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Health inequalities: Ethnicity case studies

These case studies demonstrate how local government is at the heart of addressing the health inequalities that are having a detrimental impact on ethnic minorities. They form part of the health inequalities hub, which is funded by UK Government.

The pandemic has had a disproportionate impact on ethnic minority communities. They have experienced higher levels of infection and death rates. Geography, deprivation, occupation, living arrangements and health conditions have all played a role as well as genetic factors.

But the truth is these inequalities were already having an impact on the health and wellbeing of ethnic minority communities before COVID-19 hit – it is just that the pandemic has shone a light on them like nothing before.

Dig deeper and it soon becomes clear that the picture is complex. Inequalities exist both between ethnic minority groups and the white population as well as across different ethnic communities themselves.

People from some ethnic minority groups, especially Pakistani and Bangladeshi groups, are more likely than White British to report long-term illness and poor health. But on some measures Black Caribbean and Black African communities report better outcomes than their white peers.

Certain conditions, such diabetes and cardiovascular disease, are more common among South Asian and Black groups than in the white population. Whereas for cancer the opposite is true.

Obesity levels are highest in the Black population and lowest in Chinese communities. Physical activity levels are lower among Asian and Black groups – and among women in particular. But the White British population is more likely to smoke or consume alcohol at hazardous or harmful levels.

When it comes to socio-economic factors, it is similarly stark as well as nuanced. People from ethnic minority groups are certainly more likely to live in deprived areas.

Rates of overcrowding are 12 times higher in Bangladeshi communities than White British communities. But overcrowding in Arab and Black groups are a third lower than they are in Bangladeshi communities. Meanwhile, most ethnic groups have higher education attainment levels than White British children with the exception of Black Caribbean pupils.

Structural racism and marginalisation cannot be ignored either. Whether it is accessing health care or finding work, the way society runs can reinforce inequalities.

These are the challenges that need to be addressed and the context in which councils and their partners are working. And as the examples here show responding to the challenges require different approaches across different communities.

In Lewisham there is a focussed drive to support Black pupils, while in Bradford – one of the most ethnically diverse districts in the country – the council is spearheading a programme to bring communities together, empowering them to tackle inequalities together head on.

The work in Gloucestershire includes a project to get women from ethnic minorities active, while Birmingham is using its influence as the biggest local authority in Europe to improve the employment prospects of its local ethnic minority population.

None of these initiatives will provide overnight solutions, but they demonstrate how local government is at the heart of addressing the health inequalities that are having such a detrimental impact on ethnic minorities.

Key statistics 

  • Two times higher death rates among people of Bangladeshi ethnicity after COVID-19 infection than White British in first wave
  • Six times higher risk of South Asian groups developing diabetes than white groups
  • 67 per cent of Black adults classed as overweight or obese – the highest out of all ethnic groups – compared to 32 per cent among Chinese communities
  • One in two women from Asian communities are classed as inactive
  • 22 per cent of ethnic minority population live in the most deprived areas
  • 24 per cent of Bangladeshi households living in crowded accommodation compared to two per cent of White British.