On Tuesday 2nd June 2020, the much-awaited Public Health England report commissioned by the government to find answers to disparities in mortality rates for BAME communities was finally published. The initial remit of the report was to identify what factors were causing the disproportionate impact to minority groups but also to identify appropriate measures to reduce them. This 89-page document outlined many of the findings that have already been replicated in a number of previous research papers. It stated that those living in deprivation, in overcrowded dwellings, in urban areas and working in customer or public-facing roles were more susceptible to dying from coronavirus. The report did not offer any new findings nor meet its original aim of identifying solutions to the effects of this pandemic on minority groups.
This statistical anomaly was recognised very early on in the pandemic and became widely reported with the daily televised announcement of the death toll. We all watched silently as each new day brought the spectre of another brown and black face. We watched until the silence was deafening and we could no longer ignore what was staring us in the face. In fact the first employees from ethnic minority backgrounds count for 61% of the deaths amongst NHS staff. More than a 30% of those health workers were in nursing roles in comparison to 18% amongst doctors and surgeons.
The initial hypothesis was that there were socio-economic pressures that were inherent in minority populations such as BAME people being more likely to live in deprived urban areas and subject to overcrowded housing. In addition it was also posited that these factors were compounded by health inequalities such as the prevalence of diabetes, kidney disease and heart disease in certain ethnic groups. Finally, it was argued that a deficiency in vitamin D could also play a part in explaining the differences between different demographics.
ONS statistics from 2014-2017 identified that whilst 30% of Bangladeshi families and 12% of Black household experience overcrowding only 2% of white British households are subject to overcrowded homes. BAME people are often concentrated in dense, over-populated urban areas, in homes with a multigenerational makeup and therefore with limited opportunities for social distancing.
The report states that keyworkers, nurses, doctors, taxi drivers, security personnel, cleaners, construction workers are those most effected by coronavirus. BAME people typically hold these roles. These are our keyworkers who have continued to work throughout the lockdown, whose roles do not allow them the privilege of working from home. These same people who are viewed as front-line staff are systematically dehumanised and undervalued. Those in public service roles have been subject to pay stagnation due to more than a decade of underfunding and austerity, many living on poverty pay with insufficient funds to afford a decent quality of life.
Due to the erosion of collective bargaining and union involvement and support of employment rights there are 7 million people working in the gig economy on zero hour contracts. Some are immigrants who, because of the hostile environment, have no recourse to public funds. These people do not have the option of being furloughed and face the absurd paradox of either staying at home to minimise their risk of contracting the virus and therefore having no means to feed their family or going to work and putting their lives and the lives of their family in jeopardy. These are the same people we see on public transport failing to socially distance because they have no other option. The same people who, until very recently, if working in the NHS, had to pay an annual surcharge to be able to practice their profession and to care for the people of this country. On Thursday 21st May the migrant health surcharge was abolished for non-EEA nationals thus saving at least £400 per year. Expenditure that many BAME health professionals can barely afford.
The publication of the reports highlights a number of factors that discount the spurious pro-eugenics position that black people are genetically more susceptible to the virus. If that were the case then there would be significant numbers of people dying in Africa and Asia, but that is not so. Rather, that the disparity is due to systemic and institutionalised racism that is manifested in housing, access to resources, health, wealth and opportunity.
Black and brown people face erasure of their voices and their lived experiences on a regular basis. As part of this report, 1000 BAME participants were consulted. However, their comments have been omitted from the published report. The TUC have completed their own study and are in the process of gathering more data from a greater pool of respondents. They have been told of BAME workers being disproportionately allocated duties in Covid-19 wards and not being given sufficient PPE.
We call on the government to not stop here at a report merely collating the statistics of the many injustices that our BAME colleagues, friends, sisters and brothers face. But, to hold a public enquiry with recommendations for how the government is going to implement strategies to address the stark health inequalities that have led to these variances.
It is an indictment that at the time of writing (on Tuesday 3rd June 2020), the report is no longer live on the government website, only one day after being published. The report must be published in full including the observations and statements of the BAME participants and the recommendations that were proposed by the stakeholders.
We stand with all of our brothers and sisters. We are not free until all of us are free.
If you identify as BAME and want to air your views about your lived experience throughout the coronavirus pandemic, please complete this short TUC survey: