To consider any requests received in accordance with Part 4, Section B, Paragraph 29 of the Council’s Constitution.
Minutes:
It was noted that a question had been submitted by Cllr Eldridge Culverwell in relation to item 7 of the agenda, Working in Partnership to Address Racial Discrimination and Injustice. It was agreed that, as Cllr Eldridge Culverwell was not present, a written response from Dr Will Maimaris would be provided in the minutes.
Question:Covid-19, by all accounts has affected the black communities the largest. If this is the case, WHY?Is it dietary, life styles, accommodation, alcohol/drug consumption, weather patterns, and or work environments? There must be a common denominator that the medical experts have found, or analysed, and if there is, what precautions or implementations are being garnered as a means of a cure or a precautionary guide, to address and or, reduce this stigma, dilemma or whatever phraseology is required understand this endemic?
Response: Public Health England have published the report ‘Beyond the data: Understanding the impact of Covid-19 on Black, Asian, and Minority Ethnic (BAME) groups’, which covers the issues set out in this question https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/892376/COVID_stakeholder_engagement_synthesis_beyond_the_data.pdf
This is a follow up report to the report published earlier in June which found a statistical association between increased risk of death from Covid-19 and some ethnic groups. The risk of death from Covid-19 was found to be 2x higher in people from Bangladeshi and Pakistani ethnic groups compared to the white ethnic group, and 10-50% higher in other ethnic groups including Black Caribbean and Black African.
The ‘Beyond the Data’ report explored some of the possible reasons for worse impacts of Covid-19 in BAME groups. Their reasons included:
People of Black, Asian and other minority ethnic groups may be more exposed to Covid-19, and therefore are more likely to be diagnosed. This could be the result of factors associated with ethnicity such as occupation, population density, use of public transport, household composition and housing conditions, which the currently available data did not allow us to explore in this analysis.
The review also reports that ‘once infected, many of the pre-existing health conditions that increase the risk of having severe infection (such as underlying conditions like diabetes and obesity) are more common in BAME groups and many of these conditions are socio-economically patterned. For many BAME groups, especially in poor areas, there is a higher incidence of chronic diseases and multiple long-term conditions (MLTCs), with these conditions occurring at younger ages’.
Qualitative findings in the report included that pre-existing economic and health inequalities experienced by people from BAME groups were exposed and exacerbated by Covid-19.
The report also found that racism and discrimination experienced by BAME communities was a factor influencing background health and also may be a barrier for people accessing testing and prompt treatment for Covid-19, leading to worse outcomes.
The report also made a number of national recommendations to address the issues highlighted. Recommendations include:
1. Mandate comprehensive and quality ethnicity data collection and recording as part of routine NHS and social care data collection systems, including the mandatory collection of ethnicity data at death certification.
2. Support community participatory research, in which researchers and community stakeholders engage as equal partners in all steps of the research process, to understand the social, cultural, structural, economic, religious, and commercial determinants of Covid-19 in BAME communities, and to develop readily implementable and scalable programmes to reduce risk and improve health outcomes.
3. Improve access, experiences and outcomes of NHS, local government and integrated care systems commissioned services by BAME communities including: regular equity audits; use of health impact assessments; integration of equality into quality systems; good representation of black and minority ethnic communities among staff at all levels; sustained workforce development and employment practices; trust-building dialogue with service users.
4. Accelerate the development of culturally competent occupational risk assessment tools that can be employed in a variety of occupational settings and used to reduce the risk of employee’s exposure to and acquisition of Covid-19, especially for key workers working with a large cross section of the general public or in contact with those infected with Covid-19.
5. Fund, develop and implement culturally competent Covid-19 education and prevention campaigns, working in partnership with local BAME and faith communities to reinforce individual and household risk reduction strategies; rebuild trust with and uptake of routine clinical services; reinforce messages on early identification, testing and diagnosis; and prepare communities to take full advantage of interventions including contact tracing, antibody testing and ultimately vaccine availability.
6. Accelerate efforts to target culturally competent health promotion and disease prevention programmes for non-communicable diseases promoting healthy weight, physical activity, smoking cessation, mental wellbeing and effective management of chronic conditions including diabetes, hypertension and asthma.
7. Ensure that Covid-19 recovery strategies actively reduce inequalities caused by the wider determinants of health to create long term sustainable change. Fully funded, sustained and meaningful approaches to tackling ethnic inequalities must be prioritised.
A number of these actions are being taken forward at local level.