"Racial discrimination affects people's life chances and the stress associated with being discriminated against based on race/ethnicity affects mental and physical health," the report said.
Historic racism and social inequalities are among the factors behind a higher risk faced by black, Asian and minority ethnic (BAME) contracting and dying from the coronavirus in the UK, according to a government review released on Tuesday.
‘Beyond the data: Understanding the impact of COVID-19 on BAME groups’ by Public Health England (PHE) has been at centre of a row over its non-publication alongside an earlier PHE review, which had confirmed the higher risks faced by the country’s minorities but failed to explain the factors behind it.
The new review, which did not take genetic factors into account, concludes that local and national policy initiatives will need to be sensitive to BAME communities to ensure existing health and economic inequalities are not widened due to the measures taken during the pandemic.
“Stakeholders pointed to racism and discrimination experienced by communities and more specifically by BAME key workers as a root cause affecting health, and exposure risk and disease progression risk,” the report notes.
“Racial discrimination affects people’s life chances and the stress associated with being discriminated against based on race/ethnicity affects mental and physical health,” it said.
Besides racism and discrimination, the report found that the unequal impact of the pandemic may be explained by social and economic inequalities, stigma, differing risks at work and inequalities in the prevalence of conditions such as obesity, diabetes, hypertension and asthma, which can increase the severity of COVID-19.
The results of the PHE data review suggest that people of BAME groups may be more exposed to COVID-19, and therefore are more likely to be diagnosed. This, it said, could be the result of factors associated with ethnicity such as occupation, population density, use of public transport, household composition and housing conditions, which the currently available data did not allow further analysis of.
“Historic racism and poorer experiences of healthcare or at work may mean that BAME individuals are less likely to seek care when needed or as NHS [National Health Service] staff less likely to speak up when they have concerns about PPE [personal protective equipment] or testing,” it said.
Some of the key actions recommended by stakeholders to the review include the importance of valuing and respecting the work of key workers; provision of adequate protective equipment; stronger arrangements for workplace wellbeing and risk assessments; targeted education, awareness and support for key workers; occupational risk assessments; and tackling workplace bullying, racism and discrimination to create environments that allow workers to express and address concerns about risk.
The British Medical Association (BMA), among the groups lobbying for the review to be released, said the recommendations must now be implemented urgently.
“It’s important we now move forward and deliver those changes because it’s the fair and right thing to do for our population,” said Dr Chaand Nagpaul, BMA Council Chair.
The BMA says that more than 90 per cent of UK doctors who died during the pandemic were from BAME backgrounds, including many of Indian-origin, and medics from these communities were also three times as likely to say they had felt pressured to work without sufficient PPE.
The PHE’s initial review had revealed that people of Bangladeshi ethnicity had twice the risk of death than people of white British ethnicity. The death rate from COVID-19 was found to be 1.5 times higher among people of Indian-origin, 2.8 times among Pakistani-origin and 4.3 times higher in those of black African origin.