The Guardian view on BAME death rates: inequality and injustice

A universal experience is highlighting the sharp divides in our society. Few are as stark and shocking as those revealed by Thursday’s news that black people in England and Wales are more than four times as likely to die from Covid-19 as white people. Bangladeshi and Pakistani people were about three and a half times more likely, and those of Indian origin two and a half times as likely, the

Office for National Statistics reported.

The disproportionately high toll of BAME people was already evident, notably among medical staff: a review of just over a hundred NHS staff who died found that almost two-thirds were black or Asian, though those groups account for less than one in seven workers in the health service. It is all the more striking, given that age is one of the biggest risk factors and the over-65s comprise only one in 20 of the BAME population, compared with almost one in five of the white population.

The reasons are complex, interlocking and not yet fully understood. Geography has doubtless played its part; urban dwellers have been worse hit. The prevalence of underlying conditions such as diabetes vary markedly between communities. But health is intimately tied to economic wellbeing. It cannot be divorced from other considerations. We know that, in general, the poor die younger. Black, Bangladeshi and Pakistani populations face higher levels of unemployment and child poverty than white groups, and are much more likely to live in overcrowded conditions.

Even stripping out such factors, the ONS figures show black people are still almost twice as likely as white people to die a Covid-19-related death, with Bangladeshi, Pakistani and Indian individuals also disproportionately affected.

Cultural factors may play a part; multigenerational occupancy may put older people at greater risk. But there are also difficult questions to be asked, such as whether BAME people enjoy equal access to healthcare and are treated in the same way. The head of the British Medical Association has wondered whether BAME doctors might feel less able to complain about inadequate personal protective equipment, noting that they are more likely to report feeling bullied and ha

rassed than their white counterparts, and much less likely to raise concerns for fear of the consequences. Many of those have been born outside the UK, and the BMA has rightly urged that they should be exempted from the migrant surcharge for the NHS. It is absurd and unjust that those risking their lives for others should be forced to pay for healthcare themselves.

Whether more can be done to protect them must be assessed urgently. A rapid review is needed into the high death rates of BAME people, and those working in the health service especially, to protect lives. Public Health England’s review of health records, which aims to better understand how factors such as ethnicity, deprivation, age, gender and obesity could affect the impact of coronavirus on people, is due to report back at the end of the month. Yet quite how far it will delve into these questions is still unclear, and the involvement of a firm co-founded by Trevor Phillips, former head of the equalities watchdog, has been widely criticised.

In the longer run, there are no quick solutions to our society’s health inequalities. They are deeply rooted, have entrenched themselves in the austerity years, and will not easily be eradicated. The pandemic has exposed how devastating they can be, and when it ends, the need to address them will be as deep as ever.