Racism is a public health issue. This has been undeniable since the advent of the health inequalities movement. Yet, the increasing traction of the Black Lives Matter protests and their juxtaposition with the realities of the COVID-19 pandemic has brought it to the forefront of the world’s imagination.
In April, analysis by the Guardian found that 19% of patients who had died in hospital with COVID-19 were Black, Asian and minority ethnic (BAME). This was followed by an Office of National Statistics report on 7 May, which further confirmed the devastating reality that black people are more than four times more likely to die from COVID-19 than white people.
On 2 June, months after knowing the devastating impact COVID-19 was having on BAME communities, the government-ordered inquiry ‘Disparities in the risk and outcomes of COVID-19’ was released by Public Health England. It confirmed what was already known: British people from minority ethnic groups are the worst affected by COVID-19.
The inquiry failed to add anything new to the discussion. It stated that ‘these analyses were not able to include the effect of occupation […] comorbidities or obesity’. It made no attempt to analyse the underlying socioeconomic or health causes of the disparities. Its publication is a belated and symbolic gesture that accompanied by inaction will not contribute to improved health outcomes for BAME people.
An article in the Health Service Journal stated that a section from an earlier draft of the report which detailed contributions of over 1000 organisations and individuals on the underlying causes of the inequality had been removed, effectively censoring evidence of structural racism.
The report simply restated the outcomes without investigating solutions which shows that the government is complacent in the continued death of BAME people. The government is ignoring the influence of structural racism and relinquishing any responsibility that these outcomes could have been prevented with their intervention. This is not good enough.
So, why are more BAME people dying of COVID-19?
BAME people are more likely to be working in frontline roles, including healthcare. According to the Institute of Fiscal Studies over a third of black African people are employed in key worker roles. BAME people are more likely to live in housing which is poor quality or overcrowded and are overrepresented in homeless family figures. BAME people are more likely to live in cities and thus have greater reliance on public transport. These factors leave BAME people at increased exposure to coronavirus.
Ethnic minority groups experience poorer overall health, are more likely to have a long-term health condition, in addition to poorer access to and quality of healthcare services. This greater burden of disease increases their likelihood to die from COVID-19.
It is vital to also consider those who because of their immigration status have No Recourse to Public Funds – cannot receive welfare support, furlough payments or accommodation if they become homeless. Those in this situation, and their children, have no lifelines to maintain their health.
The underlying current of all these factors is socioeconomic disadvantage – poverty – as a result of racial biases that exist within the fabric of society and government policy.
The marginalisation, stress and poverty that accompany racial discrimination have profound effects on the health of BAME people. The effects of COVID-19 highlight the inextricable links between structural racism and health inequality.
Shared Health Foundation supports calls on the government to investigate causes of the stark inequalities in COVID-19 outcomes, claim responsibility for the lack of preventable action taken to protect BAME people’s lives, and offer solutions to build a more equal society.