The Government must tackle health inequalities if they truly believe Black Lives Matter
By Natasha Dhumma, Head of Policy & Campaigns and Rosalie Hayes, Senior Policy & Campaigns Officer
The arrival of the COVID-19 pandemic earlier this year has brought much uncertainty but if this period has offered some clarity on one thing it’s that structural racism is alive and well in the UK.
Beyond the stark health disparities arising from COVID-19 the Black Lives Matter movement has shone a light on the injustice faced by Black communities at the hands of the British police and state. There has been a groundswell of public commitment to understanding and tackling these expansive inequalities and a real sense that we are at an historic moment.
While it may be politically convenient to now get side-tracked by conversations around statues, television shows and white guilt we must not lose our focus; the laws and policies killing people of colour and what our Government should be doing about it.
The COVID-19 inequalities review, published by Public Health England at the start of June, found that people of Black, Asian and other minority ethnic (BAME) groups may be more exposed to COVID-19, and therefore are more likely to be diagnosed. Death rates from COVID-19 were higher for Black and Asian ethnic groups when compared to White ethnic groups. All-cause mortality was almost 4 times higher than expected among Black males for this period, almost 3 times higher in Asian males and just under 2 times higher in White males, when compared to previous years.
The report from Professor Kevin Fenton, which specifically sought to understand better the impact of COVID-19 on BAME groups and was published this week, stated that the explanation involves a range of factors. These include social and economic inequalities, occupational risk, inequalities in the prevalence of conditions that increase the severity of disease including obesity, diabetes, CVD and asthma, and, crucially, racism, discrimination and stigma.
Like HIV, COVID-19 is a disease which illuminates and exacerbates existing heath inequalities, and there is significant overlap between the most at-risk groups.
74% of heterosexual people receiving HIV care in the UK in 2018 were from BAME communities and the highest rate of late diagnosis (the most important predictor of HIV-related illness and death) was in heterosexual Black men. These racial inequalities persist across a much wider spectrum of physical and mental health yet minority ethnic groups remain “poorly served in the NHS”, with social and economic inequalities intersecting with institutional racism within healthcare to exacerbate harm.
NAT has supported the calls to better understand the impact of COVID-19 on BAME groups and we believe that a comprehensive Government strategy is needed to address the social determinants which underlie racial disparities in health outcomes. However, these issues are not new and countless recommendations have been made that the Government have failed to seriously enact. To name but a few high-profile examples, the Marmot Review 2010, the Lammy Review 2017, and the Race Disparity Audit 2017 have all identified racial disparities caused by a range of social inequalities. Yet, the Marmot Review 10 Years On, published this year, warned that health inequalities have in fact widened over the last decade due to the increased deprivation that has arisen as a direct result of Government austerity policy and public funding cuts.
Ten years of inertia on racism proves that while the Government is all too quick to emphatically pronounce that Black Lives Matter, it is excruciatingly slow to save them.
The Coalition of Race Equality Organisations wrote to Matt Hancock on Thursday 4 June, outlining evidence-based recommendations which the Government should implement immediately. Amongst other things, these include increasing social security payments, scrapping No Recourse to Public Funds, and ending data-sharing between the NHS and Home Office – all actions which NAT, alongside others in the charity sector, have been pushing the Government to implement for many years. We need the Government to act now on these recommendations as well as those made in Professor Fenton’s report, and not use their newly announced review as an excuse to kick this issue into the long grass.
Words are easy but in this country longstanding health inequalities consistently sit alongside racial disparities in education, employment, the criminal justice system and housing, manifesting in vast social and economic inequality. Can our Government really claim to live up to the values it espouses? World events have pushed structural racism to the forefront, laying bare the complex layers of injustice that are so interwoven into our social fabric they often lie unnoticed.