Ethnic minorities and Covid-19

A recent study by the intensive care national audit and research centre (icnarc) found that minority ethnic groups were known to be disproportionately affected by Covid-19. It found that they account for 34% of critically ill Covid-19 patients in the UK despite constituting 14% of the population. But why? 

This research is the first to reveal the impact of environmental and housing deprivation. This severe impact of Covid-19 on people from minority ethnic groups has been linked to air pollution and overcrowded and poor-standard homes by a study of 400 hospital patients. The study concluded: "Patients of black, Asian and minority ethnicity (BAME) are more likely to be admitted from regions of highest air pollution, housing quality and household overcrowding deprivation. This is likely to contribute an explanation towards the higher ITU admissions reported among Covid-19 BAME patients." This reaffirms the importance of deprivation in influencing the pattern of disease. 

A Public Health England report which was published in June showed a link between deprivation and worse coronavirus outcomes but did not specify types of deprivation. It has also been suspected that there is an association between dirty air and coronavirus infections and deaths. Dr Aarash Saleh, an NHS respiratory doctor said: "We need more research like this to understand how air pollution interacts with other societal injustices to exacerbate health inequities, including death from Covid-19. Strategic responses to air pollution are urgently needed and must acknowledge and address the socioeconomic and racial intersections of this public health crisis." 

It is known that air pollution and household overcrowding to be associated with higher rates of community-acquired pneumonia. However, much work is still needed to point the finger at a specific component. The fact is that with most diseases, there is a relationship with deprivation. And if ethnic minorities are facing inequality in employment and other aspects of their life, then they are more likely to live in these deprived areas.

Perhaps in this aspect, it is the experience of racism and racial inequality which are putting them at a higher risk of Covid-19. The experience of systemic racism has meant that minorities are more likely to be among the poorer socio-economic groups and over-represented in areas, housing, occupations and jobs that expose them to the coronavirus. Black and other ethnic minority individuals make up a large share of jobs considered essential in tackling the virus. One in 5 people are working for the NHS in England, for example, is from an ethnic minority background, and these numbers are even higher when we look solely at doctors and nurses. Black African women are four times as likely as White British women to be working in social care roles while Black African men are seven times as likely as White British men to be working in such roles. 

Additionally, overcrowding can make social distancing extremely difficult if someone in the household has covid-19. Only 2% of white British households in England have fewer bedroom than they needed, in contrast to around 30% of Bangladeshi households, 16% of Pakistani households and 15% of Black African households. This makes self-isolation much more difficult and increases the risk of transmission. We need to tackle the underlying inequality in order to fully tackle Covid-19. 

These demands to address the health inequalities facing ethnic minorities date back in history. But why has it taken a global pandemic for those demands to be taken seriously?