Coronavirus information and resources
Updated 2nd April
- What we know about COVID19 and the risk factors relating to it
- How do these risk factors affect black and minority ethnic people and communities
- The wider determinants of health
- ‘Knock on’ effects
What we know about COVID19 and the risk factors relating to it
Age appears to be a significant risk factor, with older people highly vulnerable to COVID19. This may be related to the higher likelihood of having a long-term condition. By comparison, children appear to be less severely affected on average (but can still contract the disease).
People with a weaker immune system are also at greater risk, the NHS lists people who:
- have had an organ transplant and are taking immunosuppressant medicine
- are having chemotherapy or radiotherapy
- have blood or bone marrow cancer, such as leukaemia
- have a severe chest condition, such as cystic fibrosis or severe asthma
Long term conditions such as high blood pressure and diabetes are associated with higher rates of mortality from COVID19. The NHS has also written to 1.5 million people with conditions that put them in the highest risk category for mortality due to COVID19.
Institutional settings such as care homes, homeless hostels and prisons where large numbers of people with poor health and long term conditions are in a predominantly communal space, have seen the fast spread of COVID19. This has prompted, for example, the release of prisoners in some countries.
Men appear to be at greater risk of death from coronavirus. It is unclear why this is and various explanations have been offered, such as higher rates of smoking and poorer access to healthcare.
The Prime Minister described London as being ‘weeks ahead’ of the rest of the UK with regards the spread of COVID19. It is likely that other large cities and transport hubs will also experience higher rates of transmission and infection due to the larger number of people present.
How do these risk factors affect black and minority ethnic people and communities
Particular groups of black and minority ethnic people have higher rates of long term conditions associated with COVID19 fatalities, such as high blood pressure and diabetes.
African Caribbean people have higher prevalence of high blood pressure, and South Asian people (particularly first generation) have higher prevalence of Coronary Heart Disease (British Heart Foundation). South Asian people are up to six times more likely to have Type 2 diabetes (Diabetes UK). African Caribbean, South Asian, and people of Mediterranean origin are also more likely to have Sickle Cell Disease, which is one of the conditions identified by the NHS as being at highest risk of mortality relating to COVID19.
Read our briefing on ethnicity and heart disease: https://raceequalityfoundation.org.uk/wp-content/uploads/2018/03/health-brief16.pdf
Read our briefing on sickle cell disease:
Read our briefing on long-term conditions, ethnicity and poverty: https://raceequalityfoundation.org.uk/wp-content/uploads/2018/03/health-brief8.pdf
Read our briefing on anti-microbial resistance and ethnicity: https://raceequalityfoundation.org.uk/health-care/the-burden-of-antimicrobial-resistant-infections-in-black-and-minority-ethnic-groups/
While black and minority ethnic groups as a whole tend to be younger than White British people, there are particular black and minority ethnic communities that have higher averages ages such as Irish and Jewish communities. Seven per cent of African Caribbean people are aged 70-79 with a further three per cent aged 80 or more. This compares to eight percent 70-79 and seven per cent 80+ for the White British group.
Read our briefing on the health of Irish people in Britain: https://raceequalityfoundation.org.uk/health-care/the-health-of-irish-people-in-britain/
Black and minority ethnic people are more likely to be key workers and/or work in occupations where they are at a higher risk of exposure. These include cleaners, public transport (including taxis), shops, and NHS staff (Cabinet Office, 2019). Within the NHS, black and minority ethnic people are 40 per cent of doctors and 20 per cent of nurses nationally (and 50 per cent in London). Black and minority ethnic people are also 17 per cent of the social care workforce, rising to 59 per cent in London, with particular groups such as Eastern Europeans and Portuguese workers often being less visible but a significant part of the workforce.
Read our BMJ Open article on race and gender within the NHS workforce: https://bmjopen.bmj.com/content/bmjopen/10/2/e034258.full.pdf
Black and minority ethnic people are overrepresented in some institutional settings including prisons, mental health inpatient units, and homeless accommodation. This potentially puts them at greater risk of contracting COVID19. All of these settings are associated with poorer physical health and long-term conditions, so it is likely there will an impact from that.
Read our briefing on race, mental health and criminal justice: https://3bx16p38bchl32s0e12di03h-wpengine.netdna-ssl.com/wp-content/uploads/2014/05/prevalence-patterns-and-possibilities.pdf
Black and minority ethnic men tend to have poorer access to healthcare for a range of services, including mental health, screening and testing. There is also evidence that poor mental health often acts as a further barrier to accessing other health services. Some groups of black and minority ethnic men, such as Bengali men, continue to have persistently high rates of smoking, and are at a higher risk of the respiratory and cardiovascular conditions associated with it.
Read our briefing on smoking and black and minority ethnic communities: https://raceequalityfoundation.org.uk/health-care/tobacco-use-among-minority-ethnic-populations-and-cessation-interventions/
There have been reports of xenophobia (including violence) against people perceived to be from a nationality more likely to be affected by the COVID19 virus. For example, there were hate attacks on people perceived to be ‘Chinese’ and ‘Italian’. These have been fed by online misinformation. It is probable that there will be lingering xenophobia and racism directed towards people perceived to be ‘carriers’ of the virus, particularly people of East Asian origin given that the COVID19 pandemic began in Wuhan, China, and that there are persistent conspiracy theories relating to it. https://www.theguardian.com/uk-news/2020/feb/09/chinese-in-uk-report-shocking-levels-of-racism-after-coronavirus-outbreak
Far right and racist organisations have also been using the coronavirus crisis to direct hate towards minority communities through circulating misinformation: https://www.reuters.com/article/uk-factcheck-leeds-mosque/false-claimbritish-mosque-remains-openduring-coronavirus-lockdown-idUSKBN21I3AX
There have also been issues repatriating British citizens, mostly of Pakistani origin, from Pakistan. This has generated significant criticism of the government response: https://www.theguardian.com/world/2020/mar/28/britons-in-pakistan-accuse-uk-government-of-abandoning-them
The wider determinants of health
There are a range of political, cultural, social and economic factors that will determine the impact of COVID19 on black and minority ethnic communities.
Black and minority ethnic communities are more likely to have language and interpreting needs that may limit their access to information and treatment. Poor communication will limit the ability of health services to treat and respond to the pandemic. Agencies are working to address this in relation to COVID19, for example Doctors of the World are coordinating a mutlilingual resource pack.
Read our briefing on language support in health and social care: https://raceequalityfoundation.org.uk/wp-content/uploads/2018/03/Language-Support-formatted.pdf
Health inequalities are more pronounced among black and minority ethnic people already (Marmot, 2020). Recent work on mortality in the UK has highlighted the projected lower life expectancy among Pakistani and Bangladeshi people in particular (Marmot, 2020). Higher rates of poverty, the experience of discrimination, poor employment and access to health services all feed into these inequalities. Poverty is twice as high in black and minority ethnic groups on average, and much higher in specific groups, making them vulnerable to changes in prices or rents (JRF, 2017). Black and minority ethnic families also tend to be larger on average, which places additional stresses on space within the home and on bills and finances as a result.
Read our briefing on race equality and health inequalities: https://raceequalityfoundation.org.uk/health-care/race-equality-and-health-inequalities-towards-more-integrated-policy-and-practice/
Read our briefing on tackling health inequalities in London: https://raceequalityfoundation.org.uk/wp-content/uploads/2017/10/Tackling-health-inequalities-in-London-final-version.pdf
Black and minority ethnic groups tend to have poorer access to health services, this includes GPs, early intervention in mental health and screening programmes. Some specific black and minority ethnic groups, such as Gypsy and Traveller groups have even greater health access issues and are routinely refused registration with a GP (Friends, Families and Travellers, 2019).
Read our briefing on the health of Gypsies and Travellers in the UK: https://raceequalityfoundation.org.uk/health-care/the-health-of-gypsies-and-travellers-in-the-uk/
Concerns have already been raised around the impact of health charging and the hostile environment. While there is a ‘public health’ exemption within the charging regulations, there is evidence to show people delay life-saving treatment even when experiencing acute symptoms (DOTW, 2018). So it would seem reasonable to believe that people with cold and flu-like symptoms who are routinely not eligible for free NHS care (or believe they are not) will not access health services.
Housing deprivation is experienced at different levels across black and minority ethnic communities, but is generally higher than for white British groups. For example, White Gypsy and Irish Traveller households are seven and a half times more likely to experience housing deprivation than White British households. Black African households are 75 per cent more likely to experience housing deprivation and Bangladeshi households are 63 per cent more likely to experience housing deprivation (de Noronha, 2015). These figures are even higher when we look at black and minority ethnic elders (de Noronha, 2019).
Read our briefing on housing and elder black and minority ethnic people: https://www.housinglin.org.uk/_assets/Resources/Housing/Support_materials/Briefings/HLIN_Briefing_BME_Housing.pdf
Black and minority ethnic people are more likely to live in overcrowded and poor quality housing. Just under half of overcrowded households are black and minority ethnic (de Noronha, 2015). The problem is worse in London where Black and minority ethnic groups are two to three times more likely to be overcrowded than White British households.
Read our briefing on housing deprivation and black and minority ethnic people: https://raceequalityfoundation.org.uk/wp-content/uploads/2018/02/Housing-Briefing-26.pdf
Eighty thousand households share accommodation. This is at least five times more likely for Black Africans, Chinese, other black, Arab, other white and other black and minority ethnic groups (de Noronha, 2015).
The short and medium-terms effects of COVID19, including the responses by government, will almost certainly include disruption of civil liberties, public services, the economy, and political, social and cultural life. There are also a range of risks associated with ‘lock-down’ and the confinement of people to their homes.
While the scale and the nature of that disruption is unclear, we know that black and minority ethnic communities are likely to be at greater risk from some of them. https://metro.co.uk/2020/03/31/coronavirus-deepen-racial-divides-uk-12454718/
There are concerns that incidents of domestic abuse are likely to rise during the lock down, based on the experience in China. Black and minority ethnic people already face barriers to domestic violence services and these could be exacerbated during the coronavirus crisis.
Black and minority ethnic people are more vulnerable to social isolation, according to research. Pakistani and Gypsy Roma and Irish Travellers seem to be particularly vulnerable to experiencing loneliness. It is also important to note that both younger and older people experience loneliness.
Changes to mental health legislation allowing for indefinite detention. Black and minority ethnic people, particularly African Caribbean men are overrepresented within detained mental health settings. Read our publication on racial disparities in mental health: https://raceequalityfoundation.org.uk/wp-content/uploads/2020/03/mental-health-report-v5-2.pdf
The increase in police and immigration officer powers to detain. It is unclear at this stage what scrutiny or checks and balances are in place to ensure non-discrimination and the promotion of human rights. https://www.theguardian.com/commentisfree/2020/mar/31/people-colour-covid-19-laws-police-track-record
Public Health England advice in multiple languages: https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance
Doctors of the World have produce information in 21 languages on COVID19
Migration Yorkshire have just launched the new Migrant Information Hub www.migrantinfohub.co.uk to offer useful information and resources to help migrants, and those supporting them, to stay safe, connected and informed, and to reduce the harmful impacts of Covid-19
The Sickle Cell Society have produce advice and guidance for people with sickle cell disease during the coronavirus crisis: https://www.sicklecellsociety.org/coronavirus-and-scd/
The Muslim Council of Britain have release guidance to Mosques and Islamic schools:
The Sikh Council UK and the Sikh Doctors Association have released a coronavirus plan:
Guidance from Friends, Families and Travellers for Traveller and Live aboard Boater communities:
The Roma Support Group have created a video with information about COVID19: https://www.youtube.com/watch?v=lL1blJJeITk&feature=youtu.be
In Glasgow, local charities are supporting Roma communities in the city: https://www.glasgowtimes.co.uk/news/18334790.charities-work-protect-govanhills-roma-coronavirus/
Clinks have published a range of information and resources for people in the criminal justice system: https://www.clinks.org/our-work/coronavirus-covid-19
Learning Disability England has published and collected information including in Easy Read
Mencap has published information in Easy read: https://www.mencap.org.uk/advice-and-support/health/coronavirus-covid-19
The Chartered Institute for Housing has published an article on ‘Housing response to coronavirus-related hate’:
The Caribbean social forum in Woolwich are using online tools to keep in touch: https://www.bbc.co.uk/iplayer/episode/m000gy8c/bbc-london-evening-news-01042020
Bristol Muslim Strategic Leaders Group have been working with the local NHS Trust to produce a video in 8 languages to get the message of staying at home across to all communities.