Black History Month: A history of health inequalities

In this blog, to mark the end of Black History Month, we hear from the Trust’s Network and Communications Officer, Peter, on how racial inequalities have created inequalities in the health and quality of life for people of black heritage throughout history, and how we are seeing these inequalities even more starkly today with the devastating and disproportionate effects of the pandemic.

As a child growing up in East London in the late 90s, I remember my grandmother leaving early to take the 55 bus across Hackney Road to the city to work her second job. She worked in the morning as a cleaner, and a dinner lady in the afternoon to sustain our overcrowded home. I could not understand the reasons my grandmother had to work two jobs despite my grandfather working full time, and this perplexed me for years.

However, what I did know from an early age was that there were racial disparities between black and white people and I also acknowledged that my lived experience was very different from my white counterparts. Playing Sunday League football outside of Hackney was my passport to seeing how different my white counterparts lived. While I lived in a world of black-on-black knife and gun crime, poverty, fast food chains, and betting shops, a mile and a half away, it was a radically different world of the economic prosperity of bustling bars, museums, universities, high-end designer stores, and organic health outlets.

Hackney is a microcosm of the deep-seated challenges that many inner-city London neighbourhoods experienced in the 90s and are still experiencing today. An area with a large black demographic, where people have significantly shorter life expectancies than their counterparts living in more affluent areas, it was not surprising to hear from a report from the School of Geographical Sciences, University of Bristol that Hackney was one of the worst boroughs hit by the pandemic in 2020. [1]We can also see this pattern repeat in other metropolitan areas across the UK with large ethnically diverse regions such as Lozells in Birmingham and Fallowfield in Manchester that have been disproportionately affected by the virus.

A recent study from Public Health England found that Black people are more likely to die from Covid-19 than white people[2], exposing a disparity in the coronavirus' pandemic impact in England and Wales. The study found that black men were twice more likely to die from Covid-19 when compared to people of White British ethnicity. The socioeconomic disadvantage that black people in the UK face is varied, but all play a significant role in black people's livelihoods. To fully understand all of the factors that have made people of black heritage more susceptible to COVID, we must unpick a complex set of social, economic and environmental factors that affect our health - the social determinants of health.[3]

Housing and surroundings

Afro-Caribbean families are more likely to live in overcrowded housing, which could increase the likelihood of them contracting the virus. According to a 2003 study by Centre for Regional Economic and Social Research, Sheffield Hallam University, many Somali households live in severely crowded circumstances, which dramatically affects their physical, mental, and emotional well-being and future prospects. Overcrowding is common in the low demand housing markets of Liverpool and Sheffield and the high demand housing market of London, suggesting that it was influenced by constraints above and beyond the provision of bricks and mortar.[4]

Housing conditions included damp and condensation, ineffective heating systems, low-quality repairs, and maintenance and inadequate security measures causes challenges for many households. In addition, it was recently reported in the Guardian, COVID-19 patients from ethnic minorities were twice as likely as white patients to live in areas of environmental and housing deprivation and that people from these areas were twice as likely to arrive at hospitals with more severe coronavirus symptoms and be admitted to intensive care units (ITU).[5]

Baroness Doreen Lawrence, the mother of Stephen Lawrence who was tragically murdered in a racially motivated attack in 1993 confirms the detrimental impact of COVID19 on Afro Caribbean people on a recently published report examining these inequalities. She states:

"Black, Asian and minority ethnic people have been over-exposed, under-protected, stigmatised and overlooked during this pandemic - and this has been generations in the making.”

Employment

In addition to housing, Black people often find themselves in lower-paid work than their white counterparts. Regardless of qualifications, black workers earn around 8.3 percent less – an average of approximately £1.15 an hour – than white workers, according to the Trade Union Congress. A possible explanation for this disparity is based on occupational and industrial segregation, which occurs mostly in temporary, casual, and insecure work. Some minorities are known to be over-represented in specific industries such as front-line workers in the health sector. A possible correlation can be made with the disproportionate impact of Covid-19 on ethnic minority healthcare workers compared to white healthcare workers.

According to a report from BMJ, discrimination and a failure to adequately protect key workers may have contributed disproportionately to the number of deaths. The report also highlighted numerous examples of front-line workers who could not access appropriate PPE to protect themselves adequately.

Race and equality

When looking at all the factors that impact people of Afro- Caribbean heritage, quality of life can be attributed to the structural and systemic racism that continues to profoundly shape the experiences of black people in the UK today. Incidents such as the Windrush Scandal and Stop and Search legislations which racially profiles young black men, barely scratch the surface of deep-seated racism that ethnic minorities have and continue to face in the UK. In order to deal with racial inequality in the UK, we must not only work towards acknowledging that racial inequality exists, but we need to continue to work collectively with local government, businesses and civic society to build equity for those left behind. Only then will we be able to move forwards and prosper as a society where people are not forced to work two jobs to survive. Still seeing the 55 bus which took my grandmother to work every morning is a stark reminder of the racial inequality that exists in the UK however, I am hopeful that we can one day live in a society where skin colour will no longer be a determining factor to the quality of your life.

Other sources

Updating ethnic contrasts in deaths involving the coronavirus (COVID-19), England and Wales: deaths occurring 2 March to 28 July 2020, Office of National Statistics 2020

Covid body count

Black people paid less, The independent

Hackney Highest unemployment rate

Birmingham News