This week Public Health England confirmed that Black and Asian people are more likely to die from COVID-19 than the white British population. Acknowledging the problem exists is a welcome first step. But a clear strategy and recommendations are urgently needed to demonstrate that Black lives do matter.
Kemi Badenoch, the Minister for women and equality has said the evidence for action is lacking. On the contrary: the link between inequality and poor health is well-documented. Social, economic and racial injustice are key determinants of health.
The data isn’t lacking, we just need to join the dots. For example, people from Bangladeshi communities have double the risk of dying from COVID-19 as white British people. But they are also:
- twice as likely to be unemployed;
- more than twice as likely to have lower than average earnings, if working, particularly after housing costs are taken into consideration; and
- are more likely to be living in overcrowded accommodation than any other group.
This is not a matter of chance or poor choices, but the result of systemic racism ingrained in British society. As Michael Marmot and colleagues have shown:
‘Intersections between socio-economic status, ethnicity and racism intensify health inequalities for ethnic groups.’
The types of jobs that they do, and the terms on which they do it, place many Black, Asian and other minority ethnic workers at greater risk of COVID-19 and its economic impact.
Key workers unable to access PPE, or on low pay and zero hours contracts – not earning enough to be eligible for Statutory Sick Pay; migrants who have ‘No Recourse to Public Funds’: All these factors place Black and Asian workers at higher risk of contracting the virus..
The Coalition of Race Equality organisations has called for action to address these issues and protect the lives of Black people. These need to be implemented urgently.
But as the PHE report says, COVID-19 has replicated, and in some cases increased existing health inequalities(my emphasis).
To address these existing inequalities, we need to tackle the root causes of ill health, ‘the conditions in which people are born, grow, live work and age and inequities of power, money and resources’.
To achieve this we must build back better, creating a post-COVID economy that works for everyone. An economy that is shaped by the voices and experiences of those most disadvantaged by, and discriminated in the current system.
And those of us who benefit from the current system must recognise and relinquish our privilege. Its our responsibility to dismantle the barriers that we have put in the way of Black, Asian and other ethnic minority people.
Ten years ago the Marmot Review set out what needs to be done to create a fair society and healthy lives. The evidence is there. The strategy is there. All we need is the political will to make it happen. As its author has said,
‘The question we should ask is not, can we afford better health … but what kind of society do we want?’
