The disproportionate impact of Covid-19 on Black and Minority Ethnic communities is stark and is exacerbating existing health inequalities. News coverage has continually shown BAME healthcare professionals amongst those that have tragically had their lives taken by the virus, and as of April 22^nd, those of BAME background accounted for 63% of staff deaths within the NHS. Such disparities in health outcomes have been affecting those within BAME communities since long before the current pandemic. However, Covid-19 has heightened the need for an independent public inquiry to provide comprehensive insight into, as well as tackle, the inequalities that have become embedded in society at the expense of BAME communities.

Health inequalities are recognised to be the avoidable differences in health across a population between different societal groups. Sir Michael Marmot has produced a rich body of work in this area, chiefly finding that the more deprived an area, the shorter the life expectancy. Despite increased discussion of health inequalities of late, the presence of these differences in health are by no means new. 10 years on from Marmot’s initial findings, these inequalities have shown to be worsening as showcased here by the way in which Covid-19 has impacted different groups of people.  In this regard, BAME people in the UK are more likely to occupy lower levels of employment and higher levels of unemployment, live in overcrowded households and have less access to outdoor space – these factors are known to be the social determinants that are partly contributing to poorer outcomes in health in line with Marmot’s report. When considering these social determinants of health in the context of the current pandemic, it is likely that ‘controlling the virus’ may be more difficult in practice for BAME communities.

Public Health specialist, Professor David Williams, has investigated similar concepts in the United States of America and has given specific focus to establishing the effect race has on health outcomes. Here, Professor Williams has shown race to have an effect on health at every level of income and education, with even wealthy African Americans showing to be statistically less healthy than affluent white counterparts. As other factors were controlled for in this study, this work has directly challenged notions of race equality and necessitates the exploration of race as a social determinant of health. Race as an indicator of health has not been investigated in the United Kingdom to such a degree, however the disproportionate impact of Covid-19 on BAME communities should increase the urgency of such analysis.

The Office for National Statistics has highlighted the risk of death as a result of Covid-19 among some ethnic groups to be significantly greater than that of those of white ethnicity, with genetics, age and socio-economic factors only offering partial explanation for such trends. From this, we know that examination is needed into the underlying causes for this data, and it is critical that this goes beyond existing research in the UK. Public Health England are leading an inquiry into the disproportionate impacts of Covid-19 on BAME communities. However, with the intersectionality of factors known to be present in health inequalities affecting BAME communities, an independent public inquiry is likely to be more appropriate to address the root causes beyond the healthcare landscape. Given that it is continually recognised that ‘other’ factors are likely to be influencing the worse health outcomes within BAME communities; the role of race in health should be confronted. If we are to protect our key workers, the National Health Service and the wider BAME population, a transparent independent public inquiry directly addressing race is paramount.

Shaban Nganizi is a Healthcare Policy and Strategy Management Trainee, with previous experience in the housing sector. He writes in a personal capacity. 

He tweets at  @Shaban28_