411 How do we develop inclusive healthcare services that account for structural and systemic factors? - OP 14 - Lessons from a qualitative study on the lived experience of navigating health services as a Black person living with stroke in England

Sep 30, 2026

Focuses on developing inclusive healthcare services that address structural and systemic factors, drawing on qualitative evidence from England. Examines perceptions and lived experiences of Black people living with stroke (BPLS) and how they navigate health services, considering disparities in stroke incidence, earlier onset, and adverse outcomes. Reports barriers during access, including lack of provider recognition, disbelief, delayed care, cultural and age misalignment, stigma, limited representation, and distrust shaped by microaggressions, stereotyping, and racism. Concludes with practice implications for systemic cultural safety and humility education, community engagement, advocacy, stigma reduction, and trust building.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Background

Methods

Results

Conclusion

vi42 European Journal of Public Health, Vol. 35, Supplement 6, 2025 Abstract citation ID: ckaf180.116 411 How do we develop inclusive healthcare services that account for structural and systemic factors? Lessons from a qualitative study on the lived experience of navigating health services as a Black person living with stroke in England Tushna Vandrevala1, Liz Livingstone1, Jo White2 1 Kingston University, Kingston, United Kingdom 2University of West England, Bristol, United Kingdom OP 14: Health Services 3, B302 (FCSH), September 3, 2025, 17:00 - 18:00 Background: Black people are twice as likely to experience stroke, with first stroke occurring earlier and more likely to experience adverse outcomes that White people. Clinical factors and socio-economic status account for some of this increased risk, suggesting that structural and systemic factors are also involved. Methods: The aims of this study was to gain greater understanding of how Black people living with stroke (BPLS) in the UK perceive and experience health care services. Twenty semi-structured interviews were conducted with those living with stroke identifying as African, Afro-Caribbean or of mixed heritage. Results: Findings highlighted that BPLS experience a plethora of barriers while accessing services including healthcare providers (HCPs) failing to acknowledge risk or symptoms, not being believed, leading to delay in seeking treatment. While navigating the system as a Black person, they found that services were misaligned with their culture or age. Participants rejected services due to distrust of treatment, stigma associated with seeking support, lack of representation and previous negative experiences, such as microaggression, stereotyping and racism. Conclusion: Implications for practice will be discussed including the need for a systemic approach to developing cultural safety and humility education, community engagement to improve access to equitable services, advocacy to navigate service, overcoming stigma and building trust.

FAQs

What structural and systemic factors does the study connect to stroke disparities?

The study notes that clinical and socio-economic factors explain only some increased risk, indicating that structural and systemic factors also play a role in differences between Black and White people.

How was the qualitative study conducted?

Twenty semi-structured interviews were conducted with Black people living with stroke who identified as African, Afro-Caribbean, or mixed heritage.

What barriers did participants report when accessing health services?

Participants described multiple barriers, including healthcare providers failing to acknowledge risk or symptoms, not being believed, delays in seeking treatment, and services misaligned with their culture or age.

What practice implications are recommended?

The study calls for systemic approaches to cultural safety and humility education, community engagement to improve access to equitable services, advocacy to navigate service use, overcoming stigma, and building trust.

Sep 30, 2026

Uploaded by Aria Callaghan