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What is the TIDES study?

The Tackling Inequalities and Discrimination Experiences in health Services (TIDES) study will investigate how discrimination experienced by both patients and healthcare practitioners may generate and perpetuate inequalities in health service use. Using questionnaires and in-depth interviews, the study aims to (1) highlight ways in which healthcare practitioners can help reduce discrimination experiences and (2) develop an intervention framework to reduce discrimination in healthcare settings.

Why is the TIDES study important?

The TIDES study is important for understanding how differences in social status, such as gender, ethnicity, migration status and social class, can create barriers between patients, practitioners and healthcare systems. Both patients and healthcare practitioners may experience bias, stereotyping and discrimination. These experiences are likely to have an impact on healthcare practitioners’ job satisfaction and patients’ access to services and quality of treatment. Gaining healthcare practitioners’ perspectives on discrimination experiences will be vitally important for understanding why some patients may receive differential treatment or avoid using health services.

What is discrimination?

Discrimination is unequal treatment of persons or groups. People may experience discrimination based on their race, ethnicity, religion, age, gender, socioeconomic status, sexual orientation, migration status or mental health status.

Why is it important to tackle discrimination in healthcare?

Discrimination, whether it is directly experienced or anticipated, can stop someone from seeking help because they fear or mistrust health service practitioners. This causes people to stop using healthcare services and can lead to avoidance of these services in the future which can have a negative impact on their health outcomes. Discrimination can also cause psychological and physical stress responses which can have a damaging effect on health. The TIDES study is important in reducing discrimination in healthcare settings and improving service engagement among disadvantaged groups.

What does the TIDES study involve?

The TIDES study will involve four interrelated projects.

  • Project 1 will use survey data and electronic health records to investigate inequalities in health service use.
  • Project 2 will use the findings from Project 1 to facilitate conversations with healthcare practitioners about both experiencing and witnessing discrimination to see what impact these experiences have on inequalities in health service use.
  • Project 3 will build on the findings from the first two projects to look at how healthcare practitioners interact with patients in virtual reality environments.
  • Project 4 will involve talking to a range of stakeholders including carers, service users, healthcare practitioners, community members and policy makers about the findings from Projects 1-3. Stakeholders will review evidence, set priorities and develop guidance for an intervention framework to tackle discrimination experiences and inequalities in health service use.

Public engagement

We have planned a number of public engagement events with the Health Inequalities Research Network (HERON) to showcase our findings. Events included two HERON Conferences, photography workshops exploring discrimination experiences, as well as research roadshows where we presented findings at various public venues to engage directly with local communities.