Racism and social inequality have contributed to the increased risk of black, Asian and minority ethnic communities (BAME) contracting and dying from Covid-19, according to a new study.
The report from Public Health England (PHE) based on stakeholder engagement with 4,000 people found that historic racism may mean people are discriminated against when it comes to personal protective equipment (PPE) and may result in people from BAME backgrounds being less likely to seek care or demand better protection.
It also points to a raft of recommendations from stakeholders, including the need to develop “occupational risk assessment tools that can be employed in a variety of occupational settings and used to reduce the risk of employee’s exposure to and acquisition of Covid-19”.
This is especially true for BAME workers in health social care and on the front line in occupations that put them at higher risk, it said.
The Institute Fiscal Studies previously found that more than two in ten black African women of working age are employed in health and social care roles and while the Indian ethnic group makes up 3% of the working-age population of England and Wales, they account for 14% of doctors.
The report added: “Ethnic inequalities in health and wellbeing in the UK existed before Covid-19 and the pandemic has made these disparities more apparent and undoubtedly exacerbated them.
“The unequal impact of Covid-19 on BAME communities may be explained by a number of factors ranging from social and economic inequalities, racism, discrimination and stigma, occupational risk, inequalities in the prevalence of conditions that increase the severity of disease including obesity, diabetes, cardiovascular disease and asthma.
“Unpacking the relative contributions made by different factors is challenging as they do not all act independently.
“The engagement sessions highlighted the BAME group’s deep concern and anxiety that if lessons are not learnt from this initial phase of the epidemic, future waves of the disease could again have severe and disproportionate impacts.”
The Government's failure to publish this review is yet another in a litany of failures to support BAME communities during Covid-19.
Black lives matter is more than just a slogan, we cannot wait any longer for action to tackle racial injustice.https://t.co/u5jA8aM9rd— I Can’t Breathe...Marsha de Cordova MP (@MarshadeCordova)June 11, 2020
Labour had criticised the government’s lack of openness over the report, which had been eagerly awaited at a time of concern over the disproportionate number of deaths among BAME people.
At the weekend, shadow justice secretary David Lammy said it was a “scandal” that the recommendations in the study had been “buried”.
It comes after the Government was accused of holding back this second PHE report when a first report on the issue was published at the start of June.
The first report looked at why people from BAME communities may be at higher risk from Covid-19 but made no recommendations and made no reference to the 17 sessions held with stakeholders.
The British Medical Association (BMA) sent a letter to Health Secretary Matt Hancock on Saturday asking why the pages with recommendations had been “omitted” from the first report.
The latest report says that stakeholders “expressed deep dismay, anger, loss and fear in their communities about the emerging data and realities of BAME groups being harder hit by the Covid-19.”
Stakeholders pointed to the racism and discrimination experienced by BAME key workers “as a root cause affecting health, and exposure risk and disease progression risk”.
The study said there are issues around stigma and BAME fears of being diagnosed with coronavirus.
It added: “For many BAME groups, lack of trust of NHS services and healthcare treatment resulted in their reluctance to seek care on a timely basis, and late presentation with disease.”
Stakeholders called for immediate action in areas such as housing to reduce inequalities, and “targeted messaging on smoking, obesity and improving management of common conditions including hypertension and diabetes”.
Other recommendations include:
- Better data collection about ethnicity and religion, including having this recorded on death certificates;
- Making it law for health risk assessments to be carried out for BAME workers;
- Culturally sensitive public health messaging so that people, particularly those who may not speak English as a first language, can follow advice on how to protect themselves from Covid-19.
The report did not look at whether genetics plays a role in BAME risk.
