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Coronavirus (Covid-19): the virus that exposed structural racism

Nigel de Noronha, Assistant Professor at the University of Nottingham explains how mainstream statistical analyses of COVID19 masked the impact of structural racism.

Reports on the disproportionate number of deaths from Covid-19 amongst black and  minority ethnic people in the UK highlight stark health inequalities. The report from the Office for National Statistics on Covid-19 deaths between 2nd March and 15th May 2020 shows that the death rate of black males was nearly five times higher than white males and black females more than four times higher and that older people were significantly more likely to die.  The analysis used linked data from the 2011 census and controlled for socio-demographic factors including population density, deprivation and degree level qualification.  I argue that the effect of these statistical measures was to ‘explain’ or reduce the disproportionate death rates for ethnic minorities by eliminating the effects of structural racism.

The measures of deprivation from the 2011 census cover four aspects at household level:

  • Education deprivation means that no adult in the household has a level 2 qualification[1] or above: 30% of the ethnic group, white other, live in such households compared to only 15% of Indians and 18% of mixed other and black Africans with other ethnic groups around 25%[2];
  • Employment deprivation means that any member of the household over the age of 16 who is not a student is either unemployed or long-term sick: for most ethnic groups the proportion of such households is around 15% but is significantly higher for Pakistani (27%), Bangladeshi (30%) and black and mixed white and black groups (22%)2;
  • Health deprivation means that any member of the household has rated their own health as bad or very bad, or has a limiting long-term illness: the proportion rises significantly once the respondent is older affecting one in five households where the respondent is under 50, two in five for those aged 50-64 and three in five for those aged 65 or over.  More than three in five Bangladeshi and Pakistani respondents aged 50-64 and four in five aged 65 or over lived in households experiencing health deprivation2;
  • Housing deprivation means that a household is overcrowded[3], shares a kitchen or bathroom or does not have central heating

Figure 1 shows the extent to which ethnic minorities are more likely to experience housing deprivation, four in ten black African and Bangladeshi compared to one in ten white British households2.

Figure 1 – households experiencing housing deprivation by ethnicity

Figure 2 shows the differences in population density between ethnic groups[4]. It shows that ethnic minorities tend to live in much more crowded places, conditions which make the spread of infection more likely.

Figure 2 – population density by ethnic group

Deprivation measures and population density differ significantly between ethnic groups whilst older people are more likely to experience health and educational deprivation.  Controlling for these measures denies the material conditions in which ethnic minorities live.  In effect by assuming the effect of deprivation is an individual one, the structural inequalities experienced by different racial groups are not taken into account in the mortality rates reported.  As a result any actions identified are likely to focus on addressing individual risk rather than addressing the material inequalities in housing and the environment that people live in as highlighted in the stakeholder consultation by Public Health England, the Runnymede Trust and the report of the First Minister’s BAME Covid-19 advisory group in Wales.

The report acknowledges the lack of data on occupational social class for older people and uses the highest level of qualification in their analysis and uses the occupation in 2011 to assign key worker status.  It would have been useful to have looked at migration history which tends to be linked with housing deprivation.

The disproportionate level of deaths for people from ethnic minorities is rooted in the material conditions created by structural racism.  The evidence is clear and now is the time for action not another Commission or inquiry into evidence already clearly presented by stakeholders to Public Health England and analysed and reported on in the recent Race Equality Foundation briefing identifying actions to address these inequalities.

[1]           GCSE or equivalent at any grade

[2]           From analysis of the 2011 census microdata (a 5% sample of census records)

[3]           Based on the bedroom standard which is used to assess overcrowding: A couple (aged 16 or over) who live together as partners – straight or gay – should have their own bedroom and a single adult age 21 and over, should have their own bedroom. Two children under 10 of either sex can share a bedroom, two boys under 21 can share a bedroom, two girls under 21 can share a bedroom, any remaining children should have their own bedroom and young single adults who are under 21, and not in the same family, need their own bedrooms.

[4]           Measured in the number of people per hectare which is 10,000 square metres. The calculation is based on the number of people of each ethnic group at output area level from the 2011 census for England.