Report rejects ‘common view’ that ethnic minorities have worse health outcomes

A landmark race report has said it “rejects the common view” that ethnic minorities in the UK have worse health outcomes than the white population.

The Commission on Race and Ethnic Disparities review claims that for some key health metrics, including life expectancy and overall mortality, ethnic minority groups had better outcomes than the white majority population.

The report, commissioned in the wake of the Black Lives Matter movement, says this evidence “clearly suggests” ethnicity is not the “major driver” of health inequalities in the UK.

Instead, it suggests that deprivation, geography and differential exposure to key risk factors, including obesity, smoking and alcohol use, were indicators for worse health outcomes.

But NHS Providers, the organisation representing NHS trusts in England, disagreed with the report’s conclusions and called it “damaging” to deny the link between structural racism and wider health inequalities.

Meanwhile, the Centre for Mental Health charity said the report had painted a “partial picture” of racial injustice in the UK and its effects on mental health, which are often “reinforced” by people’s healthcare experiences.

“The commission rejects the common view that ethnic minorities have universally worse health outcomes compared with white people, the picture is much more variable,” the report says.

“Given that most ethnic minorities have higher levels of deprivation, compared with the white majority population, these health outcomes clearly suggest that deprivation is not destiny.”

The report suggests that for Covid-19 and many other health conditions, there is a “complex interplay” of socio-economic, behavioural, cultural and in some cases genetic risk factors which lead to disparities.

It said analyses had shown that the increased risk of dying with coronavirus of those from black and South Asian communities was due to an “increased risk of exposure to infection”, through factors such as living in urban areas.

However, the Office for National Statistics (ONS) analysis the report refers to said that studies continued to show those from a black ethnic background were at a greater risk of death involving Covid-19 than all other ethnic groups.

The ONS said that adjusting socio-economic factors and geographical location partly explained the risk, but there remained twice the risk for black males and around one and a half times for black females.

Significant differences also remained for Bangladeshi, Pakistani and Indian men, the ONS report analysis, published in June of last year, said.

The report has called for more work into why “some ethnic minority groups are doing better than others” and whether this is due to differences in family structures, social networks or health behaviours such as alcohol and smoking.

Published on Wednesday, the long-awaited 264-page report said it engaged with relevant experts and frontline workers when considering disparities in health.

It has recommended the Government establishes a new independent body to target health disparities in the UK, which would work alongside the NHS.

One of first priorities for the office, referred to as the Office for Health Disparities (OHD), should be to increase programmes aimed at levelling up health care and outcomes, the report says.

Another priority should be improving data, guidance and expertise in the causes and solutions for health disparities for specific groups, the report adds.

The commission has recommended that the acronym BAME (black, Asian and minority ethnic) should no longer be used as differences between groups are as important as what they have in common.

The report says analysis showed how “inappropriate” it is to consider health issues under the term BAME, as there are differences in outcomes of some health conditions both between and within ethnic groups.

Saffron Cordery, deputy chief executive of NHS Providers, urged for action to tackle “structural racism, bias and discrimination” in the health service and across wider society.

Reacting to the report, she said: “To achieve change, there needs to be an honest conversation about racism, its structural roots and its impact.

“When these facts are acknowledged, it is only then that mindsets can change so that privilege and prejudices can be dispelled.

“Concrete action is needed to tackle structural racism, bias and discrimination in the health service, across other public services and across society.”

Centre for Mental Health deputy chief executive Andy Bell added: “Today’s report provides a partial and incomplete picture of what drives the dramatic inequalities in mental health that are experienced by racialised communities in Britain.

“Racial inequality and injustice are deeply entrenched in our society and the harm they cause can last a lifetime.

“Too often they are reflected and reinforced in people’s interactions with public services including health and care.”

The report’s conclusions are included in the wider review into race and disparities in the UK, which also looked at crime and policing, education and employment.

In a foreword to the report, commission chairman Dr Tony Sewell said Britain is no longer a country where the “system is deliberately rigged against ethnic minorities”.