By Christy Braham
The first World Congress on Migration Ethnicity, Race and Health (MERH) – held from 17th to 19th May in Edinburgh – was an event met with anticipation amongst researchers and advocates in the field, aiming to ‘examine contemporary problems across the globe, debate solutions, and forecast the future’. The conference presentations, posters, workshops and roundtables tackled a range of disease areas, the health consequences and challenges of social, environmental and demographic change, as well as theoretical, conceptual and technical developments with regards to improving public health for increasingly diverse populations. With attendees hailing from over 50 countries in both the Global North and the Global South, I was indeed encouraged to see some commitment to diversity in the delegates list and conference organising committees, as well as in the scientific programme itself.
There was strong engagement from members of the Health Equity and Inclusion Group at MERH. On the first day, Professor Sarah Salway and Lynne Carter gave back-to-back presentations focused on research methods in relation to minority ethnic groups, the utility and importance of ethnic categorisations as methodological tools for challenging health inequalities, and identifying the racialised – and often counterproductive – ways in which such categorisations are sometimes applied. On the topic of migration, Dr Hannah Fairbrother successfully presented a poster detailing the protocol and results of four regional systematic reviews of the health of migrant children around the world – a core part of the Hidden Voices collaborative project.
The second day saw Dr Liz Such share much of her most recent work with delegates. Having recently explored the issue of modern slavery in the UK under a public health lens in collaboration with Public Health England (Such et al., 2017), she gave an oral presentation of the outcomes of this project. Additionally, a poster was presented of her co-designed tool for primary care practitioners – entitled ‘migrant.health’ – which was met with interest from other delegates engaged in similar work elsewhere in Europe. Following a thoroughly enjoyable, vibrant, and exhausting evening of traditional Scottish entertainment at the MERH social dinner, Professor Sarah Salway then led a well-attended workshop on the third and final day of MERH which was focused on the role and application of the medical humanities in understanding and tackling ethnic and racial health inequalities. As an attendee of the workshop myself, I found it to be a prime opportunity for self-reflection regarding my own journey as a health researcher – having come from a biomedical and epidemiological background yet now actively engaging in social science research for my doctoral research. Frequently exploring the concept of epistemology and considering different “ways of knowing” does highlight my own previous bias; I’m reminded of how I routinely favoured solving a scientific question exclusively within a biomedical paradigm without considering the sociological framing of the question itself.
Of the numerous areas of research, policy and practice I came across at MERH, it was particularly interesting to be able to further discuss cultural competence with those whose work centres on this concept. Having held discussions with other delegates – one example being on interventions in North America which integrate linguistic adaptions into stroke care for Hispanic patients with aphasia – it became clear how care for culturally diverse and underserved groups is still sometimes limited to making adaptions to interventions, rather than pushing for organisational and system-wide change in how one delivers care for these groups (Center for Substance Abuse Treatment, 2014). Health navigation – the topic of my doctoral research – has continually emerged as an intervention embodying many of the tenets of culturally competent and culturally safe care for minority ethnic and migrant populations, especially in comparison to other adaptions such as engaging with bilingual frontline health professionals or clinic translators (Natale-Pereira et al., 2011). However, interestingly, it has still only had limited roll-out within the American health and social care system, and exists in somewhat isolated forms elsewhere across the world.
The MERH Congress’ very own Edinburgh Declaration was published during the course of the conference, outlining the shared views and motivations of delegates and organisers, as well as a set of policy recommendations for moving forward. While the conference was indeed an inaugural, international meeting of minds and a fantastic opportunity to meet and engage with others in the field, it is hoped that such an event does not become an echo chamber. There is an urgent need for us to not lose sight of the importance of engaging with other actors outside of academic circles and of the importance of always including and amplifying the voices of those groups who we research, work with and advocate for.
Center for Substance Abuse Treatment (US). Improving Cultural Competence. Rockville, MD: Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 59.) 4, Pursuing Organizational Cultural Competence. Available from: https://www.ncbi.nlm.nih.gov/books/NBK248430/
Natale‐Pereira, A., Enard, K.R., Nevarez, L. and Jones, L.A., 2011. The role of patient navigators in eliminating health disparities. Cancer, 117(S15), pp.3541-3550. Available from: https://doi.org/10.1002/cncr.26264
Such, E., Laurent, C., Salway, S., 2017. Is Modern Slavery a Public Health Issue? Public Health England annual conference 2017. Available from: https://phe.multilearning.com/phe/2017/eposters/186620/liz.such.is.modern.slavery.a.public.health.issue.html