New evidence review exposes how structural racism connects poor-quality work, inadequate sick pay and early workforce exit
- Black and Asian workers experience health of people decades older by their 40s and 50s – yet major 2025 policy reviews treated workforce as racially uniform
- Critical evidence gaps in national data mean racial disparities in sick pay access, sickness absence and return-to-work outcomes remain unmeasured
- Workers denied sick pay, disciplined for illness, required to send hospital photos with same-day newspapers to prove they’re unwell
- Without urgent intervention, early economic exit of fastest-growing segment of UK workforce threatens productivity and widens health inequalities
5 March 2026, London: Black, Asian and minoritised ethnic workers are being pushed into jobs that damage their health and then denied the support they need to recover – but no UK study has measured the full extent of the problem, according to a new report published today.
Too Poor to Be Sick: Race, Work and Ill-Health, from the Race Equality Foundation, is an attempt to connect the full chain: how structural racism drives workers into precarious jobs, denies them adequate protection when they fall ill, and accelerates health decline to the point where some are forced out of work prematurely.
The report exposes a critical blind spot in UK policy: while the Commission on Healthier Working Lives (2025) and Keep Britain Working (2025) both recommended sweeping reforms to support ill workers, neither addressed racial inequalities – despite Black and Asian workers being disproportionately concentrated in the most insecure, poorly protected jobs.
Yet national data systems do not routinely record ethnicity in relation to sick pay access, fit-note use, occupational health provision, or return-to-work outcomes – making it impossible to measure the scale of the problem or hold employers and policymakers accountable.
The analysis, drawing on a comprehensive scoping evidence review with qualitative engagement with 26 workers, documents how these patterns play out in daily life:
- Workers arbitrarily denied sick pay by employers despite being eligible
- A healthcare worker hospitalised and required to photograph themselves with a same-day newspaper to prove their illness
- Workers disciplined or forced to resign after taking sick leave
- Workplace adjustments refused on grounds of cost – or explicitly due to race
- Even where occupational health services exist, minoritised ethnic workers describe pervasive distrust rooted in institutional racism
Jabeer Butt OBE, Chief Executive of Race Equality Foundation, said:
“This report exposes the undeniable fact that the employment system designed to protect workers who fall ill is failing those who need it most. While recent policy reviews treat the workforce as uniform, the reality is that Black, Asian and minoritised ethnic workers face a triple bind – jobs with the highest physical demands, the weakest sick pay provision, and the least access to occupational health.
“But here’s what should alarm policymakers most: we still cannot measure the full extent of the problem because national datasets do not routinely disaggregate by ethnicity. This evidence gap is not accidental – it reflects structural racism in how we monitor workplace health and outcomes.”
The report makes four urgent recommendations:
- Measurement: Improve integration of ethnicity variables into national data on employment and ill-health, including quantifying racial disparities in sick pay access, fit-note use and return-to-work rates.
- Design and evaluation: Assess future reforms to Statutory Sick Pay and occupational health for differential impact by ethnicity and employment type, developing co-production mechanisms with minoritised ethnic workers.
- Mechanisms and lived experience: Support mixed-methods research investigating how racism and discrimination operate through employment practices, benefit eligibility and healthcare navigation.
- Framing and accountability: Recognise racism as a determinant of health within work and welfare policy.
– ENDS –
For further information or interviews, please contact:
Lauren Golding, Communications and Public Affairs Manager, Race Equality Foundation
Email: Lauren@racefound.org.uk ; Telephone: 07593454182 or 07833601322
Available for Interview:
- Jabeer Butt OBE, Chief Executive, Race Equality Foundation
- Workers with lived experience of working through illness (via Race Equality Foundation)
Notes to editors:
- Too Poor to be Sick: Race, Work and Ill-Healthis published by Race Equality Foundation on 5 March 2026 and is available at: raceequalityfoundation.org.uk/health-care/toopoortobesick
- The report is based on a comprehensive scoping review of UK and international evidence, supplemented by lived experience interviews and focus groups with 26 Black, Asian and minoritised ethnic workers conducted in 2025.
- The research was commissioned by The Health Foundation and conducted by Race Equality Foundation between September and December 2025.
- The ‘weathering hypothesis’ refers to the theory that health advantages in younger minoritised ethnic groups are eroded by cumulative exposure to racism, discrimination and disadvantage, leading to accelerated health decline from middle age.
- The Commission on Healthier Working Lives (2025) and Keep Britain Working (2025) both released major policy recommendations on employment and health in 2025, but neither explicitly addressed racial inequalities in access to workplace protections.
- Recent analysis shows that minoritised ethnic workers formed a significant part of net labour force growth between 2002 and 2018, but were more likely to be in insecure employment.
- Race Equality Foundation is a registered charity (1051096) working to tackle racial inequality in health, housing, employment and social care across the UK.
