Yes, there is structural racism in the UK – COVID-19 outcomes prove it

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Sumary of Yes, there is structural racism in the UK – COVID-19 outcomes prove it:

  • The report minimises structural racism, a reality for so many that negatively impacts on their opportunities to achieve their full potential..
  • It cites deprivation, geography and differential exposure to key risk factors as the major drivers of health inequalities but fails to include ethnicity..
  • This reductive view is far removed from the vast body of robust research, including our own, which identifies racism as key to generating and reinforcing longstanding health inequity..
  • In health terms, inequity specifically refers to systematic differences in outcomes between groups that are unfair or discriminatory..
  • As frontline doctors witnessing first hand the toll of the pandemic on the east London communities where we work, we sought to explore COVID-19 outcomes across ethnic groups..
  • Our cohort of 1,737 COVID-19 patients admitted to Barts Health NHS Trust served as one of the largest and most diverse groups of COVID-19 patients in the UK..
  • The detailed nature of our dataset enabled us to address whether a range of factors including social and economic background, previous underlying conditions, lifestyle and demographic factors contributed to patient outcome..
  • Black and Asian patients were respectively 30% and 49% more likely to die within 30 days of hospital admission compared to patients from white backgrounds of a similar age and baseline health..
  • When we accounted for the role played by underlying health conditions, lifestyle, and demographic factors, this did not alter the increased risk of death in Black and Asian populations..
  • However, deprivation was not associated with higher likelihood of mortality suggesting that ethnicity may affect outcomes independent of geographical and socioeconomic factors..
  • In our study, we named structural racism as one of the risk factors associated with these worse outcomes associated with ethnicity, alongside living conditions such as multi-generational households, underlying health status, public-facing jobs and socio-economic status..
  • We also emphasised the need to take account of a number of potential factors including household composition, environmental concerns and occupation..
  • Institutional racism (which the government report said “is used too casually as an explanatory tool”) refers to the way that the policies and practices of institutions, including schools, workplaces and healthcare providers, produce outcomes that chronically advantage or disadvantage different ethnic groups, whether intentionally or not..
  • Structural racism is a system in which public policies, institutional practices, cultural representations work in varied ways to perpetuate racial group inequity..
  • Any analysis of health inequalities that only cites economic and social factors, and omits racism, will be limited in its ability to generate understanding and solutions…

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