One verifiable statistic of how COVID-19 has affected the UK population shows that, aside from deaths attributed to age, the impact on the non-white population has been notably more severe. Research indicates that 35% of COVID-19 patients in Intensive Care Units (ICUs) are from BAME groups, even though BAME groups comprise just 14% of the UK population.
Added to this, members of BAME groups have comprised 95% of all NHS medical staff deaths, despite forming just 45% of this staff group. With this staggering disparity in mind, it is hugely important to try and understand the potential causes of why there is a higher percentage of the non-white population suffering illness or death than the wider population.
Potential Causes
As might be assumed based on population numbers, most of the UK hotspots for COVID-19 have been major urban centers, such as London and Birmingham. Yet some less populated areas have also been hotspots, for example Leicester and Lancashire. What these areas have in common is high numbers of BAME residents when compared with other areas of the UK, such as much of Scotland, Wales, or the South West of England. BAME groups are far more likely than white ethnic groups to encounter an array of socio-economic obstacles, and this is thought to play a substantial role in the disparity in deaths that has been observed.
The issues of low income and indeed poverty are far more prevalent within BAME groups- just 30% of black Caribbean, black African and Bangladeshi households have enough savings to cover one month of income, in comparison to 60% of the population outside those ethnic groups. In light of the clear social gradient that has emerged from COVID-19 data, with the most deprived almost twice as likely to be admitted to an ICU as the least deprived, higher incidences of poverty are likely of huge significance to the disproportionate numbers of non-white deaths that have been recorded.
Social Inequality
Women are most likely to be affected by shut-down industries. But this is only the case within white ethnic groups. In fact, black African and black Caribbean men are 50% more likely to be employed in shut-down sectors than white British men. Bangladeshi men are four times more likely to work in shut-down sectors, due in no small part to their higher percentage of employment in the restaurant sector. Pakistani men are three times more likely to be affected, due to a high percentage working as taxi drivers. Pakistani men are also 70% more likely to be self-employed than most white British residents.
Between the ages of 30 and 44, 40% of Bangladeshi households work in a shut-down sector, compared to 14% of their white British counterparts. 29% of Bangladeshi men of working age are in a shut-down sector and have a partner who is not working- leaving no financial buffer at such a crucial time- compared to just 1% of white British men. And as mentioned at the start of this piece, only 30% of black Caribbean, African and Bangladeshi households have enough personal savings to cover one month of income.
Some informal work practices, such as recruiting via social channels – mean a barrier to entry and progression in work for non-white groups. Non-white groups are more likely to be in lower paid jobs, sometimes below the living wage; this is particularly prevalent for Pakistani workers across many sectors. In England, non-white groups are far more likely to live in the 10% of most deprived areas in the country. Pakistani and Bangladeshi individuals for example, are three times more likely than white British individuals to live in the most deprived areas of England. Overcrowded housing is a common facet of deprivation and is hugely relevant to COVID-19 outcomes as it prevents residents from adequately self-isolating if necessary. In addition, poor living standards have been found to lead to health problems such as Cardiovascular Disease (CVD) and diabetes, both of which are named as ‘at-risk’ illnesses for those with COVID-19. Taking this into account, poverty is a unifying theme in why higher numbers of BAME individuals are suffering from the virus.
Health and Social Care Sectors
Death rates amongst the non-white workforce in the health and social care sectors are disproportionately high. Members of BAME groups have accounted for 64% of deaths amongst nursing and care staff, while 95% of the doctors and dentists that have died were from BAME groups. There are several factors which may be behind these disparities, most notably the concentration of BAME individuals within low-paid roles. Low-paid roles within the NHS tend to be the most dangerous, not just because working from home is not an option, but also because they necessitate coming into close contact with the virus. This likely goes some way towards explaining the high numbers of BAME deaths within a sector that is inherently high-risk.
Moving Forward
Within the factors discussed, poverty, economic insecurity and more broadly, inequality are of huge relevance to the disproportionality in deaths. Yet these issues are not new; they are deeply ingrained and have been around far, far longer than the virus has. To prevent further unnecessary suffering, it is time for inequality to be tackled once and for all.
Paul McShane is a writer for the Immigration Advice Service, an organisation of immigration solicitors that has offered free legal advice to NHS staff during the COVID-19 pandemic.