PUBLIC HEALTH ENGLAND: Report Finds ‘Historic Racism’ And ‘Hostile Environments’ Partly To Blame For Disproportionate Risk Of COVID-19 Among Blacks, Asians And Other Minority Communities

Historic racism and hostility towards immigrants could be partly to blame for black, Asian and ethnic minority (BAME) people being more likely to die from Covid-19, officials claimed today.

Public Health England (PHE) published the long-awaited second part of its report into how the coronavirus has hit BAME communities harder. 

It said ‘hostile environments’ towards immigrants may have affected settled BAME communities through ‘heightened prejudice’ and ‘societal tensions’ — but did not explain how this has directly raised the risk of Covid-19.

 The report also claimed a lack of trust in the NHS may have left some BAME groups reluctant to seek help early on, potentially making their disease harder to treat. It said some people were ‘fearful of being deported’ if they presented to hospital. 

And it claimed that BAME NHS staff may be less likely to speak up when they have concerns about personal protective equipment (PPE) or their risk. 

The report – based on discussions with 4,000 people – noted that historic racism has meant non-white communities are generally poorer so have worse health, putting them at higher risk if they catch Covid-19.

Ethnic minority people — in particular those from black, Bangladeshi or Pakistani backgrounds — have for decades been more likely to have lower-paid jobs, leaving them with less money to live healthy lifestyles.

BAME people are more likely to have conditions such as heart disease and type 2 diabetes, PHE said, which make them more vulnerable to Covid-19. And they are more likely to work in risky jobs in which they spend time in contact with members of the public, increasing the chance of them catching the disease.

Today’s report was published after officials came under fire for failing to make any recommendations for what could actually be done about the problem in their first document, published two weeks ago on June 2.

One MP, Layla Moran, said it was ‘astonishing’ that it had taken two weeks for the Government to release the second part of the report and that it had to be ‘shamed’ into doing so.  

The seven recommendations made in this second instalment were: 

  • Make ethnicity a routine part of NHS statistics and improve the quality of BAME data;
  • Involve more BAME people in ‘community participatory research’ to discuss how social, financial, cultural and religious factors affect Covid-19 risk;
  • Improve non-white people’s experience of the NHS and health care systems by regularly auditing how they interact with healthcare, and making sure ethnic minority people are well represented across the health and care sectors;
  • Develop workplace risk assessments specifically for BAME employees, especially for key workers;
  • Fund and develop BAME-specific Covid-19 education campaigns to communicate risk and encourage people to get tested and follow public health guidance; 
  • Push public health campaigns for BAME people, who are at higher risk of obesity and serious health problems;
  • Ensure that Covid-19 recovery strategies ‘reduce inequalities caused by the wider determinants of health’.  
Data in Public Health England's first report showed that the mortality rate - the number of people dying with the coronavirus out of each 100,000 people - was considerably higher for black men than other groups. The risk for black women, people of Asian ethnicity, and mixed race people was also higher than for white people of either sex. The report warned the rate for the 'Other' category was 'likely to be an overestimate'
Data in Public Health England’s first report showed that the mortality rate – the number of people dying with the coronavirus out of each 100,000 people – was considerably higher for black men than other groups. The risk for black women, people of Asian ethnicity, and mixed race people was also higher than for white people of either sex. The report warned the rate for the ‘Other’ category was ‘likely to be an overestimate’
While white people make up a majority of Covid-19 hospital cases, they are more likely to be treated on normal wards with less severe infection. For adults in all other ethnic groups, however, there are higher rates of intensive care admission than there are admissions for low-level care
While white people make up a majority of Covid-19 hospital cases, they are more likely to be treated on normal wards with less severe infection. For adults in all other ethnic groups, however, there are higher rates of intensive care admission than there are admissions for low-level care

The report today shed more light on how ethnic minority people’s interactions with the NHS may leave them with worse health.

It explained that ‘hostile environments’ for immigrants mean some may avoid medical care.

PHE said: ‘Fear of diagnosis and death from COVID-19 was identified as negatively impacting how BAME communities took up opportunities to test for COVID-19 and their likelihood of presenting early for treatment and care. 

‘The effects of hostile environments against immigrants, particularly failed asylum seekers and undocumented immigrants, might affect settled BAME populations adversely through heightened prejudice and societal tensions. 

‘For many BAME communities, lack of trust of NHS services and treatment resulted in their reluctance to seek care on a timely basis, again resulting in late presentation with disease. 

‘Others were also fearful of being deported if they presented to hospital.

‘People in the asylum system and those with no recourse to public funds, who can often face additional barriers to accessing healthcare.’  

PHE suggested that the way immigrants and asylum seekers are treated by the Government – many must pay to use the NHS except in emergencies – has a knock-on effect on how British people in ethnic minority groups view the health service.

This self-titled ‘hostile environment’ was designed to deter health tourists from abusing free NHS healthcare.

But as a result it may have led to non-white people in Britain seeing people of the same ethnicity as them being treated unequally by the health system, PHE’s report suggests. 

This, in turn, may make minorities – even those who are British and entitled to free care – less willing to go to the NHS.

This has come to fore now that there is a health emergency, it said, adding: ‘Factors such as low health literacy, loss of trust and fear of discrimination have resulted in BAME groups not seeking health advice in a timely fashion. 

‘It has also reduced uptake of COVID-19 testing and fear of reporting COVID-19 symptoms. 

‘This has serious implications resulting in more acute symptoms and severity of condition.’  

Credit: Daily Mail

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