Black and ethnic minorities in the UK are dying in disproportionately high numbers compared with white people. They appear to be over-represented among the COVID-19 deaths, by as much as 27%.
An analysis study carried by the Guardian has found that more than 12,000 patients who died in hospitals up to 19 April, almost 20% were Black, Asian and minority ethnic (BAME) even when these groups represent only 15% of the general population in England. Other countries, local reports, and hospitalisation rates have confirmed that minority groups face the greatest risk.
So here it is where medical anthropology enters into play to answer the question: “Why communities with a proportional higher number of BAME inhabitants appear to be dying at higher rates?
The reasons why geographical areas with larger ethnic minority populations in the UK have higher mortality rates represent an equally complex biosocial phenomenon. Wasim Hanif, a professor of endocrinology and diabetes at University Hospital Birmingham, has suggested that the previous health inequalities that have existed in minority communities are now being reflected in this pandemic, “those inequalities are actually coming out”. On one hand, these biological factors have long been known to impact health outcomes and wellbeing, but Covid-19 is materialising these and other inequalities in newly visible ways.
We already knew from China and Italy that most of the deaths by the novel coronavirus are linked to people with previous medical conditions like diabetes, cardiovascular diseases, and cancers.
The black population is particularly afflicted with hypertension. Diabetes is three-fold higher in this ethnic group. Both of those conditions will increase your risk of death once you’ve got Covid. The added problem is that these conditions occur at a younger age in people of black descent. With Asian populations there is a four-fold excess in diabetes and blood pressure rises higher with age in South Asians compared to Europeans.
But ethnicity is not simply biology constructed, it is a complex socio-cultural whole. Therefore, we also need to address that race and racial inequalities are highly linked to disproportionate rates of poverty, insecure and low-paid labour, and overcrowded housing. All those conditions are putting ethnic minorities much more at risk of catching Covid-19 disease.
Ethnic minorities do also have high-risk jobs compared with the white population. A high percentage of health workers, people working in the transport sector and essential shop work belongs to BAME groups. Clearly, there’s a huge amount of heterogeneity, but overall ethnic minorities are more likely to live in deprived, dense, over-crowded urban areas and are more likely to be disadvantaged.
We believe that the more you are exposed to viral load the likely the disease is proved to become more serious. So, both through occupation and residential reasons, they’re less able to socially isolate effectively and much more likely to be exposed to high doses of the virus. Could this be perhaps one of the reasons why young healthcare workers are succumbing to the disease?
Just imagine this; there is a large number of BAME workers not able to stay at come because they are serving the nation, putting themselves at risk. Now, you add that to multigenerational and overcrowded occupancies. The result is that the infection can be brought back home and spread to other members of the family. Understanding that some bodies are more exposed than others to the coronavirus means treading a fine line in both recognising how the social shapes biological vulnerability without newly homogenising or re-stigmatising these communities.
But what I am really concerned these days is about the high death rate among BAME health care workers. Newspapers have published data with a disproportionate percentage of BAME healthcare workers getting ill and dying from the novel coronavirus. Working as a nurse for the NHS, my colleagues and I are understandably concerned about the number of known fellow doctors and nurses who have recently become seriously ill or even passed away. The Guardian newspaper has revealed that BAME doctors and nurses felt less able to complain about inadequate personal protective equipment. They are “twice as likely not to raise concern because of fears of recrimination”.
We are learning that COVID-19, like other many diseases, is linked to health inequalities, to deprivation and affluence, and to socio-economic status. All this is determining health outcomes. This isn’t just an ethnicity story; it is affecting all of us. Britain has a long history of health inequalities. It’s critically important to understand and study it, and I am relieved that the government is taking this seriously.
My advice to all the BAME healthcare workers out there is clear. While our government needs to view those racial inequalities as a serious problem to act on it, health care workers from ethnic minorities need to look after themselves and ensure they are wearing appropriate PPE. I urge all my fellow co-workers not to risk their life if they are not properly protected.
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