COVID-19 Among Ethnic Minorities: How Missing Data and Colour-Blind Policies Perpetuate Inequalities in the United Kingdom and the European Union
Keywords:covid-19, ethnic minorities, inequality
COVID-19 continues to disproportionately impact ethnic minorities across the globe in the absence of disaggregated ethnicity-based data. In Europe, governments continue to take a "colour-blind" approach to reporting COVID-19 cases and deaths, with a purported effort to avoid discrimination. However, dichotomising populations as either Black, Asian and minority ethnic (BAME) or White masks differences between ethnic groups by homogenising risk factors including gender, age, residential area, occupation, and socioeconomic status (SES), leading to vast oversimplification. Furthermore, in some European countries, data reported by ethnicity or birth country are limited or even non-existent, although recent reports from France and Scandinavia suggest a hugely disproportionate mortality rate in immigrants from low SES countries compared with Indigenous populations. Limited data on ethnicity in relation to COVID-19 infection and mortality restricts the understanding of causation factors and outcomes, a need, which must be addressed urgently as a public health priority.
Aldridge, R. W., Lewer, D., Katikireddi, S. V., Mathur, R., Pathak, N., Burns, R., Fragaszy, E. B., Johnson, A. M., Devakumar, D., Abubakar, I., and Hayward, A. (2020). Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data. Wellcome open research, 5, 88. Available at: https://doi.org/10.12688/wellcomeopenres.15922.2 [Accessed 3 October 2020]
Bentley, G. R. (2020). Don't blame the BAME: Ethnic and structural inequalities in susceptibilities to COVID-19. American journal of human biology : the official journal of the Human Biology Council, 32(5), e23478.
Boffey, D. (2017) EU criticised for leaving out ethnic minorities in 'diversity' drive. [online] The Guardian. Available at: https://www.theguardian.com/world/2017/jul/27/eu-criticised-leaving-out-ethnic-minorities-diversity-drive [Accessed 3 October 2020]
Cookson, C. and Milne, R. (2020) Nations look into why coronavirus hits ethnic minorities so hard. [online] Financial Times. Available at: https://www.ft.com/content/5fd6ab18-be4a-48de-b887-8478a391dd72. [Accessed 3 October 2020]
Drefahl, S., Wallace, M., Mussino, E., Aradhya, S., Kolk, M., Brandén, M., Malmberg, B., and Andersson, G. (2020) Socio-demographic Risk Factors of COVID-19 Deaths in Sweden: A Nationwide Register Study. [online] Stockholm Research Reports in Demography. Available at: https://su.figshare.com/articles/preprint/Socio-demographic_risk_factors_of_COVID-19_deaths_in_Sweden_A_nationwide_register_study/12420347/4 [Accessed 3 October 2020]
Farquharson, W.H. and Thornton, C.J. (2020), Debate: Exposing the most serious infirmity – racism’s impact on health in the era of COVID‐19. Child Adolesc Ment Health, 25: 182-183. doi:10.1111/camh.12407
Ford S. (2020). RCN raises concern over Welsh staff risk assessment tool for Covid-19. Nursing Times. [online] Available at: https://www.nursingtimes.net/news/workforce/rcn-raises-concern-over-welsh-staff-risk-assessment-tool-for-covid-19-02-06-2020/. [Accessed 3 October 2020]
Gavi. (2020) Why are BAME groups experiencing high rates of death from COVID-19? [online] Gavi: The Vaccine Alliance. Available at: https://www.gavi.org/vaccineswork/why-are-bame-groups-experiencing-high-rates-death-covid-19. [Accessed 3 October 2020]
IGDORE. (2020) Research highlight: Working together to examine why BAME populations in developed countries are severely affected by COVID-19. [online] IGDORE. Available at: https://medium.com/@IGDORE/researchers-working-together-to-examine-why-bame-populations-are-severely-affected-by-covid-19-3e2975c278a2 [Accessed 3 October 2020]
King-Okoye, M. and Underwood, T. (2020) The disproportionate impact of COVID-19 on BAME communities in the UK: An urgent research priority. [online] BMJ Global Health Blogs. Available at: https://blogs.bmj.com/bmjgh/2020/08/25/the-disproportionate-impact-of-covid-19-on-bame-communities-in-the-uk-an-urgent-research-priority/ [Accessed 3 October 2020]
King-Okoye, M., Belisario, K., Laguna, A., et al. (2020) A systematic review of the reported symptoms, help-seeking accounts, and diagnosis and treatment subjective experiences of black, Asian and minority ethnic (BAME) populations in developed countries with suspected, confirmed active, or previous SARS-CoV-2 and/or COVID-19 disease. [online] PROSPERO. Available at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020189336 [Accessed 3 October 2020]
Krause, T. G. (2020) Smittetallet steg yderligere i uge 32 [The infection rate increased further in week 32] [online] Statens Serum Institut. Available at: https://www.ssi.dk/aktuelt/nyheder/2020/smittetallet-steg-yderligere--i-uge-32. [Accessed 3 October 2020]
Pailliez, C. (2020) 'Colour-blind' France avoids gauging COVID impact on ethnic minorities. [online] Reuters. Available at: https://www.reuters.com/article/us-health-coronavirus-france-statistics-idUSKCN24H1ME [Accessed 3 October 2020]
Pan, D., Sze, S., Minhas, J. S., Bangash, M. N., Pareek, N., Divall, P., Williams, C. M., Oggioni, M. R., Squire, I. B., Nellums, L. B., Hanif, W., Khunti, K., and Pareek, M. (2020). The impact of ethnicity on clinical outcomes in COVID-19: A systematic review. EClinicalMedicine, 23, 100404.
Papineni, P. (2020) Ethnicity and COVID-19: analysis must be inclusive and transparent. BMJ, 369, m2166.
Papon, S. and Robert-Bobée, I. (2020). Une hausse des décès deux fois plus forte pour les personnes nées à l’étranger que pour celles nées en France en mars-avril 2020 [An increase in deaths twice as high for people born abroad than for those born in France in March-April 2020] [online] Insee. Available at: https://www.insee.fr/fr/statistiques/4627049 [Accessed 3 October 2020]
Platt, L., and Warwick, R. (2020). Are some ethnic groups more vulnerable to COVID-19 than others? [online] The Institute for fiscal studies. Available at: https://www.ifs.org.uk/inequality/wp-content/uploads/2020/04/Are-some-ethnic-groups-more-vulnerable-to-COVID-19-than-others-V2-IFS-Briefing-Note.pdf [Accessed 3 October 2020]
Rankin, J. (2018) The EU is too white – and Brexit likely to make it worse, MEPs and staff say. [online] The Guardian. https://www.theguardian.com/world/2018/aug/29/eu-is-too-white-brexit-likely-to-make-it-worse [Accessed 3 October 2020]
Rankin, J. (2020) Brussels considers EU equality law change to tackle racism. [online] The Guardian. https://www.theguardian.com/world/2020/sep/13/brussels-considers-eu-equality-law-change-to-tackle-racism [Accessed 3 October 2020]
Rubin-Miller, L., Alban, C., Artiga, S., and Sullivan, S. (2020). COVID-19 Racial Disparities in Testing, Infection, Hospitalization, and Death: Analysis of Epic Patient Data. [online] Kaiser family Foundation. Available at: https://www.kff.org/coronavirus-covid-19/issue-brief/covid-19-racial-disparities-testing-infection-hospitalization-death-analysis-epic-patient-data/?utm_campaign=KFF-2020-Coronavirus&utm_medium=email&_hsmi=2&_hsenc=p2ANqtz-_8ZHBZkPf6KR6x2mll9N0Y9vqyDgBKtPa0lD9chx8FLHZ9QTDsGmzz0zRlmF4rrf7FHt9tYYPp88hnbdYJUEDXb_Jqzw&utm_content=2&utm_source=hs_email [Accessed 3 October 2020]
Sandhu, R. (2020). Is It Time To Ditch BAME As A Term? [online] BBC News. Available at: https://www.bbc.co.uk/news/uk-politics-43831279 [Accessed 1 October 2020].
Simons, R. et al. 2016. Economic hardship and biological weathering: The epigenetics of aging in a U.S. sample of black women in: Social Science & Medicine. Volume 150, Pages 192-200.
The European Network Against Racism. (2020) Evidence of the impact of Covid-19 on racialised communities exposes need to address persistent inequalities and racism. [online] European Network Against Racism. Available at: https://www.enar-eu.org/Evidence-of-the-impact-of-Covid-19-on-racialised-communities-exposes-need-to [Accessed 3 October 2020]
Williamson, E.J., Walker, A.J., Bhaskaran, K. et al. (2020) Factors associated with COVID-19-related death using OpenSAFELY. Nature 584, 430–436.
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