Caelainn Barr, The Guardian, April 22, 2020
The government has been urged to recognise that race and racial inequalities are a risk factor for Covid-19 after Guardian research which has revealed that ethnic minorities in England are dying in disproportionately high numbers compared with white people.
The revelation that people from minority groups appear to be over-represented among the coronavirus deaths, by as much as 27%, “confirmed the worst fears” of campaigners who said there was now no question of an excessive toll.
The Guardian analysis found that of 12,593 patients who died in hospital up to 19 April, 19% were Black, Asian and minority ethnic (BAME) even though these groups make up only 15% of the general population in England.
And the analysis revealed that three London boroughs with high BAME populations – Harrow, Brent and Barnet – were also among the five local authorities with the highest death rates in hospitals and the community.
The findings confirm suspicions raised by local reports, hospitalisation rates and evidence from other countries, that minority groups face the greatest risk. And they show for the first time that areas with high ethnic minority populations in England and Wales tend to have higher mortality rates.
While it is is not yet clear why communities with proportionally higher number of BAME inhabitants appear to be dying at higher rates, one expert on public and ethnic health said that social deprivation was the strongest indicator for mortality due to an increased underlying burden of disease.
“There have been health inequalities that have existed in the [BAME] population but what is being reflected in this pandemic is that those inequalities are actually coming out,” said Wasim Hanif, professor of diabetes and endocrinology at University Hospital Birmingham.
He added: “Deaths happen in relation to complications related to diabetes all the time, as with cardiovascular diseases and cancers, but they have never hit the headlines and that’s the effect we’re seeing now.”
The findings, which run alongside separate concerns about the death rate among BAME healthcare workers, are based on two data sets and two batches of analysis. One was from the NHS and covered deaths in English hospitals up to 19 April.
The findings are based on new figures from the Office or National Statistics breaking down deaths by local authority up to 3 April, enabling the matching of deaths to data on pollution, age, deprivation, population density and BAME populations in England and Wales for the first time.
A high proportion of BAME residents was found to be the strongest predictor of a high Covid-19 death rate.
The analysis shows that for every 10% increase in ethnic minority residents there were 2.9 more Covid-19 deaths per 100,000 people.
The Guardian took into account the influence of other factors including population density and age, which explained only part of the correlation between ethnicity and death rates.
Dr Zubaida Haque, deputy director of the Runnymede Trust, said: “The Guardian’s analysis confirm our worst fears. We’re already aware that people of colour are much more likely to be critically ill with Covid-19 than their white counterparts, but we now know that BAME people are also much more at risk of mortality with Covid-19. Covid-19 is throwing into sharp relief existing racial inequalities.”
She added that the government had to recognise that race and racial inequalities were a risk factor in Covid-19 and that it should address the disproportionate rates of poverty, insecure and low-paid labour, which was often also undertaken by keyworkers, plus poorer conditions and overcrowded housing – all of which were putting ethnic minorities much more at risk of Covid-19 infection.
“There’s no question any more about whether BAME people are bearing the brunt of Covid-19; they clearly are. The question is whether the government view these racial inequalities as a serious enough problem to do something about it.”
The stark picture painted by the research comes as health authorities come under increasing pressure to publish the data held on the deaths of BAME patients from Covid-19, amid warnings that a failure to do so could be putting lives at risk.
After a public outcry the government is beginning to release official statistics on ethnicity. On Monday NHS England released a breakdown of coronavirus deaths by ethnic minorities for the first time.
Based on that and the information provided for local authorities, it emerged that the London boroughs of Harrow and Brent had had the highest death rates, of about 37 and 32 deaths per 100,000 residents respectively.
In Harrow 58% of residents are from ethnic minority backgrounds , while in Brent the figure is 64%. South Lakeland, in Cumbria, had the next highest mortality rate, with 29 deaths per 100,000. It is a largely white, rural area and is something of an outlier.
Dawn Butler, the Labour MP for Brent Central, described the Guardian’s findings as deeply concerning, adding: “It’s a particularly emotional time because every every day we are speaking to families who have lost loved ones or who have loved ones in hospital and cannot go to see them.
“It’s taking a serious toll in a community where you also have also have inter generational living with groups of families – grandchildren, parents and children – all living the one household.”
Apart from South Lakeland and Hertsmere – which is just outside London and borders Harrow and Barnet – the 10 areas with the highest mortality rates were all urban, and seven had higher than average BAME populations.
Because deaths by ethnicity are not compared to the local population, further research is required to identify to what degree minority deaths are over-represented. London and the West Midlands accounted for 46% of deaths in the dataset. In London two in five people are from an ethnic minority background, while in the West Midlands that proportion is one fifth.
The analysis is based on the first 5,186 Covid-19 deaths recorded on death certificates up until 3 April and reflects fatalities in hospitals and in the community. As the data is continually updated some areas in the data have low deaths counts and the findings may change as more deaths are registered.
The lack of any further detail about what shaped the government’s review was attacked by the shadow equalities minister, Marsha de Cordova, who called for an independent investigation into the impact of Covid-19 on BAME communities, to address health, economic and social inequalities.
She said: “It is disappointing the government has yet to commit to this and has failed to share details of its work to date. This lack of transparency and action is risking lives. NHS and Public Health England must urgently publish the data they hold, and the government must start tackling the underlying socio-economic inequalities so they are not exacerbated over the next few months.”
A Department of Health and Social Care spokesperson said: “Any death from this disease is a tragedy and we are working incredibly hard, day and night, to protect the nation’s public health.”