Marginalisation, Healthcare and Distrust - New Approaches for Supporting Local Authorities
Written by Paul Addae and Dr Shaun Danquah Feb 07, 2022

Categories: Blog, CR Blogs, Literature Reviews



Centric comprises people with lived experience and upholds a collaborative research ethos for working in partnership with marginalised communities to co-design interventions and services which can minimise risks and offer tangible and innovative solutions in healthcare. Marginalised patient groups are particularly vulnerable to experiencing a variety of patient safety issues which indicate the gaps (Cheraghi-Sohi et al., 2020). Marginalised populations sitting outside of mainstream society experience severe health inequities, as well as an increased risk of experiencing patient safety incidents.

Recent work conducted by Centric around health inequalities and disparities has identified apathy, distrust and weariness within marginalised communities. However, Centric community researchers were able to establish trust and a rapport with participants. Participants became more comfortable in discussing their healthcare experiences.

This has resulted in the most marginalised individuals contributing much more to the research. The Centric approach is therefore vital when looking at processes and initiatives to restore trust in healthcare. Hui et al. (2020) suggest that the organisational structures, policies and practices in healthcare may disadvantage marginalised groups in the UK. This also indicates that organisational structures must shift in terms of hearing black and minority community voices and adjusting their governance processes to be more reflective of the communities they serve. Hui et al. (2020) note that marginalised communities often face significant barriers to receiving basic health and social care, and find it challenging to access healthcare provision more so than the white majority population. Health and social inequalities are hence present in inpatient and community settings and in multiple ways which have led to further exclusion, disadvantage and isolation.

Local authorities can often damage relationships with sections of their communities if there is a sense that there is no avenue for consultation, little recourse for feedback and when there is a general feeling that locals are being held in contempt in lieu of the ideas of ‘experts‘. Deferring to expertise thinking is of course always necessary but it should have an equal seat around the table alongside local community knowledge and lived experience to ensure that there is not an imbalance of power.

This is all the more pertinent when it comes to health-related interventions, behaviour change and public health strategy. In discussions we have had with Dr. Maya Goldenberg (2021), it has been revealed the lack of local community knowledge can in some instances reinforce the current crisis of epistemic trust.

Centric possesses:

  • The ability to harness a social network of suitable participants across the urban locale.
  • Community researchers who possess social currency and utilise ACP (accessibility, credibility and positionality).
  • Fresh perspective to research, data collection, analysis and interpretation.
  • A new approach to systems change and exploring offstage hidden transcripts within urban and offstage counter-public spheres.
  • Bespoke processes able to explore public health engagement at its roots and to develop steps for credible co-produced solutions, equitable interventions and collaborative initiatives.

We are using this very approach, alongside Dr. Caitjin Gainty (Kings College London) and Dr. Agnes Arnold-Forster (London School of Tropical Medicine), to explore health nuances within counterpublic health spheres and also local community health innovation.

If any of the subject matters above interest you, please get in touch!





Further Reading

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Health Activism in Brixton – Real Talk

Feb 07th 2022


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Medical Scepticism – Case Study

Feb 07th 2022

Sanaa Khan - Community Researcher

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Shifting Power and Individual Agency in Urban Healthcare

Feb 07th 2022

Tracey Kirungi -

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