Key messages

• community health worker programmes and participatory care pathway design show promise in improving outcomes
• culturally tailored education, multilingual tools and peer-supported skills-building interventions are effective for managing chronic conditions
• integrating mental health and primary care improves access and outcomes for ethnic minority populations
• generic quality improvement approaches also benefit ethnic minority groups
• structural interventions, including minimum wage policies and links between care, housing and financial support, address wider social determinants.

Policy implications

• service design should include participatory approaches that involve ethnic minority communities
• culturally tailored and multilingual interventions should be embedded within routine provision
• integration between mental health, primary care and community services may reduce access gaps
• action on wider social determinants is likely to be necessary alongside service-level change.

Gaps

• relatively few studies examine structural or socio-economic interventions
• limited evidence on how anti-racist interventions translate across health and social care settings
• lack of long-term evaluation of system-level interventions.

Commentary
This review highlights the importance of equity-driven approaches that explicitly address barriers faced by ethnic minority populations. While a wide range of interventions is covered, the evidence base remains weighted towards service-level change rather than structural action.

Participatory approaches, including community health worker programmes and co-designed care pathways, are identified as particularly promising. These approaches centre lived experience and help ensure that services reflect the cultural, linguistic and social contexts of the people they aim to support.

Culturally tailored education, multilingual tools and peer-supported interventions are shown to improve outcomes for people managing long-term conditions. In social care, similar approaches may help people navigate complex systems and reduce exclusion linked to language or cultural mismatch.

The review also highlights the benefits of integrating mental health and primary care. From a care equity perspective, joined-up provision may reduce fragmentation that disproportionately affects marginalised groups and improve continuity of support.

However, the limited focus on structural interventions points to an important gap. Addressing inequities in health and social care is likely to require action beyond services alone, including policies that tackle poverty, housing insecurity and financial stress, which shape people’s ability to access and benefit from care.