The Public Health Research (PHR) Programme would like to draw researchers’ attention to the commissioning brief below, which was first advertised in June 2023. This is a brief that we have previously advertised as a commissioned funding opportunity. We are still interested in receiving applications in this research area, as it remains a priority in our portfolio. However, please note that the commissioning brief, along with the underpinning literature searches, has not been updated since originally written.
Research question
- For people from ethnic minority backgrounds in the UK, what is the impact on health inequalities of interventions that influence the wider determinants of health?
The Public Health Research (PHR) Programme wishes to fund a number of research studies on the topic of health inequalities related to ethnicity in the UK. It is recognised that this topic is broad in scope, multifaceted, and involves complex issues including those of intersectionality. It is not possible to cover all aspects of this topic in one research call, and this commissioning brief is therefore one of several that are planned.
Linking together the research we hope to fund on this topic is an acknowledgement that a key underlying mechanism that heightens health inequalities is that of structural (institutional) racism and the systemic discrimination faced by people in UK society who are from ethnic minority backgrounds (also termed ethnic minority groups).
Through this commissioning brief, the PHR Programme invites research applications that propose to evaluate interventions that have the potential to impact health inequalities – and which do this through influencing one or more of the wider determinants of health experienced by people from ethnic minority backgrounds in the UK.
The wider determinants of health – or social determinants of health – as described by the Office for Health Improvement and Disparities (OHID) are a diverse range of social, economic, and environmental factors that impact people’s health. In turn, the local, national, and international distribution of power and resources impact these wider determinants and shape the conditions of our daily lives.
The ‘10-years-on’ report of the Marmot Review found that the health of people living in more deprived areas had worsened and inequalities increased. Addressing the wider determinants of health will help to improve health outcomes for disadvantaged populations – including people from ethnic minority backgrounds, who are disproportionally affected by socioeconomic deprivation.
All factors that can be considered wider determinants of health are in scope for this research call. Commercial determinants of health linked to industry actions – both positive and negative with respect to their influence on health – together with state benefit entitlements and their uptake by people from different ethnic minority backgrounds, are also in remit for this call.
Please note that individual- or micro-level interventions seeking to address ways in which people might negotiate barriers encountered due to prejudice or structural racism are not in remit for this call. An example of such an intervention might be a training or mentoring scheme designed to help people who identify as having an ethnic minority background to succeed with job interviews. Similarly, researchers seeking to evaluate interventions that operate within a deficit model of engagement (in which a deficiency of knowledge or personal effort is assumed) are not in keeping with a focus on addressing wider determinants of health as a driver of inequalities, and such proposals are not sought.
Researchers could consider evaluating new interventions, existing interventions that might be modified or culturally adapted based on ethnicity, or interventions already occurring as a natural experiment. Applicants are encouraged to be targeted in their chosen approach, focusing their research on one or more specific ethnic minority group(s) and wider determinant(s) of health. The Figure presented here is intended to assist potential applicants in thinking through their proposal and domain(s) of choice. It will be important for applicants to strike a balance between being appropriately targeted with regard to the choice of group – characterised by ethnicity or ethnicities – that represents the study population, while seeking to generate research findings that are generalisable. Researchers will need to provide justification for their approach, but are welcome to contact the PHR Programme to discuss before applying.
Applicants might choose to focus on one or more wider determinants of health (represented by the columns) and one or more ethnic minority groups (represented by the rows), when proposing evaluative research of an intervention in response to this call. It is suggested that proposals focusing on one cell of this matrix, or a small number of cells (potentially up to one column or one row) would yield research that strikes a balance between being appropriately targeted and providing generalisable findings. Applicants must justify their proposed focus in their application. The figure is a representation only, intended to aid potential applicants in conceptualising this research call, and should be read in conjunction with all the information provided in this commissioning brief.
It is acknowledged that terminology used in relation to ethnicity varies. Preferences regarding terminology may differ both within and between groups of people who have a shared identity as it relates to ethnicity, and language in this space is both dynamic and evolving. For the purpose of this call, ethnic minority groups are defined as groups comprising people who do not identify as White British or White Irish. Ethnic groups meeting this definition, with reference to ONS Census categories, include:
- Asian or Asian British
- Black, Black British, Caribbean or African
- Mixed or multiple ethnic groups
- Other ethnic groups
People who identify as white but not as White British or White Irish – for example Gypsy, Roma, or Irish Traveller populations – are considered in scope for this call.
In some cities and local geographies in the UK, people identifying as White British are in the minority – however, such groups are not in scope for this call.
The term ‘minority’ as used in this brief is used in reference to the overall demographic composition of the UK, in which the majority of the population identify as White British. It is acknowledged that classifications of ethnicity may vary, and potential applicants with queries about remit are encouraged to contact RSS Specialist Centre for Public Health or the PHR Programme to discuss.
Research areas of interest for this call could include (but are not limited to) evaluation of interventions that:
- have an effect on inequalities in access to the natural environment (including green and blue space and the opportunity for physical activity) for people from an ethnic minority group
- influence the impact of poor quality housing (or other issues related to housing) on the physical and mental health of residents from different ethnic minority groups, including for tenants in rented accommodation and for those whose housing situation is unstable
- impact unemployment and under-employment which in turn impacts the mental and/or physical health of working-age people from different ethnic minority groups
- address the working environment (including workplace culture) and workplace health of employees from different ethnic minority backgrounds
- impact air quality in geographical areas that have, for example, a high population density of inhabitants from different ethnic minority backgrounds
- are, or could be, culturally adapted to different ethnic minority groups
- seek to act by improving engagement and communication between different sectors (for example of the economy or government) that collectively influence the wider determinants of health as they relate to people from ethnic minority backgrounds.
Primary outcomes must be health related. For this call, the PHR Programme will accept other outcomes, as long as the link to health can be justified.
Successful applications must clearly demonstrate the following:
- a plan for meaningful engagement with relevant ethnic group(s) for each phase of the study including outputs
- an impact pathway that engages with individuals who are likely to use the research outputs
- a dissemination plan to maximise the impact and benefits of the research findings
Applicants submitting proposals against this call may use a range of study designs, methods, and outcome measures. Researchers will need to identify and justify their chosen methodological approach and specify key outcomes and how these will be measured in the short, medium, and long term.
Understanding the value of public health interventions – whether the outcomes justify their use of resources – is integral to the PHR Programme, where resources relating to different economic sectors and budgets are potentially relevant. The main outcomes for economic evaluation are expected to include health (including health-related quality of life) and the impact on health inequalities as a minimum, with consideration of broader outcomes welcomed. Different approaches to economic evaluation are encouraged as long as they assess the value and distributive impact of interventions. Applications that do not include an economic component should provide appropriate justification.
Researchers must ensure that interventions are culturally competent and are planned, designed, and implemented with the people who will be using them (co-produced). The PHR Programme welcomes involvement from target population groups and from relevant organisations in the design of the evaluation and in the research team. We will consider inclusion of such experts as costed members of the study team if appropriately justified. Researchers should demonstrate the relevance of their proposed research to key stakeholders including, for example, local and national decision-makers, members of relevant population subgroups, community leaders, local government public health teams, and other relevant stakeholders. Researchers are expected to be aware of ongoing work or research in this area, and ensure their proposed research is complementary.
For further information on submitting an application to the PHR Programme, please refer to the Stage 1 guidance notes and PHR supporting information.