It contradicts most of the ‘received wisdom’. British racism, it seems, is not to blame for whites having a lower death rate from Covid than black people and Asians.

25 October 2020 By Paul Martin

Dr Ali, who was part of a team analysing various studies, says: “Even over the course of the pandemic, despite the higher Covid death rates, overall mortality in ethnic minorities has not been higher than for whites.”

He points out that blacks and Asians have a longer life span on average than white people in Britain.

He writes: “Data from England and Scotland has shown that most ethnic minority groups have both better overall health and lower rates of all-cause mortality than white groups.”

He said he had been “acutely aware”, as a frontline doctor during the first wave of the Covid crisis, that ethnic minority National Health Service colleagues had died disproportionately to their numbers.

However, says Dr Ali, if it were true that non-whites suffer from systemic racism throughout their lives — adversely affecting their health, education, income, housing, employment (the key determinants of health) — this would be reflected in life expectancy and overall mortality figures.

He takes issue with what he thinks is a misinterpretation of a Public Health England survey published in June. It was, he says, “widely reported at the time” that the increased death rate from Covid-19 among black and south Asian people had been due to systemic racism.

He adds: “Even now others continue to make the same inflammatory claim.”

The initial Public Health England review did show an increased death rate for Covid-19 in the black and south Asian populations but its analysis was unable to take into account many important risk factors including occupation or comorbidities.

In a report commissioned by the government, and published today (October 23) the Race Disparity Unit updated evidence from many studies published since then. It says these have shown that most of the increased risk can be accounted for by factors other than systemic racism.

The main differences are due, says Dr Ali, to BAME people living disproportionately in densely populated urban centres with higher levels of air pollution, and in larger, multi-generational households.

They also have a higher risk of a poorer outcome once infected, due to higher levels of comorbidities, such as obesity and diabetes.

The claims about racism were based on the subjective views of four thousand “stakeholders”, not on objective evidence, as the original Public Health England report itself acknowledged.

However, he cites data from England and Scotland as showing that most ethnic minority groups have both better overall health and lower rates of all-cause mortality than white groups do. Even over the course of the pandemic, despite the higher Covid death rates, overall mortality in ethnic minorities has not been higher than for whites, he says.

Dr Ali concludes: “Instead of focusing on ethnicity we need to look at the key underlying risk factors (which are mainly socioeconomic) that are causing their higher death rates — and that will therefore reduce the risk of death in all ethnic groups, including whites.”

Correspondent.world has found life expectancy figures for Britain from 2016 that appear to fully back up Dr Ali’s assertion about longevity.

The new analysis chimes with little-reported research in the USA and in the UK.

The paper said there were indeed proportionally more admissions to hospitals of people from the Black and Minority Ethnic ( BAME ) community — but the white ethnic group had a higher mortality rate once in hospital.

Previous reports had said that black Britons in society were four times more likely to die of Covid-19 than their white counterparts.

It was also found that Bangladeshi and Pakistani people are 50 per cent more likely to die from the virus in society than white people – with people of Indian and mixed heritage also more at risk.

The Office for National Statistics claimed that “the risk is significantly higher for some of those ethnic groupings compared to the white ethnic grouping”.

That would appear to be true. But once admitted to hospital, new research by Professor Ewen Harrison, Dr Annemarie Docherty and Professor Calum Semple states that disproportion disappears — when comparing equivalent categories. For example: economically deprived white groupings compared with equally economically deprived BAME groupings.

The researchers said there were proportionally more intensive-care admissions within the BAME community compared to the white group, but that this is explained by “differences in patient characteristics such as comorbidity”. In other words, not by racism, nor by more BAME workers being obliged to perform riskier Covid-affecting interactions, and therefore being put at greater risk on average than whites.

The report (using data available up to mid-April) stated: “No difference in HDU/ICU admission is seen after adjusting for patient characteristics. The White ethnic group has higher mortality than the BAME group. In robust matched models (propensity-score matched), no excess mortality is seen in the BAME group. 

“Black and Minority Ethnic individuals might be more likely to be admitted to hospital with COVID-19. BAME groups are more likely to be admitted to HDU/ICU. When patient characteristics are taken into account, no excess HDU/ICU admissions or deaths are seen in the BAME group.”

The clinical study focused on 23,577 patients who had been admitted to hospitals in the UK with Covid-19 – at a time when the death oll in the Uk overall for Covid was around 35 thousand.

In the study, 11,690 of the patients were white, 1,135 were ‘minority ethnic’, 835 were Asian and 568 were black.

The researchers used a system called “propensity-score matched model” to compare people in the BAME group to individuals with similar characteristics in the white ethnic group.

Of the patients sampled the researchers found that people in BAME groups were younger and more likely to have diabetes. That is one condition many people who contract the virus also have.

Here are extracts from Dr Ali:

Racism wasn’t to blame for differing Covid death rates

By Dr. Raghib Ali

Thursday October 22 2020, 12.01am, The Times

As a doctor on the front line in the first wave of the Covid crisis, I was acutely aware of reports, almost daily, of the tragic deaths of NHS colleagues, with a large majority from ethnic-minority backgrounds. A number of studies, including one from Public Health England in June, confirmed the increased death rate from Covid-19 among black and south Asian people, with a second report focusing specifically on potential reasons for this increased risk. This was widely reported at the time as being due to systemic racism and even now others continue to make the same inflammatory claim.

In response, the government asked the Race Disparity Unit to investigate further and today its first report is released, to which I was pleased to be able to contribute.

The initial PHE review did show an increased death rate for Covid-19 in the black and south Asian populations but its analysis was unable to take into account many important risk factors including occupation or comorbidities. Today’s report, with updated evidence from many studies published since then, has shown that most of the increased risk can be accounted for by other factors.

The main differences are due to increased risk of infection, with black and Asian people more likely to live in deprivation, in densely populated urban centres with higher levels of air pollution, and in larger, multi-generational households. They also have a higher risk of a poorer outcome once infected, due to higher levels of comorbidities, such as obesity and diabetes.

The claims about racism were based on the subjective views of 4,000 “stakeholders”, not on objective evidence, as the report itself acknowledged. Also, if it were true that non-whites suffer from systemic racism throughout their lives — adversely affecting their health, education, income, housing, employment (the key determinants of health) — this would be reflected in life expectancy and overall mortality figures that are the best measures of overall health.

However, data from England and Scotland has shown that most ethnic minority groups have both better overall health and lower rates of all-cause mortality than white groups. Even over the course of the pandemic, despite the higher Covid death rates, overall mortality in ethnic minorities has not been higher than for whites.

Instead of focusing on ethnicity we need to look at the key underlying risk factors (which are mainly socioeconomic) that are causing their higher death rates — and that will therefore reduce the risk of death in all ethnic groups, including whites.

Dr Raghib Ali is a senior clinical research associate at the MRC Epidemiology Unit, University of Cambridge

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