Coronavirus has hit everyone hard, with far more deaths and serious health ramifications than anyone could have anticipated. Despite that, however, it’s non-white communities who seem to have experienced the most devastating impact of the virus. Why is that? Public Health England (PHE) has just released a report looking into the impact of Covid-19 on BAME groups to establish exactly why so many more people of colour have died or suffered serious complications.
- Bangladeshi communities have twice the risk of death compared to white British
- Caribbean, Chinese, Indian, Pakistani, and other Back and Asian communities have up to 50% higher risk of death from coronavirus, compared to white British
- People from BAME backgrounds are more likely to work in key worker roles – making them more vulnerable
- Economic disadvantage puts people more at risk
- Severe mental illness is a risk factor for Covid-19 that has been overlooked by the Government’s response
While coronavirus has killed people of all ages, genders, races and social stratas, it is a fact that not everyone is affected equally. Older age and being male are both associated with a higher risk of infection, severe symptoms and death. Scientists are still working to prove that androgens (any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics) play a role in coronavirus development after two Spanish studies found that an overwhelming number of patients in coronavirus hospital wards had male pattern baldness. Age seems an obvious factor in one’s ability to fight off infection; the older you are, the less robust your immune system may be.
But the two other key elements in how ill we get with this novel disease seem to be where we live and where our ancestors hailed from – indicating that class, income and race are deciding factors in the treatment and attention we can expect to receive.
So, why are BAME communities more at risk?
The current conversation around race in the UK is nothing new; BAME communities have been fighting racial discrimination for generations. Poor experiences of healthcare (Black women are five times more likely to die in childbirth, for example) and municipal services and authorities have led to people being less likely to seek help. NHS staff, this report claims, are less likely to speak up about issues with personal protective equipment than white colleagues.
As PHE says, ‘Covid-19 did not create health inequalities but rather the pandemic exposed and exacerbated long-standing inequalities affecting BAME groups in the UK.’
Fears of diagnosis and death, as well as previous negative experiences of dealing with the NHS, stopped people from BAME backgrounds from taking up opportunities to get tested for coronavirus. As we all know, the sooner the disease is detected, the better contained and treated it is. A total lack of trust in the available healthcare services has caused coronavirus carnage in non-white communities – something PHE suggests that faith communities may be best placed in reversing.
Non-white people are more likely to work in occupations with higher risk and are more likely to use public transport to get to work. Like Belly Mujinga, the station worker who died from Covid-19 after someone apparently spat at her, BAME communities often work in key worker positions that offer little in the way of protection from the public. The PHE report also found that a lack of personal protective equipment (PPE), workplace risk assessments, bullying and racism also made workplaces potentially dangerous hotspots of infection for people of colour.
The report suggested that housing challenges may exacerbate the situation, particularly as ethnicity and income inequality are associated with death from coronavirus. According to the annual report by the Social Metrics Commission, published this week, nearly half of BAME households are living in ‘deep poverty’ in the UK, compared to just one in five white households. Perhaps it’s no great surprise then these communities are more at risk of serious illness, when poverty can often mean living in inadequate housing, malnutrition and poor access to open green spaces – all the things that go towards general good health.
Severe mental health
PHE mentioned that severe mental illness is a much under-reported risk factor for Covid-19. That matters because we are in the midst of a BAME mental health crisis. According to the charity Mind, Black people are six times more likely to be incarcerated in mental health facilities than white people. 23% of mental health inpatients are Black (3% of the UK population is Black). We also know that coronavirus has had a more detrimental impact on BAME youth mental health than on white peers.
What needs to be done
PHE concludes that change needs to be ‘large scale and transformative’ in order to change the structural and societal environments of homes, neighbourhoods and workplaces. This isn’t an individual issue – it’s a systemic problem that affects every part of life. It sets out a number of strategies and recommendations for creating healthy and supporting workplaces that have a zero-tolerance or racism. Trust between local communities and healthcare services has to be rebuilt and we’ve got to work at making BAME people feel more comfortable and confident when using health services post-Covid-19.
The body set out seven ideas for reducing the racial gap, following the coronavirus crisis:
- Make ethnicity data collection mandatory in the NHS and social care systems – including recording ethnicity on death certificates.
- Support community research, where residents and researchers work as equal partners to understand the social, cultural, structural, economic, religious and commercial ramifications of coronavirus in BAME communities.
- Improve access, experience and outcomes of NHS and local care systems by BAME communities.
- Accelerate the development of culturally competent risk assessment tools in workplaces and beyond.
- Fund, develop and implement Covid-19 education and prevention campaigns alongside BAME and faith communities.
- Accelerate targeted health promotion and disease prevention programmes – including healthy eating, exercise, smoking cessation and mental well-being.
- Ensure that Covid-19 recovery strategies reduce ethnic inequalities so that they create long-term, sustainable change.