Equality, Diversity & Human Rights

What are equality, diversity & human rights and what do we mean by ‘health inequality’?

Equality

Equality is not about treating everyone the same but:

Making sure people are treated fairly
Meeting individuals’ needs appropriately
Challenging the factors that limit individuals’ opportunities

Diversity

Diversity is about:

Recognising and valuing individual and group differences
Ensuring that many different types of people contribute to society

Human rights

Human rights refers to the basic rights and freedom that belong to every person in the world

Health inequalities

Health is determined by a complex interaction between individual characteristics, lifestyle and the physical, social and economic environment.

Health inequalities are avoidable, unfair and systematic differences in health between different groups of people.

Health inequalities affect people grouped by a range of factors:

Socio-economic factors, for example, income
Geography, for example, region or whether urban or rural
Specific characteristics including those protected in law, such as sex, ethnicity or disability
Socially excluded groups, for example, people experiencing homelessness

These differences have a huge impact because they result in people who are worse off experiencing poorer health and shorter lives.

The Equality Act 2010

The Equality Act 2010 brought together a range of existing legislation, so the majority of equality law is now contained in this single Act. The Equality Act 2010 gives legal protection to nine 'protected characteristics' - which we will now look at.

What are the 9 Protective factors?

Age

Means a person belonging to a particular age group.

Disability

A person is deemed to have a disability if they have a physical or mental impairment, and the impairment has a substantial and long-term adverse effect on the person’s ability to carry out normal day-to-day activities.

Someone who may have had an impairment or condition such as cancer is also covered by this legal definition of disability.

Gender Reassignment

The Equality Act defined gender reassignment as:

‘‘Where a person has proposed, started or completed a process to change his or her sex.

Marriage and Civil Partnership

People who are married or in a civil partnership have this protected characteristic.

Pregnancy and Maternity

Maternity refers to the period after the birth. Maternity discrimination is linked to maternity leave in employment.

In the non-work context, protection against maternity discrimination is for 26 weeks after giving birth, and includes treating a woman unfavourably because she is breastfeeding.

Race

People who have or share characteristics of colour, nationality or ethnic or national origin can be described as belonging to a particular racial group.

Religion or Belief

People who have a religion or religious or philosophical belief, or a lack of religion or belief, share this protected characteristic.

Sex

Being a man or a woman. However, it should be noted that, although not acknowledged in the Equality Act, some people may recognise themselves as non-binary or intersex.

· Intersex people are individuals whose anatomy or physiology are different from the typical definitions of male and female

· Those with non-binary genders do not see themselves as exclusively male or female

Sexual Orientation

A person’s sexual orientation may be towards:

· People of the same sex as him or her (in other words the person is a gay man or a lesbian)

· People of both sexes (the person is bisexual)

· People of the opposite sex from him or her (the person is heterosexual)

Employees and their rights.

The Equality Act protects people who work in services and people who use services.

There are two key aspects of the Equality Act that we need to look at.

It is illegal to discriminate against a person because of a protected characteristic

Health and social care we must not discriminate against our patients, people who want or need to use our services, staff members or job applicants.

The Public Sector Equality Duty

The Public Sector Equality Duty is part of the Equality Act and requires NHS and social care organisations to pay due regard to the need to:

Eliminate discrimination
Advance equality of opportunity between people who have protected characteristics and people who don’t
Foster good relations between people who have protected characteristics and people who don’t

The Public Sector Equality Duty means that organisations have to think about inequality and take action to reduce inequalities

Definition and Examples of Discrimination

There are four main types of discrimination:

Direct Discrimination

This means treating one person less favourably than someone else because of a protected characteristic.

For example, assuming that someone cannot do a role because they are male or female and therefore not offering them a job.

Indirect Discrimination

This can happen when an organisation has a rule or a policy or a way of doing things in place which has a worse impact on someone with a protected characteristic than someone without one.

For example, you have a rule that a person has to be a certain height to work in a reception area because they will be seen more easily. This may disadvantage people who use a wheelchair or women who on average are shorter than men.

Harassment

This means people cannot treat you in a way that violates your dignity, or creates a hostile, degrading, humiliating or offensive environment.

For example, a person who is deaf is signing with a friend in an office, another member of staff makes derogatory and offensive comments about her, which upset and offend her.

Victimisation

This means treating someone unfairly because they are taking action under the Equality Act (like making a complaint of discrimination), or because they are supporting someone else who is doing so.

Here are two examples of discrimination that is unlawful under the Equality Act.

It is illegal to discriminate against a person because of a protected characteristic

Peter interviews Hilary for a job which has been advertised internally and would be a promotion for her. Hilary is the strongest interviewee but Peter decides not to offer her the job because Hilary is a lesbian and Peter knows that some people in the team she would be managing have made homophobic remarks and he thinks they will not respect Hilary.

Peter’s actions are direct discrimination and he is breaking the law. Peter also should have already challenged his colleagues’ homophobic remarks to help to create an inclusive workplace.

It is illegal to discriminate against a person because of a protected characteristic

Perminder is in her late twenties and has been working in an administrative job in the NHS for 6 years. She applies for a job which will be a promotion but the person specification says that applicants need ten years’ experience of working as an administrator.

Unless the employer can lawfully justify why candidates need ten years’ experience, this is likely to be indirect discrimination against young candidates such as Perminder who can demonstrate that they are qualified and capable but don’t have ten years’ experience because of their age.

Reasonable Adjustments

Reasonable adjustments are about making changes when a disabled person is at a significant disadvantage, either when services are being provided or in the workplace.

A failure to make reasonable adjustments counts as unlawful discrimination.

There are three areas that must be considered:

Making changes to the way things are done (such as changing a practice or policy)
Making changes to the built environment (such as providing access to a building)
Providing auxiliary aids and services (such as providing special computer software or providing a different service)

Health Inequalities

The health inequalities vulnerability triangle demonstrates the interplay between various factors that can contribute to an increased risk of health inequality (the vulnerability triangle reproduced with kind permission from Pia Bruhn at eMBED Health Consortium).

Risk of vulnerability

The more sides of the triangle that come into play, the greater the risk or vulnerability to health inequalities.

Protected characteristic groups

Belonging to a protected characteristic group does not in itself mean you will experience health inequalities. However, distinct groups are more vulnerable or at risk, particularly in certain circumstances, for example, older people with learning disabilities and cultural and ethnic minority communities.

Socioeconomic deprivation

We know that poverty is the greatest indicator of health inequality and that this can also impact on education, employment, housing and access to services. Protected characteristics groups who live in deprived neighbourhoods are at increased risk or vulnerability of experiencing health inequalities.

Access and discrimination

People with a protected characteristic can often experience discrimination based on their identity, such as their age or sex. This may have a negative impact on health and well-being, and access to, and experience of using, health and social care services. This can result in poorer health outcomes and further health inequalities.

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