Inequalities and multiple discrimination in access to and quality of healthcare

Coordinated by  Professor Eleonore Kofman
UK Research Team: Alessio D’Angelo, Dr. Erica Howard, Dr. Mary Tilki,  Dr. Elena Vacchelli (Middlesex    University), Dr.    Margaret Greenfields (Buckinghamshire New University) and Professor Mark Johnson (De Montfort University, Leicester)

This project was commissioned by the European Union Fundamental Rights Agency in order to gain a better understanding of the particular vulnerabilities of persons at the intersection of ethnic origin, age and gender in access to health care. For this, fieldwork is being carried out in five EU-Member States: Austria, Czech Republic, Italy, Sweden and the United Kingdom. The research covers the analysis of existing literature and statistical evidence about inequalities in access to health care, including the legal context and a mapping of policy initiatives in the five EU Member States and at the EU level. The research is looking particularly at:

  • health conditions that have a disproportionate effect on individuals who may face discrimination;
  • identify barriers to health care services and
  • identify the ways in which health professionals address the care needs of persons belonging to vulnerable groups.

All objectives are assessed against the intersection of the grounds of age, ethnic origin and gender.

The full report was published by European Agency for Fundamental Rights in March 2013 on ‘Inequalities and multiple discrimination in access to and quality of healthcare.’ This report looks at how ‘multiple’ discrimination is addressed legally and examines relevant case law with a special focus on healthcare. It also explores health users’ and professionals’ views and experiences on how people of different gender, age, disability and ethnic origin experience discrimination and multiple discrimination when accessing the health system in Austria, Czech Republic, Italy, Sweden and the UK.

The report examines some of the practical barriers and experiences of unequal treatment in accessing healthcare that people may face because of a combination of their traits (e.g. ethnic origin, gender, age and disability). The report finds that in such cases, people and their legal advisors often have difficulties in bringing a complaint of discrimination on ‘multiple’ grounds to court. This is either because of a poor understanding of ‘multiple’ discrimination, or because legally it is simply easier to deal with a complaint on only one particular ground. In healthcare, moreover, lawyers often do not file complaints as discrimination cases, due to lower compensation compared to, for example, medical malpractice suits.

These findings will contribute to discussions on the adoption of the proposed EU ‘Horizontal Directive’, legislation that would extend equal protection against discrimination on age, disability, religion or belief and sexual orientation to all fields, including healthcare. They will also improve understanding of how ‘multiple’ discrimination is experienced and addressed in policy making, and through complaints procedures.

Download publications: