As the PHE report comments “There is unlikely to be a single explanation here and different factors may be more important for different groups.”
So, any assumption that the increased vulnerability of BAME communities to COVID-19 can somehow be tied to genetic factors is misleading.
The table below uses key vulnerability factors for the general population outlined in the PHE report and shows how these affect the BAME population in the UK.
In addition, overcrowding reduces the ability to socially distance: Yet thirty per cent of the UK Bangladeshi population are considered to live in overcrowded housing compared with 2% among the white British population. Fifteen per cent of black African people also live in overcrowded conditions, as do 16% of Pakistanis.
Conclusions and additional thoughts
As the table shows, the BAME communities tick nearly all of the “vulnerability” boxes. As you consider this, what should become clear is that significant numbers of the BAME population live in deprived urban areas working in “high risk” (and relatively low paid ) occupations and is exacerbated by the increased tendency to develop underlying health conditions which significantly reduce their chances of survival.
Note: The well-publicised shortage of personal protective equipment for “front line” workers further increased the risk of contracting COVID-19.
Not surprising then that the BAME communities have been disproportionately affected.
But inequalities in health and wellbeing are not new. In 2007 a post note from the Parliamentary Office of Science and technology noted;
Black and minority ethnic (BME) groups generally have worse health than the overall population, although some BME groups fare much worse than others, and patterns vary from one health condition to the next. Evidence suggests that the poorer socio-economic position of BME groups is the main factor driving ethnic health inequalities.
Sadly, not enough seems to have been done to rectify the situation and as the PHE report notes:
The impact of COVID-19 has replicated existing health inequalities and, in some cases, has increased them.
- The high death rates in black and Asian communities are a significant reversal of previous trends, because until the pandemic white Britons were the ethnic group most likely to die from any cause.
- Death rates from COVID-19 were highest among people of Black and Asian ethnic groups. This is the opposite of what is seen in previous years, when the mortality rates were lower in Asian and Black ethnic groups than white ethnic groups.
A note on Type 2 Diabetes
Diabetes was more likely to be mentioned on the death certificate in more deprived areas. In the most deprived areas, 26% of COVID-19 deaths also mentioned diabetes. This is significantly higher than in the least deprived areas (16%). The proportion of COVID-19 deaths where diabetes is mentioned ranged from 18% in the White ethnic group, 43% in the Asian group to 45% in the Black group (PHE report).