Connecting the Dots: COVID-19, BAME Communities, and Racial Injustice

By Aileen Editha

The COVID-19 pandemic impacted England (and the world) in ways that no one could have imagined. One that is incredibly disappointing, however, is the disproportionate impact of the pandemic on Black, Asian and minority ethnic (BAME) communities in terms of exposure and mortality rates, as well as the recent data on vaccination uptake.

This issue, however, extends beyond the pandemic. As recent statistics on the Workforce Race Equality Survey (WRES) suggest, racism remains a deeply-rooted issue in the National Health Service (NHS) more generally. The NHS and—indeed, the Government—should swallow their pride in order to combat the prejudice that has been spotlighted by the pandemic.

The disproportionate impact of COVID-19 on BAME communities

It is likely that many of us have read the news on how exposure and mortality rates of COVID-19 were higher in BAME communities. In particular, those of Bangladeshi ethnicity have the highest mortality rate whereas Black communities have the highest exposure rate to COVID-19. The Government has attempted to attribute this inequality to biological and genetic factors, but studies have shown that these are “unlikely to explain the ethnic inequalities.” (p 12) The disproportionate impact of the pandemic on BAME communities is shaped by the fundamental structural and institutional racism in healthcare systems. This, however, is not a novel finding.

Recent Data on Vaccine Uptake

According to the data available from OpenSafely as of February 24th, only 66.9% of Black people over 80+ have been vaccinated. This is relatively low compared to South Asians (80.5%) and Whites (94.9%). The trend could also be seen across other demographics such as those who are between 70-79 years old. Although 94.3% of White people in this demographic have been vaccinated, only 80.6% of South Asians and 63.8% of Black people are. Among 65-69 year olds, only 49.6% of Black people who are eligible have been vaccinated. Again, this is much lower than South Asians (69.9%) and Whites (77.6%).

Although there is a lack of data, one could assume that the number of people vaccinated by occupation also favour White than BAME as key workers are more likely to be White. Moreover, BAME NHS staff—particularly Black and Flipinx staff—are also more likely to refuse vaccines.

Although these statistics are constantly changing, the Government and the wider public have been quick to attribute these numbers to individual vaccine refusals which have been more prevalent among BAME—in particular, South Asian—communities.

Although religious and/or socio-cultural beliefs can influence these numbers, to fully focus on and blame them would bypass deeper issues. For instance, a person’s decision to refuse a vaccine could be influenced by both their socio-cultural beliefs and their lack of trust on public institutions inter alia the NHS based on experiences of systemic and institutional racism.

The Bigger Picture: Racism in the NHS

The disproportionate impact of the pandemic on BAME communities has illuminated the broader issue of racism within the NHS, which is also reflected in their recently-published Workforce Race Equality Survey (WRES). The report, which surveys all NHS Trusts in England—and, for the first time, clinical commissioning groups (CCGs)—aims to track NHS workforce equality.

The survey found that BAME staff are 2.5x more likely to have personally experienced discrimination at work from a manager, team leader and/or colleagues compared to their white colleagues. There is also—perhaps, unsurprisingly—an overall decline in the percentage of staff who believe that the NHS provides equal opportunities for career progression or promotion. Although 88.3% of white and 73.4% of BAME staff believe this in 2016, the number has declined to 86.9% and 71.2%, respectively. It is important to note, however, that the data for WRES was collected before the COVID-19 pandemic and the Black Lives Matter movement, so it would be unsurprising if the numbers have since decreased.

“The pandemic did not create race inequality, but it has thrown it into sharp relief.” In light of recent data and statistics, it has become more important to connect the dots between the pandemic, its impact on BAME communities, and prevalent institutional racism in the NHS.


Author: Aileen Editha

Affiliations: Centre for Ethics and Law in the Life Sciences, Durham Law School, Durham, United Kingdom.

Social Media accounts: @aileenedithap

 Competing interests: None declared


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