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Why Have Britain’s Ethnic Minorities Been Hit Harder by COVID-19? It’s Hardly a Mystery

COVID-19 is a disease that can strike anyone. A recent study of 5,700 sequentially hospitalized COVID-19 patients in a New York City health network, for instance, found that patients’ ages ranged from single digits to 90-plus. Roughly 60 percent were male. About 40 percent were white. Nine percent were Asian. And 23 percent were black.

As Coleman Hughes recently noted in Quillette, black people are overrepresented among American COVID-19 fatalities overall. In Chicago, for example, black people account for more than 70 percent of COVID-19 deaths, despite comprising just 30 percent of the local population. But this doesn’t necessarily tell us much about the disease itself, because “black people are more likely than white people to die of many diseases—not just this one. In other cases, the reverse is true. According to CDC mortality data, white people are more likely than black people to die of chronic lower respiratory disease, Alzheimer’s, Parkinson’s, liver disease, and eight different types of cancer.”

In the UK, too, COVID-19 has had a disproportionate effect on communities that get lumped in under the (somewhat dated) term “BAME”—black, Asian, and minority ethnic. The Intensive Care National Audit and Research Centre has reported that 34 percent of a studied group of 6,720 critically ill COVID-19 patients self-identified as black, Asian or minority ethnic. By way of comparison, the comparable figure for a group of 5,782 patients with non-COVID-19 viral pneumonia tracked between 2017 and 2019 was about 12 percent. Moreover, as the Telegraph reports, “despite only accounting for 13% of the population in England and Wales, 44% of all [National Health Service] doctors and 24% of nurses are from a BAME background. Of the 82 front-line health and social care workers in England and Wales [who] have died because of COVID-19, 61% of them were black or from an ethnic minority.”

The release of these numbers prompted an official inquiry. And last week, the Labour Party appointed civil-rights campaigner Doreen Lawrence to head up its own review of the issue. A BBC article entitled “Coronavirus: Why some racial groups are more vulnerable” informs readers that the issue might be rooted in the “physiological burden from the stresses caused by racism and race-related disadvantage, such as the frequent secretion of stress hormones.” London Mayor Sadiq Khan recently wrote an article in the Guardian, demanding that more data be collected. However, he didn’t wait for such data before suggesting that the issue is rooted in “the barriers of discrimination and structural racism that exist in our society.”

Shabnam NasimiI’m a refugee from Afghanistan who came to England as a child in the back of a refrigerated truck. So I know a little bit about these issues. I also know that the above-described statistical disparities may well be related to factors that have nothing to do with racism. Firstly, as everyone in the country knows, BAME communities are disproportionately urban. Specifically, they tend to live in Britain’s larger cities, such as London, Birmingham, and Manchester—often within populous urban wards. Contagion rates are high in these areas, in part because it’s easier for an epidemic to spread in a big city than in the country’s sparsely populated (and disproportionately white) countryside.

Secondly, BAME groups in the UK tend to have more aggravating health conditions, known as comorbidities. Given the epidemiological data, this is of enormous importance. In the aforementioned study of 5,700 COVID-19 patients in New York City, for instance, the leading comorbidities were found to be hypertension (57 percent of all patients), obesity (42 percent), and diabetes (34 percent). Overall, a stunning 94 percent of patients in the study had at least one comorbidity. And 88 percent had more than one.

According to 2006 data, South Asians in the UK are up to six times more likely to develop type-2 diabetes as compared to white people, and black people were up to five times more likely. Similarly, as the BMJ has reported, people of South Asian and Black ethnicity “are known to have worse cardiovascular outcomes than those from the white British group”—in large part because of the “significant” effect of differences in average hypertension levels.

Thirdly, immigrant households are far more likely to contain more than two generations living under one roof. (The authors of a 2017 report found that 70 percent of surveyed white households in the UK containing people aged 70-plus didn’t contain younger individuals. The comparable figure for black households was about 50 percent. For South Asians, it was 20 percent.) In such circumstances, social isolation is more difficult, and grandparents are put at risk of catching infectious diseases from (possibly asymptomatic) younger relatives. From the beginning of this pandemic, intra-household contagion has been a leading form of COVID-19 transmission. The bigger the household, the more people get infected in each cluster.

Fourthly, the problem of getting public-health information to citizens is compounded in the case of those immigrants who have limited English abilities. There is much less official information in Somali, Hindi, Farsi, or Pashto, for instance. There is lots of “fake news” circulating on WhatsApp groups, which is especially problematic in the case of those who don’t understand information coming from official channels in English. Much of this fake-news information flow flies under the radar of public officials.

Finally, as noted above, BAME workers make up a disproportionate share of National Health Service medical staff. A fifth of nurses and midwives, and a third of doctors, are from BME backgrounds. In many cases, these actually represent employment success stories. But as one would expect, these cohorts also tend to be younger, and so are disproportionately employed in entry-level roles and front-line care, as opposed to working in specialized clinics or managerial positions.

An objective assessment of such issues is welcome. But the government’s fact-finding project should take into account the underlying factors, as opposed to simply echoing some of the unhelpful generalizations that now have become common currency in the media.

The public-health policies that are put in place in coming years will affect our ability to withstand the next pandemic. And we should be mindful of the manner by which they impact different communities in different ways. Such a discussion would not only help save lives, but also help spark a larger discussion about why such differences continue to exist, and, more generally, what factors have prevented BAME communities from sharing in the benefits that come with social integration.

 

Shabnam Nasimi is founder and director at Conservative Friends of Afghanistan. Her writing has also appeared in the Times, Prospect Magazine and Conservative Home. Follow her on Twitter at @NasimiShabnam.

Comments

  1. Another factor in racial disparities may be vitamin D deficiencies- white people are white because pale skin and light hair utilises the scarce vitamin D found from sunlight in northerly latitudes to maintain healthy pregnancies- and vitamin D has been highlighted as an important supplement for fighting off the infection.

    The question of social integration is best informed by a reading of Jonathan Haidt’s The Righteous Mind. The Western Educated Industrialised Rich and Democratic (WEIRD) psychology confined to affluent cosmopolitan liberals, with its decline in ingroup preference, is largely confined to people raised in comfortable, secure and educationally aspirational environments. Higher rates of stable families in the community would go a long way to achieving this aim, because Dr Raj Chetty’s research at Stanford proves that it is key to social mobility.

    Fathers also seem to act as social immunisers at the community level, counteracting the predatory influence of gang grooming.

  2. No, not much of a mystery, but certainly a distraction a nation could do without. “And we should be mindful of the manner by which they impact different communities in different ways.” No. We should not be “mindful” of any such thing.

  3. Left is a broken record. Minorities affected? Must be ism or phobia, no other explaination.

  4. I was commenting about social mobility and social integration in that section, not COVID-19 mortality rates.

    This phenomena is caused by the brain-drain, and the fact that both nurses and doctors trained in the UK tend to underpaid by comparison to the salaries they can achieve in the US, Australia, Canada and New Zealand. At one point occupational health therapist topped the charts of sought after skills for immigration to the antipodean countries and I knew a couple of women who expanded their training with this speciality in order to immigrate.

    In the case of nursing, the move also involves a general reduction in responsibility which accompanies higher pay and benefits. For example, in most other Western countries better pay does not involve becoming a nurse practitioner and exposing oneself to the legal liability of prescribing drugs. Many specialists within hospitals are also foreign-born (although often from Eastern Europe), because salaried GP’s (family doctors) are more often than not better paid than specialists, because of the history of GP Fundholding towards the end of Margaret Thatcher’s tenure in office.

    But another reason why mortality rates are disproportionately high is because London is 40% BAME, with NHS staffing likely to be reflectively high in London, which has been the epicentre of the pandemic in the UK. It should be noted that a great deal of NHS recruitment, especially towards the lower end of the skills and knowledge spectrum, has been focused on non-EU migration, because of competition from other European States.

    Another possible hypothesis which should be explored is that in the UK those in public service, such as police, medical workers, civil servants and ambulance drivers, tend to downsize to more rural areas from around 50 onwards. The reasons behind this are usually lower living costs in rural smaller cities and towns, as well as the chance to free-up capital in housing in preparation for retirement. It would be disturbing to think that BAME individuals were not availing themselves of this golden opportunity to achieve a better lifestyle, because of emotional attachments to local communities in cities like London, Manchester and Birmingham.

    Although you may agree on this point, I wouldn’t been to quick to quote a man who has singularly failed to provide PPE to the transport workers for which he is responsible, even through he has had the budget and opportunity to do so. Low income workers, who rely on public transport to get to their essential jobs, have also been placed at increased risk, because of this failure of oversight and planning.

  5. “physiological burden from the stresses caused by racism and race-related disadvantage, such as the frequent secretion of stress hormones.”

    There is literally nothing that cannot be blamed on racism.

  6. This is going to seem like a very random comment; however, people of middle-eastern descent also appear to have, at least in their native countries, zinc deficiency/zinc absorbancy problems.

    After reviewing multiple control trials from all over the world attempting to replicate the efficacy of zinc sulfate to treat HPV infection (the studies I looked at reviewed verruca appearing on the face, hands, and feet), the places with the highest success rate were Egypt, Iran, and Iraq.

    For those of you who aren’t aware: HPV is a common viral infection with most people being infected with at least one strain in their lifetimes. Zinc has anti-viral properties and I’m not a naturalpathic raisin cake - I took a course of zinc sulfate, 300mg/day for 90 days to see if it would treat a recalcitrant plantar wart (common verruca). It was working with partial resolution and enough to impress my GP.

    It was hypothesized by the researchers that zinc may be lacking in middle-eastern diets, or people from those populations don’t absorb zinc with equal efficiency as others - Japan and America also attempted to replicate the original study and did not experience successful outcomes.

    Zinc is an essential mineral which impacts the immune system.

    This could also be an explanation.

  7. All of the factors stated by the writer may contribute to the disproportionate number of BAME deaths but there is no way of attributing how or if they are significant or minor. The other factor which the writer doesn’t appear to want to consider is that there may be a genetic reason. Some diseases such as diabetes effect South Asians more than other groups and COVID-19 may simply be one of those diseases. It disproportionately kills men as well but nobody seems that interested in investigating that. We are still in the very early days of this new virus and there is certainly more we don’t know.

  8. I know how to solve the problem of Britain’s Ethnic Minorities.

    All old white people should be immediately evicted from their homes, which are transferred to minorities. Their retirement savings must be transferred to minorities. Each new immigrant to Britain is given a house expropriated from a white old man. Perhaps this will not solve the problem completely, but, in any case, will increase the mortality rate of white elderly people, men in the first place.
    So we will achieve the desired justice and defeat racism!

  9. Actually Geary most likely didn’t contradict that, because a stable family isn’t counted by number of generations in one place but by the relations between them, i.e. these are two distinct things.

    So, for instance, a woman with two kids who is separated from the father of her children and lives with her parents is an example of three generations under one roof but also a family that is missing a member (the father in this example).

  10. But the italicized part was the incindiary part, the primary reason it was quoted. It blames the white UK population for the extra deaths under colored people, a very grave and IMHO very unfair accusation that needs extraordinary proof. So far genetic and behavioral differences seem to be able to explain some disparities. Racism should be the last reason to look at, not the first.

    Before we accuse other people and polarize the situation, should we investigate the facts and not jump conclusions?

  11. For me it’s very comfortable to ignore this statement because it’s absolutely false and misleading; minorities are suffering due to objective reasons which are nothing to do with racism.
    Moreover, this statement leads to the nursing of minorities and making their problems persistent instead of actually helping them. It’s a deeply racist statement.

  12. I think this is the most simple explanation indeed - geographic location plus large local variations differences in composition of population. More convoluted explanations don’t pass the test of Occam’s razor. London gets lots of tourists/business travel. They bring Covid. Local people catch and spread Covid to their neighbours. It just so happens that those neighbours have this or that skin colour, but that’s irrelevant. Guardianistas throw a tantrum as per usual.

    Ironically, maybe it’s time London re-examined the idea of packing large amounts of social housing into tower blocks in an overpopulated city - that is most likely the single most relevant policy decision that has caused these differences in how people are affected. But it will be cold in hell before Labour accept that actually it’s probably their fault :roll_eyes:

    I find it deeply pernicious that people should accuse the British population of racism before having even attempted to falsify other simpler and more natural explanations. They are relying on the old correlation = causation fallacy and they know it. But they just can’t resist the urge because they hate this country so much.

  13. Me: This was a nice, blessedly short, well-organized piece which raises interesting points.

    SJW: Ms. Nashimi has clearly been brainwashed by too many years living under a racist whitey western regime. Her POC status is hereby revoked.

  14. Inequality is not a mystery. It is the nature of life.

  15. Interesting article and kudos to the author for raising the issue. Time and again, the all-consuming and highly contagious (or simply autocratic?) social justice ideology from the radical left (in the words of Steven Pinker, the left pole) is continually spreading eastward within the ranks of the liberals, to the extent that even those do not not subscribe to every claim within the orthodoxy manual (which was un-democratically assembled by the radical leftists) increasingly feel compelled to repeat the same very predictable slogans- nearly as an autonomous reflex - at each opportunity, and in particular, where other people of the same team may be listening as this serves to reinforce one’s credentials within the tribe.

    What is quite unfortunate is that this very important article is written by an author with links to UK Conservatives. As such, the author’s response will equally be seen as predictable and reactionary (despite her “credentials” as an ethnic minority and a woman) response, and despite the fact that some or all of her claims may well be vindicated in the end (see below).

    The only way to tackle such questions is to revert to the Enlightenment Principles and to use the scientific method to set up a series of hypotheses which can be tested. I would like to see journalism (and certain university departments including the humanities of course) moving towards a model in which facts are discerned from hypotheses or ideological claims. Anything else is tantamount to indoctrination or fake news.

    Under such a model, Sadiq Kahn’s and the Guardian’s (and other SJW’s) claims could be established as hypotheses which could then go off and be tested by social scientists before coming to the hasty conclusion that the susceptibility to diseases is linked to the stress caused by structural racism (or similar derivative arguments).

    (As an aside, we know that at least 60% of deaths have been male. So there goes the patriarchy accusation up in smoke?).

    There is always a risk that the likes of this article will be branded as right-wing, rather than being given the coverage that it deserves.

    I am (in the classical sense at least) center right on some things and center left on others. Take the average of all my political positions and this puts me broadly in the center of the political spectrum (with an instinctive tendency of throwing caution to the wind, which give me a “conservative” predisposition/trait). I consider myself a classic liberal, which of course means that there is no question that I would be branded right-wing by people who characterise themselves as belonging on the left (and I would no doubt be a fascist to the elements of the radical left)

    But the key to transcending this tribal and partisan nonsense is at all times to remain agnostic, and agnosticism can only be achieved by forcing oneself to plant a foot on the left, as well as on the right of the political divide, or at the very least to be prepared to submit one’s claims to the scientific method to settle it.

    It is important to hold our universities to account. The universities in the West are known to have a left-leaning bias which is problematic to the extent that claims get repeated without being submitted to empirical testing, and this appears to be spilling over into the media and every day conversation.

    In the same way that the author Shabnam Nasimi is not the right person to get maximal coverage for this very good and interesting article / topic (and indeed I applaud her bravery), Doreen Lawrence is not the right person to carry out this review if she is not prepared to leave her ideology at the door and to submit the question to an impartial / disinterested scientific investigation (though I am willing to give her the benefit of the doubt, though I feel as though I will regret these words).

    Science is the best tool that we have to rank-order competing claims in an attempt to get to the truth. We need to hold our leaders to account that they do just that, and this particular question would be a good place to start.

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