{"id":48924,"date":"2020-10-28T17:51:54","date_gmt":"2020-10-28T16:51:54","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=48924"},"modified":"2020-11-06T17:50:13","modified_gmt":"2020-11-06T16:50:13","slug":"jabeer-butt-racism-and-covid-19-a-matter-of-life-and-death","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/10\/28\/jabeer-butt-racism-and-covid-19-a-matter-of-life-and-death\/","title":{"rendered":"Jabeer Butt: Racism and covid-19\u2014a matter of life and death"},"content":{"rendered":"

The omission of racism from the government’s new report on covid-19’s health inequalities marks its latest failure to tackle this important issue, says Jabeer Butt<\/p>\n

Last week the UK government\u2019s Race Disparity Unit published its <\/span>first quarterly report<\/span><\/a> on covid-19 health inequalities. Much of the interviews and reporting that accompanied the report\u2019s publication have focused on comments made at the launch of the report, suggesting that racism does not explain the disproportionate impact<\/a> of covid-19 on Britain\u2019s Black, Asian, and minority ethnic (BAME) communities. This conclusion does not appear in the 62 pages of the report, where neither racism nor racial inequality is mentioned at all, but is rather how Raghib Ali, one of the government\u2019s new expert advisers, chose to present the findings at the media launch.\u00a0\u00a0<\/span><\/p>\n

Some might say that the report\u2019s focus on \u201cethnic disparities\u201d means I am being churlish in suggesting the government\u2019s report has not investigated the impact of racism. But the report\u2019s failure to address at all whether racism has played a part in the pandemic is telling, as are the remarks of government adviser Raghib Ali that structural racism does not seem to explain ethnic disparities in the burden of covid-19 on communities. The report concludes that \u201ca range of socioeconomic and geographical factors such as occupational exposure, population density, household composition, and pre-existing health conditions may contribute to the higher infection and mortality rates for ethnic minority groups.\u201d Using the data from this report, a strong argument can be made that all these factors demonstrate the impact of structural racism.\u00a0\u00a0<\/span><\/p>\n

The report uses multiple datasets to show that there is a higher risk of infection and higher risk of death as a result of infection among BAME communities. While it suggests that the \u201crelative risk\u201d of dying for \u201cBlack and South Asian” groups is reduced \u201cwhen taking into account socioeconomic and geographical factors,\u201d it is silent as to why these communities are at greater risk of experiencing the \u201cdeprivation\u201d that is \u201ca good marker of many of these factors.\u201d It is worth here reminding ourselves of the findings of <\/span>Sir Michael Marmot\u2019s 2020 review<\/span><\/a> of health inequalities over the past 10 years. Marmot\u2019s review noted the toll of austerity, from \u201c\u2026a rise in homelessness, to people with insufficient money to lead a healthy life and resorting to foodbanks in large numbers, to ignored communities with poor conditions and little reason for hope. And these outcomes, on the whole, are even worse for minority ethnic population groups\u2026\u201d<\/span><\/p>\n

Worryingly, the Race Disparity Unit\u2019s report and accompanying presentation of its findings are another example of the government\u2019s reluctance to address the underlying causes of covid-19\u2019s disproportionate impact on BAME communities. It is not hyperbole to say that the many warnings at the onset of the pandemic about people from BAME communities being at greater risk were not heeded until the dead bodies started to mount up.\u00a0\u00a0<\/span><\/p>\n

By the time England\u2019s chief medical officer <\/span>announced<\/span><\/a> an investigation into this disparity on 16 April, we already had community voices highlighting the rising death toll, evidence of a disproportionate number of deaths of health workers, and <\/span>ICNARC<\/span><\/a> reporting an over-representation of these communities in ICU beds.\u00a0\u00a0<\/span><\/p>\n

The formation of the inquiry by Public Health England was then almost immediately mired in controversy with the announcement that <\/span>Trevor Phillips and his consultancy<\/span><\/a> were to have a significant role in the investigation. His <\/span>media interviews<\/span><\/a> suggested that he was sceptical about whether racism explained the disproportionate impact of covid-19. While Phillips <\/span>was quietly dropped from any role in the inquiry<\/span><\/a>, the <\/span>subsequent report<\/span><\/a> still drew criticism, because it neither included the multiple inputs from the consultation events, nor did it have any recommendations for action.\u00a0\u00a0<\/span><\/p>\n

In the tumult that followed the publication of the first PHE report, two government \u201cinquiries\u201d were announced and weeks later <\/span>a second PHE report appeared<\/span><\/a>, which included the responses from the consultations and a set of recommendations. This second report suggested that many respondents had identified that racism had played a part in BAME communities\u2019 experience of covid-19, but the report\u2019s authors were not able to provide any data to illuminate this. Equally problematic, the recommendations rarely identified who was responsible for implementation and how we would know if these recommendations have been progressed.<\/span><\/p>\n

The past two months have seen multiple reports on the disproportionate negative impacts of covid-19, the accompanying lockdown, and subsequent restrictions we are now in on Britain\u2019s BAME communities. The denial that racism plays a part in shaping this disproportionate impact is only possible if we deny the \u201ccauses of the causes,\u201d to borrow a phrase from Marmot. Crucially, it also means that the actions we will take are unlikely to have an impact.\u00a0\u00a0<\/span><\/p>\n

The Race Disparity Unit\u2019s report identifies the government\u2019s plan to put aside \u00a325m to support a community champions scheme, which will improve the reach of public health guidance. Yet there is no money or recommendations for other key steps. The report seems content to record how deprivation and the places where BAME communities live has impacted their experience of covid-19, but there is no recommendation or money to help people with following the rules and guidance that their circumstances make difficult.<\/span><\/p>\n

As we face winter and the prospect of rising cases of covid-19, the government cannot afford to ignore the role of racism in the distribution of infections and deaths. With evidence that BAME communities are once again over-represented among patients in ICUs in the second wave, it literally is a matter of life and death.<\/span><\/p>\n

\"\"<\/a><\/p>\n

Jabeer Butt<\/strong> is chief executive of the Race Equality Foundation. Jabeer has an applied research background and has gained an international reputation for the use of evidence in developing interventions that help overcome discrimination and disadvantage. Twitter @ButtJabeer<\/a><\/em><\/p>\n

Competing interests:<\/strong> None.<\/p>\n","protected":false},"excerpt":{"rendered":"

The omission of racism from the government’s new report on covid-19’s health inequalities marks its latest failure to tackle this important issue, says Jabeer Butt […]<\/p>\n

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