1. I NEQUALITIES : T HE INTERSECTION OF RACE AND GENDER T HE W OMEN ’ S H EALTH A ND E QUALITY C ONSORTIUM (WHEC) October 2014

2. W HAT IS WHEC? It is a partnership of women’s charity organisations who share common goals of health and equality for women and girls. It pools the expertise of member organisations to better influence decision-makers and government. WHEC works to improve the sustainability of the women’s and girls’ health and social care sector, and to strengthen women’s and girls’ capacity to engage with the health and social care systems

3. W OMEN ’ S H EALTH “Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity. Women’s health involves their emotional, social and physical well-being and is determined by the social, political and economic context of their lives, as well as by biology … major barrier for women to the achievement of the highest attainable standard of health is inequality, both between men and women and among women in different geographical regions, social classes and indigenous and ethnic groups.” Source: Fourth World Conference on Women (Beijing, September, 1995)

4. W OMEN ’ S H EALTH AND I NEQUALITY Poverty – 22% of women are on persistently low incomes Low pay- two thirds of those working in low paid jobs are women Discrimination - 30,000 women lose their jobs every year because they are pregnant C aring responsibilities – over 50% of women will have been carers before they are 60 and are more likely to experience poor health and long-term condition Violence Against Women and Girls (VAWG) – over one in four women experience domestic violence and 6,500 girls are at risk of FGM every year Anxiety and depression – recorded rates are twice as high for women and girls

5. B LACK AND M INORITY E THNIC WOMEN Severe maternal morbidity among BME women as compared to their white peers Black African women are five times more likely to die in childbirth than white women and Black Caribbean women three times more likely Data collected from 24,319 women in 2010 noted a similar pattern in infant death rates BME women are significantly more likely to report shortfalls in choice and continuity of care Black and Asian women start attending maternity services later in pregnancy

6. B ME WOMEN, CONT. FORWARD reported that in 2001, 4.5% of pregnant women in Greater London coming from communities that practice FGM had undergone some form of it. Affected women are more at risk of obstetric complications Poor living conditions of many vulnerable migrant women can contribute to poor health outcomes

7. W HY ? Some studies have found evidence of cultural insensitivity and racism in health services Widespread reports about institutional racism in public services Stigma surrounding mental health problems, including dementia, in some BME groups Language barriers Women who experience socio-economic disadvantages are at disproportionally high risk of both mental and physical illness

8. W HY ? C ONT. Health inequalities derive from factors like poverty, unemployment, and the quality of the physical and social environment. This includes poor quality housing and an increased risk of violence and discrimination

9. R ECOMMENDATIONS Health professionals should update their skills & knowledge by accessing professional training on improving care for women refugees and asylum seekers, and on working with vulnerable migrant women That CCGs ensure that health and social support services are targeted to address the needs of specific migrant or BME communities in their areas, in recognition of the access problems that have been found to affect BME women. This may entail commissioning specialist services

10. R ECOMMENDATIONS, CONT. That health commissioners ensure that confidential interpretation services are provided free of charge to those who require it, in order to meet equalities commitments about equal access. Female interpreters should be made available to women who request them That the government reconsider its decision not to uprate asylum support. Given the particular health risks facing asylum seeking women during pregnancy and after birth, asylum support levels for pregnant women on both section 95 and section 4 support should not fall below the equivalent of 70% of Income Support

11. R ECOMMENDATIONS, CONT. That pregnant undocumented migrants are exempted from charges for maternity care, since charges, even if applied retrospectively, constitute a barrier to immediately necessary care That the government does more to meet its stated commitment of avoiding custodial sentences for mothers who do not pose a risk to the public, and to making the community sentences the norm for these women. This will reduce both costs and long-term health impacts

12. C ONTACT WHEC Website: www.whec.org.ukwww.whec.org.uk Email: annette@wrc.org.uk