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Structural racism worsens Covid-19 health inequality, study finds

Ethnic minority groups are disproportionately affected by covid-19 due to structural racism, a joint UK-US study found.

Researchers from the University of Manchester, St George’s University of London, Imperial College London and Harvard University found structural racism is the root cause of health inequalities among ethnic minorities during the pandemic.

The study, published on Friday in the British Medical Journal, explores the societal causes behind higher covid-19 death and diagnosis rates, hospitalisations, and admissions to intensive care units among ethnic minorities.

Structural racism – also known as systemic or institutional racism – are social policies, processes or laws that disadvantage minority groups.

The study explains how repeated exposure to racism and discrimination – known as weathering – can cause psychosocial, physical and chemical stressors that accelerate biological ageing.

This could be directly impacting the health of ethnic minorities, by exacerbating the effects of the pandemic.

Residential segregation is one proposed factor, with Bangladeshi and Pakistani people more likely to live in deprived neighbourhoods than white British people.

The study shows how living in poorer areas, and a lower socioeconomic status, negatively affects residents’ health outcomes. High risk jobs, and communities with a higher burden of chronic disease, also contribute to health problems.

Professor Aneez Esmail, a co-author from the University of Manchester, said: “What we need is concerted action from governments and national health systems to deal with the impact of this disease on ethnic minority communities.

“We have already identified evidence-based interventions, which if implemented, could help in reducing these inequalities. The time to act is now.”

The study also found that cultural racism, caused by unconscious biases, can lead to poorer quality communication during medical consultations or treatment.

Sarah Malik, health and wellbeing manager for New Step for African Community, said: 

“This is going to echo a lot of the voices of the people that we’ve been speaking to, the fears that they’ve experienced being locked in at home, or not being understood by their employers.”

The Rochdale charity runs a telephone counselling service ‘Ear For You’, which provides support for ethnic minorities affected by the pandemic.

Miss Malik said: “A lot of the calls we get are due to unconscious biases, or people within ethnic minorities that don’t really know how to verbalise what they’ve experienced.

“It’s about a level of understanding. People aren’t asking for special for special treatment, but just to be acknowledged that actually yes, there is a problem here, and for it to be accepted.”

The researchers suggest a series of recommendations to improve the health outcomes of ethnic minorities.

These include recognition by the government and public health bodies of racism as a key factor of ill health, increased funding of covid-19 prevention and education programmes for minority groups.

The study also suggests the inclusion of ethnic minority groups in the ‘extremely vulnerable’ category for covid-19, and more supportive work environments to reduce the risk of exposure to the virus.

Dr Mohammad Razai, first author on the paper, from St George’s University of London, said: “The impacts of racism and discrimination on health are well established and measures must be taken to address the root causes of these disparities.

“At the same time, we need to urgently protect ethnic groups most at risk of adverse outcomes from Covid-19.”

Link to the study can be found here: https://www.bmj.com/content/372/bmj.m4921 

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