Disproportionate number of deaths
BLACK, Asian and Minority Ethnic (BAME) people in the Midlands make up a disproportionate number of coronavirus hospital deaths, analysis of NHS England figures shows.
There were 4,328 Covid-19 hospital deaths in the Midlands as of May 5 - the highest percentage of Covid-19 deaths (19.6%) outside of London.
Analysis of figures obtained by the Local Democracy Reporting Service show that 3,359 of those deaths were attributed to white people, which is 78% of all deaths, or 85% of deaths where ethnicity is stated.
BAME deaths account for 595 of the total, which is 14% of all deaths, or 15% of deaths where ethnicity is stated.
When compared to the most recent population figures for the Midlands based on the 2011 census, it shows the percentage of BAME deaths in the Midlands is marginally higher than the 13.35% BAME population, while the percentage of white deaths is far lower than the 86.05% white population.
Indian patients have the highest BAME death count in the Midlands with 158 (4%), followed by Pakistani with 156 (4%), and Black Caribbean with 133 (3%).
Concerns have been raised since the outbreak that some ethnic groups in the UK have suffered a disproportionate number of coronavirus deaths.
NHS England has said “BAME backgrounds are being disproportionately affected by Covid-19?, while the Office for National Statistics (ONS) has said some ethinic groups have a “significantly higher” risk of death from Covid-19 than those of white ethnicity.
It has prompted the government to commission a review by Public Health England.
An ONS study released on May 7 has found black people are four times more likely to die from Covid-19 than white people (4.2 times more likely for men, compared to 4.3 times more likely for women).
After taking account of other socio-demographic factors such as education, employment and income, the risk of Covid-19 related death for black males and females is reduced to 1.9 times more likely than those of white ethnicity.
Similarly, males in the Bangladeshi and Pakistani ethnic group were 1.8 times more likely to have a Covid19-related death than white males, while for females the figure was 1.6 times more likely.
The ONS has said the disproportionate BAME deaths is “partly a result of socio-economic disadvantage and other circumstances”, but a remaining part of the difference “has not yet been explained”.
Dr Veronica Nanton from Warwick Medical School - a senior research fellow in Health and Medical Sciences which investigates health problems from multiple perspectives - said the disproportionate number of deaths within BAME communities is “not surprising”, particularly in the Midlands.
She said: “It does not surprise me tremendously as there are massive health disparities between population groups and you would expect those to be reflected in the figures.
“We would expect to see higher rates of infection in areas of higher population density so that is probably one of the major factors for the Midlands numbers being higher.
“We also have multiple areas of deprivations across Birmingham and the Midlands as well which leads to low socio-economic status and health so that is going to increase the risk of infection.
“With this particular virus we know ethnic minorities are filling a lot of high-risk jobs such as in health and transport so they have that extra risk to increased exposure.
“We know certain BAME communities are affected to certain long-term conditions that could increase vulnerability to the virus.
“It is a complicated picture and we really need an understanding of all the variables.
“A lot of the data has been lumping BAME communities together so I have been pleased that people are starting to look at the impact on different ethnicities.”
One localised study into the impact on certain BAME communities is being carried out by Birmingham City Council.
The authority this week partnered with Lewisham to launch a review into health inequalities within Black African and Caribbean communities, taking into account specific issues such as health conditions, lifestyle, mental health, employment, and housing.
Dr Nanton believes these will be key in understanding the impact on people with BAME backgrounds.
She said: “Small localised studies will be very important as they will look at the fine grained data.
“When you look across populations you get averages but when you look more closely you get individual information which will lead to more interesting and important questions.
“We need to look very closely at all the variables associated with the increased mortality which is difficult to do as some we measure routinely such as geography and jobs, but others we do not.
“We have many ethnic minorities working in transport and the hospitals who may be going home to houses that are crowded and the risk is increased, so data needs to reflect things like that.”
Coventry has a 26% BAME population according to the latest 2011 census, but Covid19 deaths are not split by individual ethnicity due to the way NHS England presents data. Coventry City Council’s director of public health and wellbeing, Liz Gaulton, said: “We do need to better understand how different people are more affected by Covid19, and that includes factors such as ethnicity and deprivation. Work is underway nationally to look at this and insights we gain from what is being done at a national level to look at this in more detail, will then be used to help to mitigate the risks that Covid19 presents.”