Decades of structural discrimination led to the disproportionate impact of the coronavirus pandemic on black, Asian and minority ethnic (BAME) communities, a review has said.
Baroness Doreen Lawrence, mother of murdered black teenager Stephen Lawrence, claimed there were structural inequalities within government, health, employment and the education system that Covid-19 ‘thrived on’ as the outbreak took hold.
She said BAME people have been overexposed to the virus by being overrepresented in public-facing industries where they cannot work from home and living in overcrowded housing.
‘Black, Asian and minority ethnic people have been overexposed, under-protected, stigmatised and overlooked during this pandemic – and this has been generations in the making,’ Baroness Lawrence wrote in the report’s foreword.
The findings conflict with those of Downing Street Covid adviser Dr Raghib Ali, who said last week that structural racism was not a ‘reasonable explanation’ for the high Covid toll among minority groups.
Decades of structural discrimination led to the disproportionate impact of the coronavirus pandemic on black, Asian and minority ethnic (BAME) communities, a review has said. Pictured are some of the BAME healthcare staff who fell victim to the disease
Baroness Lawrence was commissioned to lead the review into how Covid-19 is affecting BAME communities by Labour leader Sir Keir Starmer.
Workers have been put at risk by the Government’s failure to facilitate Covid-secure workplaces, and the ‘no recourse to public funds’ rule has disproportionately affected BAME communities, she said.
They have also experienced what she called ‘disgraceful racism’, fuelled in part by global leaders calling Covid-19 the ‘Chinese virus’.
The terms was used by US President Donald Trump and others after the virus first emerged in the Chinese city of Wuhan late last year.
Baroness Doreen Lawrence was commissioned to lead the review
Baroness Lawrence said it was hoped that a previous Public Health England report would recommend action to reduce disparities, but added that it failed to do so.
And a statement last week from the Minister for Equalities Kemi Badenoch, to mark the launch of a Government report, risks being ‘too little too late’ and failed to address systemic, structural drivers, Baronesss Lawrence said.
Dr Raghib Ali, who helped with the report on progress to address Covid-19 health inequalities, said he is not convinced structural racism played a role.
In the new report’s foreword, Baroness Lawrence also wrote: ’This must be a watershed moment for change.
‘The impact of Covid is not random, but foreseeable and inevitable, the consequence of decades of structural injustice, inequality and discrimination that blights our society.
‘We are in the middle of an avoidable crisis.
‘And this report is a rallying cry to break that clear and tragic pattern.’
She said BAME people have been overexposed to the virus by being overrepresented in public-facing industries where they cannot work from home and living in overcrowded housing. Pictured: The rate of death of ethnic minorities compared to white people, which was illustrated in a recent Public Health England report using ONS data
Public Health England previously found the mortality rate – the number of people dying with the coronavirus out of each 100,000 people – was considerably higher for black men than other groups. The risk for black women, people of Asian ethnicity, and mixed race people was also higher than for white people of either sex. The report warned the rate for the ‘Other’ category was ‘likely to be an overestimate’
A PHE report from July found that while white people make up a majority of Covid-19 hospital cases, they are more likely to be treated on normal wards with less severe infection. This graph shows that of admitted hospital cases, although most are white, BAME people are more than twice as likely to require treatment in ICU
The Labour report also said structural racism – the supposed combination of public policy, employment practices and everyday behaviour said to enforce white privilege – has had a ‘devastating impact’ during the pandemic.
It found that ‘Covid-19 has thrived on inequalities that have long scarred British society.
Black, Asian and minority ethnic people are more likely to work in frontline or shutdown sectors which have been overexposed to Covid-19, more likely to have co-morbidities which increase the risk of serious illness and more likely to face barriers to accessing healthcare.
Almost 60,000 more Covid-19 deaths could have occurred in England and Wales if white people faced the same risk as black people
Almost 60,000 more coronavirus deaths could have occurred in England and Wales if white people faced the same risk as black people, a damning report has claimed.
Data has shown black people are two-and-a-half times more likely to die from Covid-19 than whites, according to the Office for National Statistics.
The Institute for Public Policy Research (IPPR) and Runnymede Trust said this is because black people face inequalities that leave them more exposed and vulnerable to the disease.
These include unequal social conditions, such as public-facing jobs that force them to interact with strangers more often and crowded housing, where social distancing is impossible. Minorities also face unequal access to healthcare, and structural and institutional racism, according to the report.
Its authors called for ethnicity to be considered a risk factor when deciding who should be prioritised for Covid-19 tests alongside age, gender, occupation and underlying health conditions.
The report by the IPPR said 35,000 more could have died if white people faced the same risk as the South Asian population, who’re statistically one-and-a-half times more likely to succumb to Covid-19 than white people.
‘Black, Asian and minority ethnic people have also been subject to disgraceful racism as some have sought to blame different communities for the spread of the virus.’
If no immediate action is taken more people will ‘unnecessarily die’, she claimed, adding that this pattern of injustice may continue beyond the pandemic.
Among a string of recommendations the report called for more spending to help migrant families, greater protection for ethnic minority workers, and higher rent benefits.
It also urged the creation of an urgent plan for the winter and said the Government should remind employers they have a legal duty to record Covid-19 deaths caused by occupational exposure.
It added that it should be a legal requirement for employers to publish their Covid-19 risk assessments on a central government portal, while they must provide appropriate personal protective equipment (PPE).
The Government must outline a plan to tackle a rise in hate crime and scapegoating, with leaders issuing a joint statement condemning attempts to pit communities against one other, the report also urged.
In the longer term, the Government must remove barriers to accessing health services and information, collect comprehensive data on ethnicity and reform the immigration system.
Baronesss Lawrence’s report also accused some politicians of feeding rather than opposing prejudice during the pandemic and said police were seven times more likely to impose lockdown breach fines on black or Asian people than on others.
The report praised the controversial Black Lives Matter movement and added: ‘It is the responsibility of all those in positions of power to be absolutely clear that any disproportionate impact of this virus on Black, Asian and minority ethnic communities is not a result of choice but due to structural inequality, inadequate protective measures and Government inaction.’
Dr Ali said last week that he was not convinced that racism contributed to Covid deaths and added: ‘If structural racism was an important problem – I’m not saying it doesn’t exist – but if it was an important problem in health outcomes, then you’d expect that to be reflected not just in Covid but in other outcomes as well.’
He said the latest data shows that many ethnic minority groups in England and Scotland enjoy better overall health and have lower rates of morality than their white counterparts.
Labour leader Sir Keir Starmer said: ‘Government ministers should absorb this report and act immediately.
Failure to do so will leave many of our fellow citizens badly exposed over the winter.
‘This must be a turning point.
The study into Covid-19 death rates in London found that black men face a 1.9 times higher risk of dying than white men, even when their differences in age, where they live, and their wealth and health are taken into account (yellow bars indicate the increased risk when all those factors except race are taken out of the equation)
When the data does not take into account the fact that non-white people are likely to be poorer and in worse general health, the difference in risk of death is considerably higher, reaching higher than a four-fold increase among black men and women
‘That’s why the next Labour government will introduce a new Race Equality Act to tackle the structural inequalities that led to the disproportionate impact of this crisis.’
Marsha de Cordova, Labour’s shadow minister for women and equalities, said the Government is ‘unwilling to accept that these issues are structural and are again failing to understand that race is a social determinant of health’.
‘This is a complete abdication of responsibility,’ she added.
A Government spokesman said: ‘The current evidence shows that a range of factors result in different groups being at an increased risk of infection and death from Covid-19 – from exposure in the workplace, to pre-existing health conditions.
‘For this reason we must be careful to identify the root causes of the disparities we’re seeing and not assume they are evidence of discrimination or unfair treatment in public services like the NHS. Indeed, many of the factors identified in the report affect non-ethnic groups as well.
‘We will continue taking this work forward, to ensure that we do everything we can to protect those most at risk.’
Earlier this month, the report led by Dr Raghib Ali did find that ethnic minorities have a higher risk of catching Covid-19 and dying from it than white people do because of their jobs and were they live.
Number 10’s Race Disparity Unit reviewed the findings of all major studies looking into the disproportionate coronavirus has had on people from BAME backgrounds.
However, the researchers did rule out structural racism as a driving factor behind the poorer health outcomes.
Dr Ali said that ‘most ethnic minorities have higher life expectancy’ than white Britons and better survival rates for a slew of other health conditions.
Dr Ali said, therefore, there would be no reason to presume racism was playing a role in the treatment of the new virus.
He added that socioeconomic factors were the real reasons behind poorer health outcomes, not skin colour, and said focusing on BAME people ‘forgets about whites in deprived settings and public-facing jobs’.
Baroness Larence’s findings conflict with those of Downing Street Covid adviser Dr Raghib Ali (pictured)
Living in overcrowded and multi-generational homes, working front-facing jobs and relying on public transport raise the risk of getting infected in the first place.
In June, Public Health England published the second part of its long-awaited reported into how coronavirus has hit BAME communities harder.
It claimed that a lack of trust in the NHS among people from BAME backgrounds may have left them reluctant to seek help early on.
This potentially made their disease harder to treat. The report added that some people were ‘fearful of being reported’ if they presented to hospital.
It also claimed that BAME NHS staff may be less likely to speak up when they have concerns about the risk they’re being exposed to or in their lack of access to personal protective equipment (PPE).
The report’s findings were based on discussions with 4,000 people.
Historic racism did play a part in worse outcomes because it has meant people from non-white communities are generally poorer and have worse health, the report said.
Ethnic minority people have also for decades been more likely to have lower-paid jobs, meaning they have less money to afford healthy lifestyles.
They are also more likely to work in risky jobs in which they have close contact with members of the public, which boosts the likelihood that they will contract the disease.
The reports findings came after officials came under fire for failing to make any recommendations about what could be done about the issue when the first part of the document was released.
WHAT WERE THE SEVEN RECOMMENDATIONS OF PUBLIC HEALTH ENGLAND’S REPORT INTO HW THE VORONAVIRUS HAS HIT BAME COMMUNITIES HARDER?
- Mandate comprehensive and quality ethnicity data collection and recording as part of routine NHS and social care data collection systems, including the mandatory collection of ethnicity data at death certification, and ensure that data are readily available to local health and care partners to inform actions to mitigate the impact of COVID-19 on BAME communities.
- Support community participatory research, in which researchers and community stakeholders engage as equal partners in all steps of the research process, to understand the social, cultural, structural, economic, religious, and commercial determinants of COVID-19 in BAME communities, and to develop readily implementable and scalable programmes to reduce risk and improve health outcomes.
- Improve access, experiences and outcomes of NHS, local government and Integrated Care Systems commissioned services by BAME communities including: regular equity audits; use of Health Impact Assessments; integration of equality into quality systems; good representation of black and minority ethnic communities among staff at all levels; sustained workforce development and employment practices; trust-building dialogue with service users.
- Accelerate the development of culturally competent occupational risk assessment tools that can be employed in a variety of occupational settings and used to reduce the risk of an employee’s exposure to and acquisition of COVID-19, especially for key workers working with a large cross section of the general public or in contact with those infected with COVID-19.
- Fund, develop and implement culturally competent COVID-19 education and prevention campaigns, working in partnership with local BAME and faith communities to reinforce individual and household risk reduction strategies; rebuild trust with and uptake of routine clinical services; reinforce messages on early identification, testing and diagnosis; and prepare communities to take full advantage of interventions including contact tracing, antibody testing and ultimately vaccine availability.
- Accelerate efforts to target culturally competent health promotion and disease prevention programmes for non-communicable diseases promoting healthy weight, physical activity, smoking cessation, mental wellbeing and effective management of chronic conditions including diabetes, hypertension and asthma.
- Ensure that COVID-19 recovery strategies actively reduce inequalities caused by the wider determinants of health to create long term sustainable change. Fully funded, sustained and meaningful approaches to tackling ethnic inequalities must be prioritised.
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