This week our host is Sherri Kapadia @ot_withsherri_
As part of our OT Week activities, Sherri will host this week’s chat on
The role of research in supporting occupational therapists to achieve health equity
Eliminating health inequalities are a priority in effective occupational therapy practice. In their simplest form, health inequalities consider the variations in people’s health status, which encompasses life expectancy and disease prevalence (Kings Fund, 2020). The evidence reflects that drivers of such differences in people’s health stem from social factors including education, income, gender and ethnicity (World Health Organisation, 2018). Equally, it is important to acknowledge who health inequalities occur between. Four main factors in which health inequalities are typically analysed are: socioeconomic factors, geographical location, characteristic (including ones protected by the law such as race and disability) and socially excluded groups (Kings Fund, 2020).
For occupational therapists, tackling health inequalities has no defined pathway. However, we can begin by putting occupation at the centre of the solution. Occupational therapists may consider the impact that driving factors of health inequalities have on individuals’ engagement in occupation. For example, health management is an occupation outlined in the Occupational Therapy Practice Framework (OTPF; AOTA, 2020), and within this is communicating with healthcare systems. Occupational therapists may seek to understand the systemic and social barriers to accessing healthcare that different groups may face. Occupational therapists can identify strategies that lessen these barriers and enable these groups to participate in health management activities.
Alternatively, occupational therapists may consider the impact on participation that unequal health outcomes have on individuals’ engagement in occupation. Here, occupational therapist’s may seek to understand how a disease may influence a person’s participation in a particular occupation. For example, when interventions provided are not centred towards an individual’s needs, they may engage in occupations that temporarily reduce their symptoms but negatively impact their health in the long term. At this stage, occupational therapists may be well placed to help individuals manage their symptoms and find substitute occupations that can positively impact their health and lifestyle.
Research is a crucial factor in highlighting the role of occupational therapy in tackling health inequalities and ensuring occupational therapy interventions are adaptable and, therefore, equally effective on different individuals. It is well known that occupational therapists work with a diverse range of clients. However, it is not well known if our evidence base reflects the same diversity. Therefore, it is crucial to acknowledge the role of research in helping occupational therapists to bridge the gaps in health inequalities.
Furthermore, it is essential to acknowledge that the type of research needed to improve our understanding of health inequalities spans qualitative and quantitative methods. For example, the Richmond Group report, ‘You only had to ask: what people with multiple conditions say about health equity’, stated that statistical analysis between long-term conditions and socioeconomic status was evident. However, less research focused on exploring the lived experience of individuals facing these health inequalities (Richmond Group of Charities; Impact on Urban Health, 2021). This example reflects the need to analyse the impact of health inequalities from both an objective and subjective perspective.
Additionally, the systemic drivers of health inequalities require those with lived experience to be at the forefront of research efforts. Facilitating co-produced or community-led research may ensure that occupational therapy interventions produce equitable outcomes and are meaningful to different individuals and groups. Further research is required to trial new and old interventions with various groups, understand the occupational needs that are not being acknowledged, and thoroughly examine our role in preventative measures.
Through meaningful research, occupational therapists can enact significant change and be a part of providing equitable care for everyone. The questions below will hopefully provoke the conversation about conducting research in occupational therapy to support health equity for all.
- What role do you think research plays in supporting health equity? Do you have examples to share?
- What evidence do we need to build upon to create greater health equity? What new evidence should the OT profession generate which highlights and provides solutions to overcoming health inequalities?
- What methodological considerations do we need to address when designing and carrying out research which highlights and provides solutions to achieving health equity?
- Ethical research is essential. What ethical considerations might we need to consider when planning to research groups facing health inequalities?
- Health equity is an important issue. What are effective ways of disseminating new research in this area to ensure practicing OTs are aware of its findings and able to translate these findings into their practice?
American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), Article 7412410010. https://doi.org/10.5014/ajot.2020.74S2001
Kings Fund, Williams, E., Buck, D. and Babalola, G. (2020) What are health inequalities? Available at: https://www.kingsfund.org.uk/publications/what-are-health-inequalities (Accessed: 26/10/2021)
The Richmond Group of Charities and Impact on Urban Health (2021) You only had to ask
What people with multiple conditions say about health equity A report from the Taskforce on Multiple Conditions. Available at: https://richmondgroupofcharities.org.uk/sites/default/files/youonlyhadtoask_fullreport_july2021_final.pdf?utm_source=The%20King%27s%20Fund%20newsletters%20%28main%20account%29&utm_medium=email&utm_campaign=12554246_NEWSL_HWB%202021-08-09&dm_i=21A8,7H2X2,6W4S2E,UDUYQ,1 (Accessed: 26/10/2021)
World Health Organisation (2018) ‘Health inequalities and their causes’
Host: This week our host is Sherri Kapadia @ot_withsherri_
Support on OTalk Account: @preston_jenny
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