Ethnic minorities: policy context

Race Equality Framework for Scotland (REFS)

The Race Equality Framework for Scotland (2016-2030) sets out the Scottish Government’s approach to promoting race equality and tackling institutional racism and inequality between 2016 and 2030. In order to bring about positive changes to the systems and practices that sustain inequalities, even if these are unintentional, the values, biases, and behaviours that fuel prejudice must be identified, understood, and changed. This framework has a number of key principles at its foundation which are detailed here. Chief among these principles is the proposition to make it common knowledge to the Scottish public that race equality benefits everyone in society and Scottish society as a whole.  The purpose of the REFS is to help guide Scottish Government in developing education, health, and housing policies - to name just a few - with the aim of reducing racial and ethnic prejudice and bringing about a more equitable Scottish society. In developing the REFS Race Equality was conceptually guided by the Equality Act 2010.

Equality Legislation

The Equality Act 2010  has consolidated the previous legislation around preventing discrimination and improving equality of opportunity and good relations. The Act applies to both the private and public sectors, however there are additional provisions for the public sector and guidance has been published by the UK Home Office Equalities Unit. The previous legislation on ethnicity included the Race Relations (Amendment) Act (2000) , which amended the earlier Race Relations Act 1976.

Equally Well and Fair for All

In June 2008 the Scottish Government published Equally Well, the report of the ministerial task force on health inequalities. The aim of this project was to collect and review the growing body of scientific evidence of the upstream drivers of health inequalities. The purpose of this was to identify tangible actions that can be taken to help reduce inequalities in health and wellbeing in Scotland. The report focuses on a range of factors that contribute to unfair and unjust health inequalities such as income, age, disability, gender, as well as race and ethnicity. In regards to the latter two factors, the report recommended a review of data needs in relation to diversity (recommendation 74) and recommended that NHS targets should be set to support work on patient monitoring and collection of equalities data (recommendation 75). This data can be used to help inform us of the current profiles of health across ethnic groups in Scotland and to help track how these profiles change over time. The supporting papers (chapter 10) include a useful review of inequalities related to ethnicity.

The Scottish Government set up the Equalities Directorate in 2008 as a unit of NHS Health Scotland (now part of Public Health Scotland) and as a centre of expert advice and support to NHS Scotland on delivering equality and diversity, eliminating discrimination and reducing health inequalities. The Scottish Government then published the  Equally Well Implementation Plan in December 2008. Work previously done by NHS Health Scotland in the Equalities Directorate is now the responsibility of the Place and Wellbeing Directorate and Public Health Scotland.

To support policy implementation, NHS Scotland launched an Equality and Diversity Impact Assessment Toolkit in 2005.

In Scotland, the response to the murder of Stephen Lawrence and the subsequent Macpherson report (1999) included the 'Fair for All' policy initiative outlined in the Scottish Executive Health Department Letter 2002/51(111Kb). Requirements for the NHS in Scotland to provide appropriate religious and spiritual care for minority ethnic groups are set out in the Scottish Executive Health Department Letter 2002/76 (97Kb).

Addressing the needs of ethnic minorities is increasingly being set in the context of a broader equality and diversity agenda. This examines six "diversity strands": in addition to ethnicity these include age, gender, disability, religion and sexual orientation. These wider issues are summarised in a leaflet published in 2004 and entitled Fair for All, 2001 (100Kb).

 The Scottish Government published A fairer Scotland for all: race equality action plan and highlight report 2017-2021. It included action on key social determinants of health (employment, education, housing, poverty, community cohesion and safety) for minority ethnic communities. The Race equality action plan: final report was published in March 2021.

Equality Data

The Review of Equality Health Data Needs in Scotland arose from Equally Well recommendation 74 as mentioned above and was published in 2012. This review included a data audit matrix which helps to clarify what data is and isn’t collected by ethnic group. The Scottish Health and Ethnicity Research Strategy Steering group (SHERSS) was set up in December 2010 as recommended by the Health in Our Multi-ethnic Scotland report. SHERSS revised its strategy in 2014 and changed its name to the Scottish Migrant and Ethnic Health Research Strategy group (SMEHRS) to reflect a new strategic focus to include migrant health research. 

In 2022, the Scottish Government published updated guidance for public bodies on collecting data on the ethnicity of people in Scotland. This includes recommended questions, guidance for interviewers and guidance on the analysis and presentation of results. The new ethnicity categories for use in Scottish Morbidity Record (SMR) returns which collect hospital discharge data can be found in ISD's data dictionary. 

Equality Research

SHERSS made its first annual report in December 2011, and its second annual report for 2012 was published in in 2013. As the renamed 'SMEHRS', the group released its combined Report  (2013) and Strategy 2014-19  in 2014. The 2015 report has now been published also, it and subsequent reports are available through the SMEHRS website. The 2015 report has also now been published, through the SMEHRS website.

In November 2009 NHS Health Scotland published Health in our Multi-ethnic Scotland. This report set out a proposed strategy for research on the health of ethnic minorities in Scotland. 

A useful summary of recent key demographic research is available in a report: The changing ethnic profiles of Glasgow and Scotland, and the implications for population health  540KB (Walsh, 2017)

COVID-19 and ethnic minorities

In June 2020, the Scottish Government established an Expert Reference Group on COVID-19 and Ethnicity to consider and inform its approach in relation to the impacts of COVID-19 on minority ethnic communities. In March 2022, Public Health Scotland published a report compiling the data and evidence on this, and noted the need for further action.