Protecting the vulnerable

The most vulnerable in society are often those who experience the cumulative impact of health inequalities. Our work to identify and tackle ethnic health inequalities recognises the complexity of the social determinants of health as well as the resulting effect that can have on individual personal choices.

Black and minority ethnic people have up to twice the mortality risk from COVID-19 than people from a white British background. Reference

Across the country, fewer than 5% of blood donors are from Black and minority ethnic communities. Reference

Consent rates for organ donation are at 42% for Black and minority ethnic communities and 71% for white eligible donors. Reference

We will begin by focussing on:

COVID-19 and its impact upon Black and minority ethnic communities and health and care staff

The COVID-19 pandemic has had a profound impact on communities across the country and will impact the way all of us live our lives for many years to come. It has not, however, impacted all communities equally. The Public Health England report released in 2020 found that even having accounted for effects of sex, age, deprivation and region, people of Bangladeshi ethnicity had around twice the risk of death compared to those in the White British group. It also concluded that ‘people of Chinese, Indian, Pakistani, Other Asian, Black Caribbean and Other Black ethnicity had between 10 and 50% higher risk of death when compared to White British.’  

When looking at all-cause mortality, the report found that the rate was almost four times higher for Black males during the pandemic, and almost three times higher for Asian males.

And this trend was not just apparent amongst patient communities. Although Black and Asian staff represent only 21% of the NHS workforce, early analysis showed that they accounted for 63% of deaths among health and social care workers in the first wave of the pandemic.

The pandemic has not created health inequalities, but it has exposed them like never before. The Observatory is committed to better understanding the social factors that have contributed to these disparities, including the complex impacts of racism and discrimination on health outcomes.

Healthcare conditions and interventions that impact upon Black and minority ethnic patients and communities

We know that different ethnic groups in the UK have different experiences of healthcare and different health outcomes. As has been broadly explored in the past, analyses and policy responses in the past have too often revolved around unproven assumptions about genetic difference or supposed cultural difference. In reality, the causes of ethnic inequality are likely a complicated mix of social, economic, and geographical factors, impacted further by discrimination and systemic and institutional racism. Understanding inequalities, therefore, requires a holistic approach to understanding specific problems.  

At the Observatory, we will be guided by our academic reference group in devising targeted research, with a view to developing actionable policy recommendations. Our early focus will include examining ethnicity and blood plasma donation, where fewer than 5% of blood donations came from Black and minority ethnic communities over the past year. We have also published a rapid review into pulse oximetry, where emerging evidence suggests that the colour of a person’s skin may have an impact on the accuracy of pulse oximetry readings.