Health Inequalities – challenges to a self-management approach

by Noha Al-Afifi, Interim CEO, Arthritis Action

There’s no doubt from the ARMA Act Now report that the current tough economic environment is exacerbating inequalities in healthcare provision and access. With the scale of the task, it could be easy to get overwhelmed by the challenge. As important is that the report urges all to recognise the wider context and environment in which healthcare sits and to encourage small scale, localised action plans.

Helping both our members and the wider public to take control of their arthritis has inevitably led us to provide resources beyond health advice. One of the most visited areas of our website is our budgeting and benefits pages, such as access to PIP. It was no surprise that The Observer [1], in a recent piece of research, found that 40% of those with both osteoarthritis and inflammatory arthritis are turned down for PIP by tribunal on appeal. Many find themselves unable to pursue their claim to this level when the burden of proof needed is simply too much to navigate.

Addressing this, our new 3 Year Strategy [2] has at its heart the need to do more to reach diverse and difficult to reach groups. Our team have worked with community groups at a local level and larger organisations such as Emmaus and the YMCA to spread the self-management message through direct contact, events and meetings. We have also implemented an extensive programme of outreach via NHS Talking Therapies to highlight the toll pain plays on mental health.

A shared-ownership project to deliver services for those most in need was the starting point with our collaboration with partners from Good Boost, ukactive, Orthopaedic Research UK and ESCAPE-pain – the UKRI Leisure Centre Project. Working across almost 100 leisure centres in the UK, its aim was to reach out within local communities to those with arthritis and MSK conditions who struggle to actively exercise.

We know that this is only scratching the surface. For many, arthritis may be one of several health conditions they have [3], alongside environmental concerns such as poor housing, limited work opportunities, flexibility to make appointments, and accessible healthcare services, as identified in our most recent YouGov report [4]. These drivers need to be addressed, for self-management to be achievable. We will continue to assist people to minimise the impact of arthritis, through practical, health and exercise advice, whilst adapting our offering to meet the individual needs of those with arthritis, in these difficult times. In this way we hope that we can contribute to addressing these vital issues the Act Now report has raised.