The review into the disparities in risks and outcomes by Public Health England has officially stated what has been long known to many – vulnerable groups, those facing the severest of health inequalities, are being disproportionately impacted by the pandemic.
These health inequalities are not a new phenomenon and have existed in society since before Covid-19 but the pandemic has shone a light on an area that has always been side-lined and brought them to the fore.
The analyses take into account age, sex, deprivation, region and ethnicity, and has found that older people, males, those living in deprived areas, and BME communities are at higher risk to Covid-19.
Evidence suggests that Covid-19 has had a disproportionate impact on people from Black, Asian and Minority Ethnic (BAME) groups, with death rates higher for these groups when compared to White ethnic groups. The review does not attempt to explain the reasons behind the higher risk – it does not recognise health inequalities as a consequence of socioeconomic policies, as well as structural racism and discrimination – key factors in understanding the impact better.
It’s also important to note the level of risk faced by health and care workers from BME communities, especially in light of their over-representation in the mortality figures from Covid-19. People from BME communities are more likely to be in frontline jobs, disparagingly termed as “low-skilled” in the review, that have been recognised as “essential” to continue provision of services during the pandemic – however, overrepresentation in these places the minority communities at further risk of contracting Covid-19.
Significantly, the mental health impact on these communities is concerning with one small helpline working with a particular faith community reporting at least one call about suicide every night, compared to fortnightly previously. Helplines, such as this one, have seen more than a 300% increase in calls, web chats, and emails and it is essential that BME-led/-focused provider organisations working with communities at higher risk are supported effectively.
Kathy Roberts, CEO, Association of Mental Health Providers, commented:
“The review has highlighted the detrimental impact of Covid-19 on BME communities but it does not state anything that was not previously known. The review looks at the disparities but does not consider that a black older male, living in a deprived area will be at a much higher risk and as such, an intersectional approach to reviewing data would have been of import.
“A notable omission from the review is the outline of reasons behind the disproportionality and a set of key actions. It is disappointing to see the lack of a clear action plan to prevent the future loss of life at a disproportionate rate.
“Going forward, we need to support and invest in the development of culturally-appropriate services and work alongside (with, not for) BME communities and grassroots organisations to enable them to reach their communities.
“There is a need for an equitable response to the pandemic which so far has been lacking, especially in terms of funding. The time to act was months ago, but we must take swift action to prevent further disproportionate losses.”
It is hugely disappointing to see the review does not meet its initial objectives of providing clear actions and recommendations to prevent and limit the disproportionate impact on high-risk communities. Furthermore, having participated in engagement sessions as representatives of the VCSE mental health sector, we have been dismayed to learn of the removal of a chapter which included responses of evidence from 1000+ organisations and stakeholders highlighting concerns of discrimination, racism, and poor life chances as factors for the increased risk of Covid-19 to those from BME communities.