Disparity report on COVID-19 outcomes
When the COVID-19 pandemic first began to spread in towns and cities across the UK, the first 10 doctors who died following infection were all of Black, Asian or ethnic minorities (BAME) background. This trend was not unique to doctors either, as 71% of nurses and midwives were also disproportionately dying due to COVID-19 infection. Since the early stages of this pandemic, BAME Brits had found themselves hospitalised due to COVID-19 infection at a higher rate than their White British counterparts. This trend continued further; as BAME citizens filled a third of all intensive care (ICU) beds, despite making up only 14% of the population.
These finding led many scientists to question why BAME Brits were more prone to dying from COVID-19. Public Health England (PHE) compiled a report that presented the disparities in patient risks and outcomes from COVID-19. The report confirmed that COVID-19 impacts the UK following a similar pattern to existing health inequalities populations. Therefore, the report aimed to plan a future public health response to COVID-19 by improving scientific understanding of the pandemic.
However, the report did not provide any recommendations for BAME Brits. Although it did confirm BAME Brits have an increased risk of suffering a bad outcome following COVID-19 infection. This disturbed David Lammy, Shadow Lord Chancellor and Labour MP for Tottenham as the report failed to reassure BAME Brits as to how they can avoid COVID-19 “on the front line, given that many of these minorities work in the public sector”. Mr Lammy went on further to say, “If we’re serious about saving the NHS and saving lives, then we have to be serious about black and brown lives as well”. Suggesting that many BAME citizens are “fearful”, “anxious”, and “concerned” due to the findings in the report. Even more so now, as there’s no additional advice from the government as to how BAME communities can protect themselves.
The findings of the report show that Black Brits are 2.5 times more likely to be diagnosed with COVID-19, compared to their White British counterparts. British Asians, particularly those of Bangladeshi descent, were 2 times more likely to die from COVID-19 compared to White Brits. Whereas, Black Brits were just over 3 times as likely to die from COVID-19 infection.
Comparing the deaths to those who are within the working-age population (20–64), BAME Brits were again more susceptible to die due to COVID-19. British Asians of Bangladeshi descent were 80% more likely to die compared to White brits; this dropped to 50% for British Asians of Pakistani descent and Black Brits of African descent. Black Brits of Caribbean background had a 30% increased risk of dying compared to White Brits.
Not only were BAME Brits disproportionately dying from COVID-19. But immigrants to the UK from the Caribbean and West/Central Africa were also suffering worse outcomes compared to the wider population. These findings suggest that there may be a genetic link associated with the disproportionality that BAME Brits face against COVID-19. It is already well known that Black Brits are more likely to suffer from high blood pressure and British Asians are more likely to have underlying heart conditions, while both communities have a disproportionally high number of diabetic patients.
As these underlying health conditions increase a person risk of a bad resulting from COVID-19 infection; many have attributed these factors as the cause of the disparity seen in BAME communities. However, the report does go onto to address other social factors, such as occupation and level of deprivation; play just as an important role in determining the severity of COVID-19 outcome as a person’s ethnicity.
In terms of occupation, the report showed that men who work as security guards, bus drivers and taxi drivers were more likely to die from COVID-19. As these occupations require frequent contact with individuals, daily; such workers would have increased susceptibility to infection. Similarly, healthcare workers are more likely to be infected with COVID-19; again, due to frequent close contact with others during work. However, while only 1 in 5 BAME Brits works in a high-risk occupation, BAME staff are still dying in disproportionally higher numbers to their White British counterparts.
Social deprivation and poverty had also thought of the cause of the disproportionality seen amongst BAME Brits. The report revealed that individuals living in the most deprived areas of the country were more likely to become infected with COVID-19, suffering worse health outcomes than those better off. It is unknown if deprived cities are associated with more COVID-19 cases because Brits are living in increased proximity to infected individuals. Or if a high number of ‘high-risk’ workers are still going to work, becoming infected as they are forced to break lockdown guidelines to feed their family. However, the results of the report suggest a strong relationship between social deprivation and ethnicity regarding COVID-19 outcomes.
This was evident in the PHE report, where individuals who lived in socially deprived areas were 2 times more likely to die from COVID-19 than those in the least deprived areas. Alongside that, socially deprived Britons filled a quarter of ICU beds due to COVID-19 infection. It is also worth mentioning that in a government report published in 2018 concluded that; of the top 10% deprived neighbourhoods in terms of income and employment, Black Brits and British Asians were more likely to be residents than their White counterparts.
Haroon Siddique, senior reporter at The Guardian reported that there could be many reasons as to why BAME Brits are more likely to die due to COVID-19 infection. Aside from underlying health conditions such as “heart disease, kidney disease, diabetes and hypertension”, all conditions which are over-represented by BAME Brits. Mr Siddique also said that there could be up to 3 societal causes for the disparity in COVID-19 outcomes for BAME individuals. Poverty, over-representation as key workers and overcrowding in houses.
While the PHE report addresses the disparities for those who live in socially deprived areas and those who have to work in public-facing roles during the COVID-19 outbreak. PHE failed to recommend any solutions to correct the impact social housing plays in the health outcomes of those infected with COVID-19. Especially since it is well recognised that living in a household with many people increase an individual’s risk of exposure to COVID-19. Even more, since poor housing conditions are also associated with respiratory problems.
It is good that the PHE report recognised that BAME Brits are disproportionally affected worse by COVID-19. However, the lack of any plans to protect BAME Brits lives has caused unease amongst many. Many BAME Brits are already struggling to live in a society where they must live in deprivation, forced into work for a public-facing role during a health pandemic and with limited options to change the circumstances of the situation they must face.
Therefore, the government must reach out to the BAME community by showing that they understand the health struggles BAME Brits are going through during this pandemic. The government must show that they are actively trying to reduce the health inequalities for BAME Brits. More importantly, if the government want to show that they have understood the links between health status and social deprivation; they must introduce policies to improve disadvantaged neighbourhoods. So that there is no gap in social deprivation between cities, towns and villages across the country.
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