UK

Why are more people from BAME backgrounds dying from coronavirus?

NHS doctors Image copyright Getty Images
Image caption A large proportion of NHS doctors are from an ethnic minority background

Health Secretary Matt Hancock has said that people from ethnic minority backgrounds are "disproportionately" dying with coronavirus.

Public Health England are already undertaking a review, while Labour have also announced one led by Baroness Doreen Lawrence.

Prof Chris Whitty, the chief medical officer for England, has said that while the evidence is not conclusive, "it is absolutely critical that we find out which groups are most at risk".

What is the situation in the UK?

There were at least 3,378 deaths of black and minority ethnic (BAME) individuals in hospitals in England up to 5 May.

This means that, where ethnicity is known, BAME people represented 17% of all deaths to this point.

The 2011 census - the most accurate source - showed that 14.5% of the English population were from BAME backgrounds. But clearly the proportion may have grown since then.

In 2016, the Office for National Statistics estimated that it could have increased to 15.4% of the population.

Using these estimates, the figures show there have been 36 deaths with coronavirus for every 100,000 white people. The figure for Asian people is slightly less at 33 per 100,000 people.

However, it jumps to 56 deaths with coronavirus for every 100,000 black people and 59 per 100,000 individuals from other ethnic minority backgrounds.

Similar breakdowns by ethnicity for Wales, Scotland and Northern Ireland are not currently available.

Further evidence shows that a third of all critically-ill coronavirus patients were from BAME backgrounds.

The research from the Intensive Care National Audit and Research Centre (ICNARC) is based on 6,770 patients from intensive care units across England, Wales and Northern Ireland.

Location

Some of the highest death and hospitalisation rates during the outbreak have been in London, where 40% of the population are from ethnic minority backgrounds (according to the 2011 census).

But even when you adjust for where the coronavirus outbreak has hit hardest, both the Office for National Statistics and think-tank Institute for Fiscal Studies have concluded that ethnic minorities are being disproportionately impacted.

Research from the Institute for Fiscal Studies (IFS) shows that if we only looked at where BAME communities were concentrated, we might expect to see higher death rates than that for white British individuals.

However, the research says that this geographical factor is counter-balanced by the factor of age.

Most minority groups are much younger than white Britons - and therefore should be less susceptible to the virus.

The IFS concludes that, if we look at both geography and age combined, the death rate should be lower for most ethnicities than for white people.

They estimate that the deaths of black Africans are 3.7 times higher than might be expected by geography and age, 2.9 times higher for Pakistanis and 1.8 for black Caribbean (who are older on average than other minority groups).

The ONS research goes one step further and looks at other factors, such as health and deprivation.

It concludes that:

  • Black people are 1.9 times more likely to die than white people
  • Bangladeshis and Pakistanis are 1.8 times more likely to die
  • Indians are around 1.5 times more likely

What reasons could there be?

Health issues, living conditions and occupation could all play a role.

While there is no conclusive evidence that minority groups are more at risk from the disease, some are more likely to have certain underlying health conditions.

Black people are more likely to be overweight than white people, for example, while both Asian and black populations have been found to have a higher risk of diabetes and hearts disease, according to the IFS.

Both of these have been linked to higher coronavirus death rates.

Various factors can play into these health inequalities, according to Public Health England, including socio-economic situation, access to health care and deprivation in an area.

It's worth noting that deprivation in general, regardless of ethnicity, appears to play a role.

According to the Office of National Statistics, the death rate in the poorest communities in England and Wales is twice as high as the wealthiest.

Issues with self-isolation in larger households could also play a factor.

Just under a third of Bangladeshi households are classified overcrowded, as are 15% of black African households, according to government statistics.

Only 2% of white British households are classified as overcrowded.

Why might occupations play a role?

Black and other ethnic minority individuals make up a large share of jobs considered essential in tackling 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.

Analysis by BBC News suggests that 103 healthcare workers were believed to have died from coronavirus as of 23 April.

Black, Asian and minority ethnic (BAME) people represented 65 of those deaths, where ethnicity has been established.

This article was first published on 24 April and has been updated to reflect new figures from the ICNARC and NHS England.

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