Gogoi, Mayuri, Qureshi, Irtiza, Chaloner, Jonathan, Al-Oraibi, Amani, Reilly, Holly, Wobi, Fatimah, Agbonmwandolor, Joy Oghogho, Ekezie, Winifred, Hassan, Osama, Lal, Zainab, Kapilashrami, Anuj, Nellums, Laura and Pareek, Manish (2024). Discrimination, disadvantage and disempowerment during COVID-19:a qualitative intrasectional analysis of the lived experiences of an ethnically diverse healthcare workforce in the United Kingdom. International Journal for Equity in Health, 23 (1),
Abstract
Background: Healthcare workers (HCWs) in the United Kingdom (UK) have faced many challenges during the COVID-19 pandemic, some of these arising out of their social positions. Existing literature explicating these challenges (e.g., lack of appropriate PPE, redeployment, understaffing) have highlighted inequities in how these have been experienced by HCWs based on ethnicity, gender or, job role. In this paper, we move a step ahead and examine how the intersection of these social positions have impacted HCWs’ experiences of challenges during the pandemic. Methods: We collected qualitative data, using interviews and focus groups, from 164 HCWs from different ethnicities, gender, job roles, migration statuses, and regions in the United Kingdom (UK) between December 2020 and July 2021. Interviews and focus groups were conducted online or by telephone, and recorded with participants’ permission. Recordings were transcribed and a hybrid thematic analytical approach integrating inductive data-driven codes with deductive ones informed by an intersectional framework was adopted to analyse the transcripts. Results: Thematic analysis of transcripts identified disempowerment, disadvantage and, discrimination as the three main themes around which HCWs’ experiences of challenges were centred, based on their intersecting identities (e.g., ethnicity gender, and/or migration status). Our analysis also acknowledges that disadvantages faced by HCWs were linked to systemic and structural factors at the micro, meso and macro ecosystemic levels. This merging of analysis which is grounded in intersectionality and considers the ecosystemic levels has been termed as ‘intrasectionalism’. Discussion: Our research demonstrates how an intrasectional lens can help better understand how different forms of mutually reinforcing inequities exist at all levels within the healthcare workforce and how these impact HCWs from certain backgrounds who face greater disadvantage, discrimination and disempowerment, particularly during times of crisis like the COVID-19 pandemic.
| Publication DOI: | https://doi.org/10.1186/s12939-024-02198-0 |
|---|---|
| Divisions: | College of Business and Social Sciences > School of Social Sciences & Humanities > Sociology and Policy College of Business and Social Sciences > School of Social Sciences & Humanities > Centre for Health and Society College of Business and Social Sciences > School of Social Sciences & Humanities |
| Funding Information: | The authors would like to express their gratitude to the UK-REACH Collaborative Group for their role in acquiring the funding for this research. We would also like to thank all the healthcare workers who took part in this study when the NHS was under immense pressure. We wish to acknowledge the members of the UK-REACH Professional Expert Panel, the UK-REACH Stakeholder Group, and Heather Moorhead, Northern Ireland Confederation for Health and Social Services as well as the following people for their support in setting up the study: Kerrin Clapton and Andrew Ledgard (General Medical Council), Caroline Kenny (Nursing and Midwifery Council), David Teeman and Lisa Bainbridge (General Dental Council), My Phan and John Tse (General Pharmaceutical Council), Angharad Jones and Marcus Dye (General Optical Council), Charlotte Rogers (The Health and Care Professions Council), and Mark Neale (Pharmaceutical Society of Northern Ireland). We would also like to acknowledge the following trusts and sites who recruited participants to the study: Nottinghamshire Healthcare NHS Foundation Trust, University Hospitals Leicester, Lancashire Teaching Hospitals NHS Foundation Trust, Northumbria Healthcare, Berkshire Healthcare, Derbyshire Healthcare NHS Foundation Trust, South Tees NHS Foundation Trust, Birmingham and Solihull NHS Foundation Trust, Affinity Care, Royal Brompton and Harefield, Sheffield Teaching Hospitals, St George\u2019s Hospital, Yeovil District Hospital, Lewisham and Greenwich NHS Trust, Black Country Community Healthcare NHS Foundation Trust, Sussex Community NHS Foundation Trust, South Central Ambulance Service, University Hospitals Coventry and Warwickshire, University Hospitals Southampton NHS Foundation Trust, London Ambulance Trust, Royal Free, Birmingham Community Healthcare NHS Foundation Trust, Central London Community Healthcare, Chesterfield Royal Hospital, Bridgewater Community Healthcare, Northern Borders, County Durham and Darlington Foundation Trust, Walsall Healthcare NHS Trust. UK-REACH Study Collaborative Group Members aManish Pareek, Department of Respiratory Sciences, University of Leicester, UK (Chief investigator) bLaura Gray, Department of Health Sciences, University of Leicester, UK (Co-Investigator) cLaura B Nellums, Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, UK (Co-Investigator) dAnna L Guyatt, Department of Health Sciences, University of Leicester, UK (Co-Investigator) eCatherine Johns, Department of Health Sciences, University of Leicester, UK (Co-Investigator) fI Chris McManus, University College London Medical School, UK (Co-Investigator) gKatherine Woolf, University College London Medical School, UK (Co-Investigator) hIbrahim Abubakar, Faculty of Population Health Sciences, University College London, UK (Co-Investigator) iAmit Gupta, Oxford University Hospitals NHS Foundation Trust, UK (Co-Investigator) jKeith R Abrams, Centre for Health Economics, University of York, UK (Co-Investigator) kMartin D Tobin, Department of Health Sciences, University of Leicester, UK (Co-Investigator) lLouise Wain, Department of Health Sciences, University of Leicester, UK (Co-Investigator) mSue Carr, General Medical Council, UK (Co-Investigator) nEdward Dove, School of Law, University of Edinburgh, Edinburgh, UK (Co-Investigator) oKamlesh Khunti, Diabetes Research Centre, University of Leicester, UK (Co-Investigator) pDavid Ford, Population Data Science, Swansea University Medical School, Swansea, UK (Co-Investigator) qRobert Free, Department of Respiratory Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK (Co-Investigator) UK-REACH is supported by a grant (MR/V027549/1) from the MRC-UK Research and Innovation (UKRI) and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19. Core funding was also provided by NIHR Leicester Biomedical Research Centre. MP is funded by an NIHR Development and Skills Enhancement Award. LBN is supported by the Academy of Medical Sciences (SBF005/1047). This work is carried out with the support of BREATHE-the Health Data Research Hub for Respiratory Health (MC_PC_19004) funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. |
| Additional Information: | Publisher Copyright: © The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License http://creativecommons.org/licenses/by/4.0/. |
| Uncontrolled Keywords: | COVID-19 pandemic,Disadvantage,Discrimination,Disempowerment,Healthcare workers,Intersectionality; intrasectionalism,Health Policy,Public Health, Environmental and Occupational Health |
| Publication ISSN: | 1475-9276 |
| Data Access Statement: | The data for this study consists of interview transcripts of participants that<br/>contain potentially identifying and sensitive information. The data cannot<br/>be shared publicly due to concerns of participant confidentiality and ethics<br/>requirements. Participants consented to the study with the understanding<br/>that only de‑identified quotations would be made public, not the entirety of<br/>the transcripts. Therefore, only illustrative quotes from the transcripts have<br/>been included in this paper. Data for this study could be made available upon<br/>reasonable request to the UK‑REACH Data Access Committee (uk‑reach@le.ac.<br/>uk), which is the institutional email of the UK‑REACH project. |
| Last Modified: | 30 Jan 2026 08:05 |
| Date Deposited: | 17 Jun 2024 14:59 |
| Full Text Link: | |
| Related URLs: |
http://www.scop ... tnerID=8YFLogxK
(Scopus URL) |
PURE Output Type: | Article |
| Published Date: | 2024-05-23 |
| Published Online Date: | 2024-05-23 |
| Accepted Date: | 2024-05-14 |
| Authors: |
Gogoi, Mayuri
Qureshi, Irtiza Chaloner, Jonathan Al-Oraibi, Amani Reilly, Holly Wobi, Fatimah Agbonmwandolor, Joy Oghogho Ekezie, Winifred ( 
0000-0001-6622-0784)
Hassan, Osama Lal, Zainab Kapilashrami, Anuj Nellums, Laura Pareek, Manish |