Racial inequality in health, education, housing and employment is well known in Black, Asian and Minority Ethnic (BAME) communities.
In the week that marked the second National Stephen Lawrence Day, questions were once again raised about the existence of institutional racism in the UK, as it was revealed that 35% of patients critically ill with coronavirus are BAME, despite only making up 14% of the population.
Starkly, there have been over 20,000 deaths from coronavirus in the UK. Of those in critical care, 14.4% are Asian, and 11.9% are Black. There is currently no data available breaking down deaths by ethnicity in the UK, as normal practice is to not register an individual’s ethnicity on their death certificate.
WHY ARE BAME COMMUNITIES MORE LIKELY TO SUFFER FROM CORONAVIRUS?
The reasons are numerous and complex. Firstly, BAME people are more likely to work in frontline roles, with 40% of doctors, 20% of nurses and 67% of adult social care workers coming from BAME backgrounds.
Secondly, countless BAME workers cannot work at home, as they live in multi-generational households, and overcrowded accommodation. BAME communities are often also subject to precarious work in high exposure roles, whether that be within the NHS or key workers in other roles.
Finally, there are higher proportions of BAME individuals in both the homeless and prison communities - two groups of the population that are known to be more vulnerable during the pandemic.
In short, as the examples above show, the prevalence of COVID-19 in the BAME community is a social issue.
THE NHS AND THE HOSTILE ENVIRONMENT
The World Health Organisation (WHO) constitution considers access to the highest attainable standard of health to be a fundamental human right. The provision of affordable, appropriate, and accessible healthcare forms a part of a government’s obligations to its citizens.
Despite the WHO’s requirements, there are well-known barriers to BAME communities receiving adequate healthcare.
The UK’s National Health Service (NHS) has upheld the hostile environment faced by migrants in the UK by demanding ‘proof of entitlement’ from migrants seeking access to healthcare. Notably, thirty human rights organisations called for the Home Office to suspend this policy in March amidst fears that infected migrant communities would not seek healthcare for fear of deportation, harassment and discrimination.
Public health experts have also been vocal on this matter, urging the government to suspend NHS charges and stop information sharing with the Home Office.
Discrimination in the healthcare context is not just a migrant issue. The UK Confidential Enquiry into Maternal Deaths concluded in a 2018 report that black women are five times more likely to die in childbirth than their white counterparts. BAME populations generally are known to experience barriers to accessing medical services, and poorer health.
These inequalities apply to healthcare employees as well as patients. Approximately 44% of NHS workers are from BAME backgrounds, and they have been vocal about their experience of racism within the health service- from their patients, their colleagues and their superiors.
SOCIAL DEPRIVATION
Statistics show that BAME people are more likely to experience poverty than their white counterparts, with many BAME people in unsecure and/or low paid employment. As a result, they need to keep working, even if that puts them at greater risk of contracting the virus. Low paid work also means low-quality, and often over-crowded, accommodation, with little room to self-isolate should one member of a household contract the virus.
The reality is that a disproportionate number of BAME people are considered ‘low skilled’, when in reality, retail workers, cleaners, social carers and NHS workers are in fact key workers, stationed on the frontline of this crisis.
The disproportionate number of BAME deaths from COVID-19 is not a problem unique to the UK. In Chicago, 70% of coronavirus deaths were from the Black community, despite making up only 30% of Chicago’s population. Many black Americans also work on the frontline, in retail, healthcare and transport - jobs that often low paid and do not have sick leave or health insurance as standard.
More generally in the US, Native Americans, Hispanic Americans, and African Americans are less likely than White Americans to have health insurance. Essentially, the economic and racial disparities that already exist in the USA have been amplified by the pandemic.
In Asia, aid workers are bracing for coronavirus to hit refugee camps. The minority Rohingya community have sought refuge from Myanmar in Bangladesh since 2017. The camps are overcrowded and lack basic healthcare and sanitation, leading to concerns they are a "ticking time bomb". Elsewhere, Rohingya who have fled by boat and are yet to settle are finding themselves stranded at sea.
IS THERE A SOLUTION?
The coronavirus crisis has shone a light on the experiences of BAME people in modern British society. Public health experts have called on Public Health England to monitor and release data based on ethnicity, BAME population density and associated risk factors of patients.
Data collection will help the government analyse why BAME people are disproportionately affected by coronavirus not only in the UK, but internationally. In turn, this will hopefully enable prevention of future disparities, and mitigate the severe impact of a potential recession on BAME communities.
