Over the last few months we have seen an alarming number of deaths in ethnic minority groups due to coronavirus. In fact, the figures show that the death rate for Black and Asian people is four and three times greater respectively than for White people (Public Health England). With prospects of a coronavirus free life slowly dwindling, we as a nation need to examine why there are a disproportionate number of deaths and most importantly what can be done to combat this.
Why the disparity?
There are a number of factors that contribute to the higher amount of individuals of ethnic minorities acquiring and dying from COVID-19.
Socioeconomic factors due to racism and inequality: Black, Asian or minority ethnic people are more likely to have jobs that pay less, have longer hours and subject them to higher risk of coronavirus. Lesser paid jobs and long working hours result in a lack of time and money to spend on a healthy lifestyle.
Cultural apparel and skin coverings: Darker skin and the wearing of skin coverings for religious reasons means that individuals of ethnic minority are at higher risk of vitamin D deficiency, a lack of which can negatively affect the immune system.
Language barriers causing problems with access to healthcare: Individuals may refrain from contacting a healthcare provider through fear of being misunderstood or may misinterpret the advice they have been given.
Susceptibility to long term health conditions: It is also known that Black, Asian and minority ethnic groups have a higher likelihood of experiencing long term or chronic health conditions, in particular those that impact the immune system. For example, cardiovascular disease and Type 2 diabetes, both of which are in the high risk category for coronavirus.
How can we start to tackle this inequality during the pandemic?
For the time being we need to focus on implementing things that can immediately positively impact the death toll and improve survivability. This includes:
Advising people of ethnic minority to increase their daily dose of sunlight and make changes to their diet. Individuals could be advised to spend more time outside with as much skin exposed as they are comfortable with. To address dietary deficiencies – individuals would be encouraged to up the amount of vitamins and minerals (i.e zinc, iron and vitamin C) to bolster the body’s immune response to the virus.
Another key contributor to fast results could be educating people on healthier lifestyles, through public information campaigns that contain culturally sensitive and relevant messaging.
But what about in the longer term?
Public health focus on Black, Asian and ethnic minorities: There is a need for policy changes to accommodate for all the ethnicities that exist within the UK. Policy that is relevant to all groups and clear messaging will encourage individuals to adjust their lifestyles as required.
Educational courses: The implementation of educational programmes in colleges, universities, places of worship and community centres to inform people about nutrition and exercise that is aligned to specific needs. This will increase health literacy across our population.
Training of health and community professionals: These professions could be given more advice and training on how to support individuals of ethnic minority in managing their conditions, particularly those that result in an increased risk of COVID-19 such as diabetes.
Inclusion of ethnic minorities in clinical trials: It is rare that Black, Asian and minority ethnic groups appear in the inclusion criteria for trials. This results in the development of drugs and vaccines for COVID-19 that have only been tested on a subset of the population and are likely less effective on those of ethnic minority, who may in fact rely on them the most.
Recruiting people of colour into research: By actively recruiting Black, Asian and minority ethnic candidates, academic and professional labs can begin to create reference information that will assist scientists in designing and developing studies that will be of benefit to these communities.
Data transparency: It is not just clinical trials that underrepresent ethnic minorities, the issue spans into databases too. Every data handler and genetic researcher much ensure that they are being completely transparent with regards to how their data is being used. This is particularly important for ethnic minority groups as previous miscarriages of trust mean that promises of aggregated and anonymised data carry very little weight in persuading individuals to share their personal information. Yet, the obtention of this information is crucial if the world of genetics and medicines is to change. In order to get individuals to invest their data, we must take the time to demonstrate the rewards that can be reaped from information sharing.
However, most importantly, we must tackle the racism that indubitably runs in our society. If we don’t change this, we cannot overcome any of the issues aforementioned. I sincerely hope that COVID-19 is a catalyst in helping our understanding of the adversities that ethnic minorities face on a day to day basis. If this is the case, this worldwide crisis could be a steppingstone to a wholly inclusive healthcare and wellness system that looks after everyone in this country as best as it possibly can.
References:
https://bjgp.org/content/63/612/342
https://www.bbc.co.uk/news/health-53035054
