Tackling Health Inequalities with and for the Deaf BSL-Using Communities in Wales

The Deaf British Sign Language (BSL) using community in Wales have more challenges than hearing populations in accessing healthcare services (especially in emergency situations), health information, mental health care services and support, and family-related services and training. The Deaf in Wales also suffer from inconsistent interpreting services and poor communication in many health-care settings and, as a result, are also at greater risk of underdiagnoses and under-treatment of chronic diseases and tend to have poorer health than the general population (Sign Health, 2019; Shank & Foltz, 2019; Foltz & Shank, 2020; Foltz et al., 2022). Deaf people also have an incidence of mental health problems that is twice as high as the general population and face barriers accessing support services (Terry et al., 2021). Research has shown that access to nature and outdoor activities is a health asset (Houlden et al. 2018; Rebar et al. 2015); however, many of Wales's cultural and natural assets are not accessible because materials are rarely available in BSL.

The goal of this project is to design, implement and evaluate Deaf-community-lead solutions for these known and documented health inequities and inequalities. We are a transdisciplinary team of academic and non-academic, hearing, and Deaf partners. Our project will use innovative social networking techniques, community outreach, focus groups, interviews, and custom video-based questionnaires and app technologies to identify sustainable, community-led, culturally, and linguistically driven solutions to improve the health and wellbeing of this community. We will then develop, implement, and evaluate these solutions in five areas that impact Deaf Welsh citizens' health and wellbeing. These areas are: (1) public health, (2) mental health, (3) interpreting services, (4) access to natural resources, parks, and use of natural environment resources and (5) language and communication.

In the areas of (1) public health, (2) mental health, and (3) interpreting services we will work with the Deaf community as well as the NHS, Health Boards, interpreters, and other service providers to develop culturally and linguistically driven proposals to improve services at every stage of the healthcare delivery process. Solutions will focus on access to interpreters and BSL language services and improving d/Deaf awareness with respect to language and culture and d/Deaf rights with respect to the law. In the area of (4) natural resources, we will develop BSL video guide apps for better accessibility to Welsh natural resources, parks, and heritage sites at three locations across Wales. In the area of (5) language and communication, the Welsh dialect of BSL, it's lexicon and regional variations, remains undocumented and undescribed. This project will develop an on-line dictionary and corpus resources, with a particular focus on medical terminology, to aid interpreters and service providers in Wales. We will assess the potential positive impact of the resources that we are developing as part of this project and use the results obtained from this project to inform and influence current local and national health care policy, services, practices, and delivery to aid compliance with the 2010 Equality and 2015 Well-being of Future generations Acts.