Public Health England (PHE) published its report into the inequalities in Covid-19 risk and outcomes that have become glaringly apparent over the last few months. And the conclusion seems to be that yes there are significant disparities and we will begin to address those disparities by…ah, no wait that bit seems to be missing.
The report found a range of disparities in those dying from Covid-19. Age was by far the biggest factor: people who were 80 or older were seventy times more likely to die than those under 40. Men are more at risk of dying than women; living in deprivation; living in certain urban areas; being in a care home; being born outside the UK; working in specific occupations; certain comorbidities; and being from black and minority ethnic groups all carry higher risks to one degree or another. People from Bangladeshi origin are twice as likely to die as the majority white population and for other groups, including Asian, Black Caribbean and other Asian groups the risk is between 10 and 50 per cent higher than for the white population.
The PHE report provides some statistical evidence of the uneven distribution of the effects of coronavirus, but there are some odd gaps in the analyses. The study does not factor in the effects of obesity, comorbidity and occupation in all cases, which for BAME groups could be very significant as for example they are often likely to be employed in the jobs that appear to be at highest risk. (Read the LGIU briefing on ONS bulletin looking at Covid deaths among different occupational groups). There are also no reasons given for the uneven spread of the serious effects of the virus – beyond the remit of the report and likely to be highly complex and nuanced.
Health inequality is just one aspect of the structural and institutionalised inequalities and racism that successive governments in this country and elsewhere have failed to address. The timing is coincidental but what is currently happening in the US is another facet of the same injustice.
In a long read on 5 May I said that this pandemic is an unfolding infographic of the devastation that health inequalities wreak on people’s lives. And while we watch that picture continue to evolve there is, so far, little in terms of practical guidance from the government that even attempts to address the immediate and life threatening situation faced by BAME groups and others right now.
When asked about the risk to BAME groups and any specific recommendations at the briefing on Tuesday, Matt Hancock replied that people in high risk groups should follow the social distancing and other guidelines “very stringently”. That’s not acceptable: the lives of low paid key workers, people living in deprivation and BAME groups (often one and the same) are worth more effort from the government than: ‘wash your hands more thoroughly and stand a bit further apart’.
As the lockdown eases and more and more people return to work the government’s approach to facilitating the transition needs to reflect what we now know is not a one size fits all situation. Guidance for employers for example needs to be more nuanced and more specific and be updated as we continue to learn more about the effects and risks of Covid for certain groups. Ignoring the lives of black and minority ethnic people is no longer an option.