case.

And last week, a thinktank said the Government’s manifesto pledge to recruit 6,000 new GPs by 2024 could ‘widen’ inequities in access to care if the policy is not executed ‘with equity in mind’.