Healthcare inequalities improvement: a fair, equitable division of resources, opportunities, and privileges. By Dr. Nagina Khan

Nagina Khan, Ph.D. – Senior Postdoctoral Researcher, CHiMES Group, Dept. of Psychiatry, University of Oxford

It is a great source of pride for me to be invited as the Editorial Fellow at the BMJ Leader Journal and to curate a series of blogs on healthcare inequalities and social justice, which are relevant to contemporary times and the issues we are seeing, reading or dealing with in healthcare at the current time of writing and which resonates with the recent topic collection on leadership and social justice published by BMJ Leader.1

For more than 15 years, social justice has been evident in my professional lived experience of working in the academic and healthcare arena. I started my academic journey as a Medical Research Council (MRC) Research Training Fellow, School of Medicine, University of Manchester, my research was centred on complex interventions for people with depression. My post-doctoral studies were also undertaken at the NIHR School for Primary Care Research, UK focusing on First episode Psychosis in Young People Using Early Intervention services and focusing on issues pertinent to young peoples’ treatment in mental health services.  I worked globally and my work took me to the Centre for Addiction and Mental Health (CAMH – Canada) to work on the mixed method study focused on the Cultural adaptation of CBT for Canadians of South Asian Origin, making mental health services culturally appropriate. This study along with my other research has highlighted concepts that I feel one cannot ignore: the inequity, inequality, and social determinants of health which impact racialised and minority groups everywhere on the globe.  Recently I have been working at the University of Oxford, Dept. of Psychiatry, on the Experience based investigation and Co-design of approaches to Prevent and reduce Mental Health Act Use: (CO-PACT) study in collaboration with Professor Kam Bhui and the CHiMES Group. My analysis was on the staff dataset, which will inform some of the key changes to the Mental Health Act on involuntary admissions in the Black and Ethnic Minority populations in the UK. The other research projects that I have led include, Social Justice in medical education (RCPsych) which has been a strong force to motivate innovation in student development, impacting factors related to Professionalism in undergraduate medicine, this was undertaken with US colleagues (Touro University Nevada). I have also focused on Incentivisation Schemes (Pay for Performance, P4P) in healthcare for HICs and LMICs (CHSS, Kent) that have unfairly overlooked the inclusion and role of certain professionals involved in the P4P schemes.’

Undertaking research and advocating to make healthcare more equitable and equal for both our workforce and those who use healthcare services has been a both a personal and professional motivating factor to bring if not huge then some degree of change for those who cannot. Furthermore, I am also on the Editorial Board of the BioMed Central Medical Education Journal, where I believe we can make a change at the foundation level in medical and healthcare, education – where it all begins, the very base and root of most careers.  I am senior postdoctoral researcher at the University of Oxford, and I am currently based in the Dept. of Psychiatry, Cultural Psychiatry & Health Inequalities (CHiMES) and continue my research on inequalities improvement in mental healthcare.

The introduction above confirms how my research and work to date has a prominent link to social justice, inequality, diversity, inclusion, and bringing a fairness lens to healthcare improvement. Therefore, the focus of this series is predetermined, yet it is a novel and unique series because it develops at a time where social justice is being amplified every day.

  • In a socially-just society, human rights are respected and discrimination is not allowed to flourish.
  • Justice is the concept of fairness.
  • Social justice is fairness as it manifests in society.
  • That includes fairness in healthcare, employment, housing, and more because we now expanded this phrase significantly and so it applies to all parts of society.
  • It’s seen through the lens of traits like race, class, sexuality, and gender.

Therefore, my intention is that these blogs will attempt to shine a light, educate, enlighten, and improve leadership nationally and internationally and show us altogether – what social justice on the floor, can look and feel like for individuals now and in the future. With focus on – ‘how are things experienced in this sphere?’ Along with stimulating out-thoughts of how we need to transform our own current leadership to achieve a society that’s fair, safe and just in healthcare settings.

I launch this series as a full spectrum on the issues that arise in their corresponding blogs.  The blogs for publication will feature national and international authors from different backgrounds in healthcare and academia, presenting differing perspectives and cases of social (in) justice in healthcare. I have been very lucky to work with a very supportive team at BMJ Leader, and with several if not more fabulous authors who are established leaders, emerging leaders, and those who wish to express their passion for change with some gusto and for social justice in this series. I could not have imagined hosting such passionate leaders focused on kindness and fairness, in my series and so I thank them all for working with me, and for their time and efforts.

The opening blog of this series is written jointly by Professor Kam Bhui and I, aptly titled; Epistemological relevance in social justice: a justified belief or pinion?

Reference

  1. Mountford, J. & Nigam, A. Why BMJ Leader is focusing on equity, diversity, inclusion and on social justice. BMJ Lead. 7, e000884 (2023).

Author

Photo of Nagina Khan

Dr. Nagina Khan, BHSc, PGCert, Ph.D. 

Dr Nagina Khan is a Senior Postdoctoral Researcher, Cultural Psychiatry & Health Inequalities (CHiMES), Department of Psychiatry, Oxford University. Nagina’s research is focused on social justice, equality, and fairness, in culturally appropriate mental health care and complex interventions. She is working on the staff data analysis of Experience based investigation and Co-design of approaches to Prevent and reduce Mental Health Act Use: (CO-PACT) study. Nagina has worked as a Scientist at Centre for Addiction and Mental Health (CAMH) on the mixed method study focused on the Cultural adaptation of CBT for Canadians of South Asian Origin. She was a Medical Research Council (MRC) Research Training Fellow, her research was centred on complex interventions for people with depression, University of Manchester. Her post-doctoral studies were undertaken at the NIHR School for Primary Care Research, UK focusing on First episode Psychosis in Young People Using Early Intervention services. Other research interests include, Social Justice in medical education, Professionalism in undergraduate medicine and Incentivisation Schemes (P4P) in healthcare for HICs and LMICs. Nagina is an Editorial board member of the BioMed Central Medical Education Journal. She is also the BMJ Leader Editorial Fellow.

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: None

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