The impoverishment of the wider society ‘drives’ differences in Covid-19 among minority ethnic groups – predominantly South Asian and Black African or Caribbean populations – and could be seen as a major cause of disproportionate infection, hospitalization and death rates, according to a new analysis from the University of Leicester.
The study, supported by the National Institutes of Health Research (NIHR) Leicester Center for Biomedical Research (BRC), comes a day after a government audit concluded that race and racism have become less important factors in explaining social differences in the UK.
Researchers at the University of Leicester used UK Biobank data on 407,830 South Asian, black-and-white individuals to model a hypothetical intervention that removed 50 percent of the general population from material deprivation status (the ‘degree’ of deprivation measured a highly valued Townsend score of four domains: unemployment, car-free ownership, out-of-home ownership, and household overcrowding).
By relocating 50 percent of the most vulnerable in the general population sample from material deprivation, over 80 percent of the additional, ‘excess’ risk of Covid-19 outcomes for South Asian and black populations was eliminated.
Even just moving 25 percent of the sample out of deprivation has mitigated between 40-50 percent of the additional risk for South Asian and black populations.
The striking results of this large, unprecedented analysis challenge several existing studies, some of which argue that poorer health status among ethnic minority populations could be a driving factor for differences in Covid-19.
Cameron Razieh, lead author of the analysis and epidemiologist at the University of Leicester, specializes in the health conditions of ethnic minorities. Explains:
“The method of analysis we used in this study confirms that inequalities in health or health behavior in people living with high deprivation are mainly the result of high deprivation itself.
“If we take this as true, then we can conclude that high levels of deprivation help foster ethnic disparities in Covid-19. Reducing deprivation across the entire population could therefore play a key role in reducing ethnic inequalities in Covid-19 outcomes observed in South Asian and black countries. communities “.
Professor Kamlesh Khunti, co-author of the study, who also works as director of the UK NIHR Applied Research Collaborations East Midlands (ARC EM), said:
“Material deprivation is a universal fundamental determinant of health inequalities within and between populations.
“It is important to quantify the extent to which material deprivation reduces risk, but it is even more important to ask how we can reduce social inequality and increase social mobility.
“There’s a window that closes quickly to use research evidence like this to give those most in need a chance for better health management.”
Data from this study call for improved assistance to the poorest communities.
In what we hope is the last part of this pandemic we must now unite – backed up by research – to ensure that at the end of this very long tunnel there is still light for those most at risk from the outcome of Covid-19.
History may judge harshly if we fail to do so despite enlightened evidence. “
Tom Yates, Joint Senior Author, Professor of Physical Activity, Sedentary Behavior and Health at the University of Leicester
Razieh, C., et al. (2021) Ethnic Minorities and COVID-19: Examining whether excess risk is mediated by denial. European Journal of Public Health. doi.org/10.1093/eurpub/ckab041.