Gender inequalities in social support and access to healthcare for cardiovascular risk prevention in the Pakistani community, UK: a qualitative study.

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The problem

Cardiovascular disease (CVD) and associated mortality is high amongst the South Asian community, especially for Pakistanis compared to the general population.Furthermore, social barriers such as a low socio-economic status, limited education and gender inequalities that can present a challenge towards living a healthy lifestyle are present within the Pakistani community.

The approach

A community-based qualitative study design was used, with the application of the social capital theory to develop a better understanding of how social networks function as a resource for support and information in developing behaviours associated with CVD prevention. Questions were asked with regard to social network, trust and cultural norms in relation to diet and exercise for preventing CVD. Research advocates in business districts, third sector organisations and social media facilitated recruitment in the West Midlands. Word-of-mouth advertising and feedback from community members to inform lay-led posters was used to facilitate the recruitment process. Forty-two participants were interviewed (20 men, 22 women) and the convoy model task was used to illicit responses on social networks. Participants were from diverse educational, occupational and migrant backgrounds.


Thematic analysis provided insight into the perceptions and experiences of members of the Pakistani community. Gender inequalities were identified when accessing health information and sources of support. Social network, trust and cultural norms differed for men and women from different generations when seeking healthcare support.Women expressed views about marginalisation within their homes and community, resulting in limited support and influence over their social networks. This translated into healthcare settings where second and third generation women felt stereotyped by their GPs, resulting in limited interaction with healthcare providers. Conversely, first generation migrant men and women approached their GPs for medical advice regularly and relied on them as primary sources for health and support.Consequence Recommendations can be made for health professionals to consider a more socially and culturally contextualised patient-centred approach prior to advising patients on CVD prevention. By understanding the shifting perceptions of health in relation to culture and ethnic-identity, primary care practitioners can have a better-informed idea of how to advise patients from high-risk backgrounds.Wider community engagement for patients can also provide greater social sources of support and information for pursuing (at times) non-traditional, healthier lifestyles.


  • Farina Kokab
  • Sheila Greenfield
  • Paramjit Gill