Factors Contributing to Delays in Health-Seeking Behaviours Among Pakistani Communities in Sunderland

Background: Health inequalities persist among UK ethnic minorities, with Pakistani communities experiencing pronounced delays in health-seeking behaviour (HSB), leading to poorer outcomes. Even though national studies have highlighted broad barriers for Black, Asian, and Minority Ethnic (BAME) groups, there is a critical lack of nuanced, qualitative research that focuses on specific subgroups, specifically the Pakistani community, in understudied, high-deprivation contexts like Sunderland. This study aimed to explore the cultural, social, and structural factors contributing to delays in health-seeking behaviour among adults within the Pakistani community in Sunderland, UK.

Methods: A qualitative, interpretivist phenomenological design was employed. Semi-structured interviews were conducted with Pakistani community aged 24-50, including healthcare professionals. Data were analysed using Braun and Clarke’s reflexive thematic analysis facilitated by NVivo software.

Results: Three key themes were identified: (1) Navigating the Healthcare System, where complexities, digital exclusion, and nuanced communication barriers (medical jargon, accents) impeded access; (2) Generational Tensions, revealing a divide between traditional, fatalistic health beliefs in older generations and more proactive, health-literate attitudes in young generation, especially UK-raised youth; and (3) Systemic Delays and Trust Erosion, where pervasive NHS waiting times, perceived discrimination, and dismissive care experiences fostered distrust and led to medical tourism.

Recommendations: Incorporate co-designed Health System Navigators into high-need GP practices. Ensure communication is accessible by using multilingual and plain English and provide staff training focused on cultural safety and clear speech to minimize jargon and accent barriers.

Conclusion: Delays in health-seeking behaviour are a rational response to overlapping cultural practises and systems failure, and not patient choice. The erosion of trust is a vital consequence.