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Mon 28 September 2020
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Public Health England’s report into risk factors associated with COVID-19 deaths has revealed the structural inequality and poverty endangering lives.

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COVID-19 has exposed England’s stark health inequalities linked to poverty and structural social issues putting people’s lives in danger – with those from black and Asian ethnic groups most likely to die of the disease, a new report has confirmed.

Public Health England published its inquiry into Coronavirus deaths today, Disparities in the Risk and Outcomes from COVID-19, which concluded that “the impact of COVID-19 has replicated existing health inequalities and, in some cases, has increased them”.

Its key findings confirm fears around black and ethnic minority (BAME) people being particularly susceptible to the disease, and also found that factors such as poverty, a person’s occupation, their living conditions and certain health problems also increase the risk of contracting and dying from the virus.

Although the report did not investigate the impact of occupation, co-morbidities – one or more additional conditions co-occurring with a primary condition – or obesity with regards to the disproportionate impact of COVID-19 on BAME people, it highlighted how these issues, which can be a result of structural inequalities, “are important factors because they are associated with the risk of acquiring COVID-19, the risk of dying, or both”.

For example, the report states that “we know some key occupations have a high proportion of workers from BAME groups” and, among workers in jobs that involve frequent contact with the public, one in five are from BAME groups. An analysis of 119 deaths of NHS staff showed a disproportionately high number of BAME staff among those who had died, according to the report.

It also states that comorbidities or obesity “are more commonly seen in some BAME groups”. People of Bangladeshi and Pakistani background have higher rates of cardiovascular disease than white people, and those of black Caribbean and black African ethnicity have higher rates of hypertension compared with other ethnic groups. The proportion of COVID-19 deaths where diabetes was mentioned on the death certificate ranged from 18% for white people to 43% for Asian people and 45% for black people, Public Health England found. Diabetes was also more likely to be mentioned on the death certificate where those who died lived in more deprived areas.

The report states that people from BAME communities are at a higher risk of catching the Coronavirus because they are more likely to live in “urban areas, in overcrowded households, in deprived areas, and have jobs that expose them to higher risk”.

They are also more likely to be born abroad than white people, it states, meaning they “may face additional barriers in accessing services that are created by, for example, cultural and language differences”.

Dr Zubaida Haque, interim director of The Runnymede Trust, criticised the report for only devoting 11 of its 89 pages to the issue of racial inequalities with regards to Coronavirus deaths and for not making any recommendations on how to save BAME lives.


KEY FINDINGS:

  • People who live in deprived areas are more likely to be diagnosed and die of COVID-19 than those living in less deprived areas. COVID-19 mortality rates in the most deprived areas are more than double those in the least deprived areas.
  • Black people are most likely to be diagnosed with COVID-19 and death rates are highest among people of black and Asian ethnic groups. Bangladeshi people are around twice as likely to die from COVID-19 than white people. People from Chinese, Indian, Pakistani, other Asian, Caribbean and other black ethnic groups have a 10-50% higher risk of death from COVID-19, compared to white people. 
  • A higher percentage of death certificates which mentioned COVID-19 also mentioned diabetes, hypertensive diseases, chronic kidney disease, chronic obstructive pulmonary disease and dementia. 
  • Men working as security guards, taxi drivers and chauffeurs, bus and coach drivers, chefs, sales and retail assistants, lower skilled workers in construction and processing plants, and men and women working in social care have significantly high rates of death from COVID-19.
  • There has been a larger increase in deaths among people born outside the UK, compared to previous years, with the biggest increase being among those born in central and western Africa, the Caribbean, south-east Asia, the Middle East and south and eastern Africa. 

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