Why are Ethnic Minorities More Vulnerable to Coronavirus?

Inequality, Comorbidities, Public-Facing Jobs and Language Barriers Mean Some Groups are More Likely to Bear the Brunt of the Virus

During the coronavirus epidemic, people from black, Asian and minority ethnic (BAME) face a disproportionately high risk of death from coronavirus, according to emerging data. Recent figures compiled by the UK’s Intensive Care National Audit and Research Centre suggests that of nearly 5000 people critically ill with covid-19 in England, Wales and Northern Ireland whose ethnicity was known, 34 per cent were from BAME backgrounds. New NHS England figures also reveal that, of the 13,918 patients in hospital who tested positive for Covid-19 up to April 17, 16.2 per cent were of BAME background. But people from such groups make up only 14 per cent of the population of England and Wales, for instance. The first 10 doctors in the UK reported to have died from Covid-19 were all BAME and analysis suggests 60 percent of the total number of deaths among NHS staff with the disease are from a BAME background. 
 
The UK is far from the only country where people from black and minority ethnic groups have been disproportionately affected.  When Norway’s public health experts began looking into the backgrounds of those infected by coronavirus, they found that born in Somalia have infection rates more than 10 times above the national average. In the US, black Americans represent around 14 per cent of the population but 30 per cent of those who have contracted the virus. In the US, in Chicago, as of early April 2020, 72 percent of people who died of coronavirus were black, although they only make up one-third of the city’s population. Similar reports have emerged from New York, Detroit and New Orleans.
 
The pandemic sheds new light on how racial dynamics manifest in ways that are complex and not entirely understood. An international research effort is under way to examine genetic differences that make some people more likely than others to be infected with the virus or to develop severe symptoms. In the UK, the Department of Health and Social Care announced on 16 April that a review would be conducted, to investigate why BAME people were being affected disproportionately.
 
While it is not yet clear why communities with proportionally higher number of BAME inhabitants appear to be dying at higher rate, scientists have already highlighted factors including the increased underlying health conditions among BAME people, such as heart conditions, type 2 diabetes and respiratory issues. The black population, where the discrepancy appears to be greatest, is particularly afflicted with hypertension. Diabetes is three-fold higher in this ethnic group, according to The Guardian. Both of those conditions will increase your risk of death once you’ve got Covid.
 




The first ten doctors to die in the UK were all from BME backgrounds. 

 
There are also concerns that social and economic inequality, which impacts minority communities more starkly, could be playing a role. In many majority-white countries, people from other ethnic and racial minority groups have less access to economic resources – such as high-earning jobs. That economic vulnerability often translates to food insecurity and a lack of access to consistent nutrition, has a number of consequences, including higher risk of underlying health conditions “There have been health inequalities that have existed in the [BAME] population but what is being reflected in this pandemic is that those inequalities are actually coming out,” Wasim Hanif, professor of diabetes and endocrinology at University Hospital Birmingham told The Guardian. He added: “Deaths happen in relation to complications related to diabetes all the time, as with cardiovascular diseases and cancers, but they have never hit the headlines and that’s the effect we’re seeing now.”
 
There are healthcare disparities as well.  In the US, Native Americans, Hispanic Americans and African Americans are less likely than whites and Asian Americans to have health insurance. Racial biases also play a role. US surveys have found that medical staff are more uncertain and less communicative with non-white patients than with whites, according to the BBC.
People from minority communities are also less able to socially distance as they often live more closely together than in the general population. BAME families are more likely to have multi-generational –  grandchildren, parents and children –  overcrowded homes than white counterparts. In the UK, just under a third of Bangladeshi households are classified overcrowded, as are 15 percent of black African households, according to government statistics. Meanwhile, only 2 percent of white British households are classified as overcrowded. Chinese households in the UK also have higher rates of elderly people living with children.
 
People from BAME backgrounds are also concentrated in essential roles public-facing jobs such as transport and delivery drivers, shop keepers, as well as health and social care, where they risk greater exposure to the virus.  One in five people working for the NHS in England, for example, is from an ethnic minority background, however these numbers are even higher when we look solely at doctors and nurses. 26.4 percent of Transport for London staff are from BAME groups. People of colour are also substantially more likely to be unemployed, underemployed or precariously employed, which makes them especially likely to undertake hazardous temporary or gig economy work like delivering food. In the US, farmworkers are often undocumented migrants from Latin America with little control over safe working conditions. It can be difficult to ensure physical distancing in the fields, isolation in the farmworker camps, or proximity to medical facilities, according to the BBC.
 
Even language barriers have had a marginalising effect. Much of the initial public health guidance around Covid-19 has been in dominant languages, points out Salman Waqar, an academic GP registrar at the University of Oxford and the general secretary of the British Islamic Medical Association. “There needed to be a better understanding at the beginning of this pandemic that these messages may not necessarily get through to the grassroots,” he told the BBC. Dr Sheikh-Mohamed, a doctor working in Norway, told the Finanical Times the authorities made a mistake by relying solely on written material that many in the Somali community could not understand.