Ethnic disparities in awareness, engagement and acceptance of NHS health checks: a community-led participatory study in Birmingham, UK

Safi, Ayazullah and Jadhakhan, Ferozkhan and Hossain, Muhammad (2026) Ethnic disparities in awareness, engagement and acceptance of NHS health checks: a community-led participatory study in Birmingham, UK. Discover Public Health, 23 (1). ISSN 3005-0774

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Abstract

Introduction

Cardiovascular disease (CVD) remains the leading cause of mortality globally and in the United Kingdom (UK), with disproportionate burdens among Global Majority and migrant populations. Despite the introduction of the National Health Service (NHS) Health Check programme to support early detection and prevention of CVD among adults aged 40–74, uptake remains uneven, particularly among those from the Global Majority heritage. This study aimed to explore how diverse ethnic communities in Birmingham, UK perceive, engage with and access NHS Health Checks.

Methods

Using a community-based participatory action research (PAR) approach, we partnered with ten local community organisations to co-design, co-facilitate and interpret focus groups on NHS Health Checks. Twenty-two focus groups were conducted with 180 participants across ten global majority communities (Arab, Bangladeshi, Black Caribbean, Chinese, Ghanaian, Indian, Nigerian, Pakistani, Somali and White British). Data were analysed inductively using NVivo 12, supported by sensitising concepts related to awareness, access, engagement and cultural relevance.

Results

Five major themes were identified: (1) Awareness and Understanding, characterised by confusion about the purpose of Health Checks and low awareness in several communities; (2) Cultural and Linguistic Barriers, including English-only communication, gender norms and culturally embedded reactive health behaviours; (3) Uptake Variations by Ethnicity, demonstrating substantial intra-ethnic and gender differences; (4) Trust and Previous Experiences, where both negative and respectful encounters shaped willingness to engage; and (5) Structural Access Barriers, including inconvenient appointment times, complex booking systems and limited community-based provision.

Discussion and conclusion

NHS Health Check uptake disparities reflect intersecting cultural, linguistic, experiential and structural influences rather than individual reluctance. Findings highlight the need for culturally tailored communication, gender-sensitive delivery, community-based models and improved ethnicity data granularity.

Item Type:	Article
Identification Number:	10.1186/s12982-026-01676-w
Dates:	Date Event 2 March 2026 Accepted 15 March 2026 Published Online
Uncontrolled Keywords:	NHS Health Check, Cardiovascular disease prevention, Ethnic minority health, Global Majority, Participatory Action Research, Health inequalities
Subjects:	CAH02 - subjects allied to medicine > CAH02-06 - allied health > CAH02-06-04 - environmental and public health
Divisions:	Life and Health Sciences > Life and Sports Sciences
Depositing User:	Gemma Tonks
Date Deposited:	14 May 2026 12:21
Last Modified:	14 May 2026 12:21
URI:	https://www.open-access.bcu.ac.uk/id/eprint/17043

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