These statistics have been collated from a variety of different sources, which have differing ways of categorising and describing ‘race’ and ethnicity. (For example, some sources differentiate between particular black ‘groups’ whilst others do not. Some sources may just use the term Asian, others may differentiate between different Asian groups or different religious groups.) Where we have used other organisations’ statistics, we have followed the categorisation/names used by them – which means that there may be inconsistencies in terminology within and between pages.
HEALTH DIFFERENTIALS AND DEATH RATES
The effects of the COVID-19 pandemic have made it clear that ethnicity can be a potent social determinant of health. A Public Health England report published on 2 June 2020 shows that Black people are the group most likely to be diagnosed with the disease. The Intensive Care National Audit and Research Centre (ICNARC) study published on 22 May 2020, found that Black and Asian patients were overrepresented among those critically ill with confirmed COVID-19 receiving advanced respiratory support. The study of almost 2,000 patients found that 35% were non-white, nearly triple the 13% proportion in the UK population as a whole. Fourteen per cent of those with the most serious cases were Asian and the same proportion were black.
Once diagnosed, as shown by the Public Health England report, the death rate from the virus is highest amongst Black and Asian ethnic groups, while people of Chinese, Indian, Pakistani, other Asian, Caribbean and other Black backgrounds also face a much higher risk of death compared with white Britons. Statistics also show that people from Bangladeshi backgrounds in England are twice as likely as White British people to die if they contract Covid-19.
The report which compared mortality rates during the Covid pandemic with previous years’, showed that overall mortality was almost four times higher than the norm among Black males for this period, almost three times higher in Asian males, while mortality in White males was only almost twice as high. Among females, deaths were almost three times higher in Black, Mixed and Other females, and 2.4 times higher in Asian females compared with 1.6 times in White females.
The Intensive Care National Audit and Research Centre (ICNARC) report identified that comorbidities, which increase the risk of poorer outcomes from COVID-19, are more common among certain ethnic groups. People of Bangladeshi and Pakistani background have higher rates of cardiovascular disease than White British people, and people of Black Caribbean and Black African ethnicity have higher rates of hypertension compared with other ethnic groups. Data from the National Diabetes Audit also suggests that type II diabetes prevalence is higher in people from BAME communities.
Moreover, as noted by the Race Equality Foundation, the fact that Black and minority ethnic people are overrepresented in some institutional settings including prisons, mental health inpatient units, and homeless accommodation puts them at greater risk of contracting COVID-19.
Government statistics also show that Black and minority ethnic people are more likely to be key workers and/or work in occupations where they are at a higher risk of exposure. These include cleaners, public and private transport, shops, care and the NHS itself.
Cramped housing is also far more likely to be a problem for ethnic minorities. Statistics suggest that thirty per cent of the UK Bangladeshi population live in overcrowded housing compared with two per cent among the white British population. Fifteen per cent of Black African people also live in overcrowded conditions, as do sixteen per cent of Pakistanis. Maintaining social distancing and self-isolation is therefore far more difficult for these groups.
NHS WORKER DEATHS
The increased risk posed to BME NHS workers has been very evident.
Statistics from March 2019 suggest that BME people comprise 44% of the NHS workforce, therefore leaving them disproportionately at risk of contracting the virus through work. This was borne out in the early weeks of the crisis as the first ten doctors to die of COVID were all from BME backgrounds.
Analysis published on 25 May 2020 by the Guardian found that 61% per cent of healthcare workers to die during the pandemic were from an ethnic minority background. The British Medical Journal published research in 2020 to show that two thirds of healthcare workers who have died from covid-19 were from an ethnic minority background, and at least half were not born in the UK. Researchers looking at the deaths of 106 healthcare workers, 63% of whom were from an ethnic minority background, found 18 of the 19 doctors and dentists who had died from covid-19 were from ethnic minority backgrounds. The same was true of 71% of the 35 nurses and midwives who had died, 56% of the 27 healthcare support workers who had died, and 29% of the 25 other staff who had died.
A review by Public Health England, based on stakeholder engagement with more than 4,000 people, suggested that historical racism may make BME individuals less likely to seek care when needed or, as NHS staff, to speak up when they have concerns about personal protective equipment (PPE) or increased risk.
During the early weeks of the COVID-19 pandemic, anecdotal evidence suggested an increase in racist attacks against particularly Chinese and East Asian people. Data published after a freedom of information request showed that in February 2020 there were 64 hate crimes against people of south and east Asian backgrounds reported to the Met Police, more than twice the average for the previous year.
At a session of the Home Affairs Select Committee on 13 May 2020 it was reported that there has been a 21% rise in hate crime against South and East Asian groups since the onset of the pandemic.
Analysis published by Liberty Investigates and the Guardian in May 2020 showed that between 27 March and 11 May, English police forces handed out 13,445 of the fines for breaching lockdown rules, also known as Fixed Penalty Notices. People of colour were 54% more likely to be fined than White people, with around 2,218 fines being meted out to BAME people and 7,865 to White people. The report also highlighted that stop and searches in London have surged by twenty-two per cent under lockdown, with stops of black people increasing by 7.2 per 100,000 people to 9.3 per 100,000 people.
Updated analysis based on freedom of information requests published in June, furthermore, shows that police enforcing the lockdown in England and Wales were almost seven times more likely to issue fines to BAME people than White people. The data shows that disproportionate policing against BAME communities is taking place across the country. Seventeen Police Forces were more likely to issue a penalty notice to BAME people than to white people. The most ethnically disproportionate use of fines was by the Cumbria police force, where BAME people were 6.8 times more likely to be fined than white people. Other disproportionate forces were Avon and Somerset, where BAME people were 4.4 times more likely to be fined than white people, Lincolnshire, where BAME people were also 4.4 times more likely, and Suffolk, where BAME people were 4.1 times more likely to be fined.
In Europe, this trend has also been present beyond the UK. Amnesty International have reported that, for example, in Seine-Saint-Denis in Paris – home to a high proportion of black residents – the number of police checks on compliance with social distancing measures is more than double the French national average. The number of fines issued was also three times higher than in the rest of the country, despite levels of respect shown for lockdown measures being comparable with other regions in France.
MIGRANTS AND ASYLUM SEEKERS
The Local Government Association has reported that high numbers of people with no recourse to public funds (NRPC) have been approaching councils for support during the pandemic. NRPC is a condition placed on individuals as a result of their immigration status, removing their access to welfare benefits. It applies to all who are subject to ‘immigration control’. Many of these people, mainly from BAME backgrounds, have suffered loss of income, employment or housing since the pandemic and have therefore been left destitute and homeless due to the enforcement of the NRPF condition.
Statistics show that there were 367,827 decisions on applications to extend a person’s stay in the UK in the year ending March 2020, 32 per cent more than in the previous year. The largest contribution to this increase was from extensions to leave provided to Chinese nationals who were unable to return home due to coronavirus restrictions. Few statistics, however, have yet been gathered on the effects the pandemic has had upon these people.
In a recent report published by Patients Not Passports 57% of the respondents to their research reported that during the pandemic migrants have avoided seeking healthcare because of fears of being charged for NHS care, data sharing and other migration enforcement concerns. While treatment for coronavirus and other communicable diseases is exempt from charging, few respondents (20%) agreed that migrants are aware of this exemption. Most of those responding to the survey (56%) had not seen any information from public bodies raising awareness of migrants’ rights to healthcare during the coronavirus crisis. Fewer still (9%) think that information about charging exemptions is reaching all sections of their communities in an accessible format. The overall effect of this is migrants and asylum seekers failing to gain access to the healthcare they need.