Racism and social inequality behind BAME COVID-19 disparities

Racism, social and economic inequalities and increased prevalence of diseases such as obesity and diabetes may be behind the unequal impact of COVID-19 on black, Asian or minority ethnic (BAME) groups, a Public Health England (PHE) investigation reveals.

COVID-19 risk (Photo: ER Productions/Getty Images)
COVID-19 risk (Photo: ER Productions/Getty Images)

Safeguards to protect staff working in health and care services 'were not applied equally across ethnic groups' - reflecting 'a fundamental break in trust between employers and organisations', the report found.

The PHE report - Beyond the data: Understanding the impact of COVID-19 on BAME groups - comes a fortnight after a review by its director of health and wellbeing Professor Kevin Fenton confirmed that deaths from COVID-19 were highest among patients from BAME backgrounds.

Initial findings published on 2 June did not include recommendations on tackling the disparity, with doctors' leaders calling that first report a 'missed opportunity'. The government has come under increasing pressure to make recommendations - and to publish further findings on the risk to BAME groups contained in the report released today.

COVID-19 impact

The report published today contains a string of recommendations - including mandatory collection of 'comprehensive and quality ethnicity data' as part of routine NHS data collection systems to help the health service understand and mitigate the impact of COVID-19 on BAME communities.

It also demands improvements to 'access, experiences and outcomes of NHS, local government and integrated care systems commissioned services by BAME communities' - as part of a 'long-term sustainable change' to reduce health inequalities.

The report found that 'historic racism and poorer experiences of healthcare' means people in BAME groups are less likely to seek care when they need it.

NHS staff from BAME groups are less likely to speak up when they have concerns about personal protective equipment (PPE), testing or risk, putting them at increased risk, it adds.

BAME risk

The report also found that risks associated with COVID-19 transmission, morbidity, and mortality could be exacerbated by housing challenges faced by some people in BAME groups.

It also found that a high proportion of people from the BAME community are key workers or in occupations that increase social contact, increasing their risk of being exposed to COVID-19.

COVID-19 ‘exposed and exacerbated long standing inequalities’ affecting BAME groups in the UK, the damning report warns.

It says: '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, CVD 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 groups 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. All were united in the commitment that urgent, collaborative and decisive action is required to avoid a repeat of this in the future.'

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