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  • ‘Intersecting forms of disadvantage’ explain varying coronavirus health outcomes

    Varying coronavirus (Covid-19) health outcomes are the result of “intersecting forms of disadvantage”, including structural inequalities faced by certain communities, experts have said.

    Intersections

    A combination of political, economic, and social factors can have “exponential impacts” on certain groups. That’s according to a paper from the ethnicity subgroup of the Scientific Advisory Group for Emergencies (Sage). A Sage meeting on 25 March considered the paper. It was published on 9 April.

    It follows the government-commissioned ‘Sewell Report’ on racial disparities which was published last week. Many experts criticised the report for failing to recognise the impact of institutional racism in British society.

    The ethnicity sub-group of Sage noted that people from all minority ethnic groups had a higher risk of dying with coronavirus compared to white British people in the first wave. The sub-group advises the government on the coronavirus risks and impacts for minority ethnic groups.

    During the second wave, the elevated risks among black African and Black Caribbean groups had “attenuated somewhat”. But it remained considerably higher for Bangladeshi and Pakistani groups.

    Interaction of factors

    The paper said evidence suggests the continued high mortality rates in Bangladeshi and Pakistani groups are due to the amplifying interaction of four key factors. These are:

    • Long-standing health inequities.
    • Occupation and housing factors.
    • Barriers to accessing care.
    • Including stigma and racism, and the potential influence of policy on behaviour.

    Moreover, many co-morbidities associated with severe coronavirus, such as diabetes, are more prevalent among British Pakistani and Bangladeshi groups, the paper notes.

    These groups are also more likely to work in occupations with a greater risk of exposure, such as hospitality and retail. They’re also more likely to be in precarious work, making it harder to take sick leave, or be self-employed with uncertain incomes.

    Tackling the problems

    Measures addressing their economic situation and workplace rights will help decrease exposure and transmission, the paper says.

    It says evidence shows that increased self-isolation payments would assist all low-paid workers. And family members may require further support through food delivery, paid care workers, and paid-for accommodation outside the home in order to self-isolate.

    It also suggests introducing workplace vaccination schemes in high-risk workplaces. And adds that incentivising, or legally requiring, employers to give paid time off for vaccination could improve take-up rates.

    The paper also said that members of larger, multigenerational households are at higher risk due to poor quality, dense housing. It further said that older members are at risk of exposure from younger relatives and care networks linking households.

    A focused public health campaign could help improve uptake in disadvantaged, minority community areas, the authors say. The campaign could explain the importance of testing in schools to prevent transmission into the family home.

    The paper also notes evidence which suggests that stigma, including racism, is a fundamental cause of health inequalities. It drives morbidity and mortality, undermining access to housing, employment and healthcare.

    A history of experiencing stigma can directly affect an individual’s health and also stop people from accessing care, the paper says.

    A general view of a Muslim woman in Bradford
    The paper notes that stigma, including racism, is a fundamental cause of health inequalities and drives morbidity and mortality (Danny Lawson/PA)

    Driving stigma

    Recent research suggests some government interventions increased stigma. For example, introducing restrictions before Ramadan and Eid last year “fuelled disproportionate public emphasis on transmission within this religious group”.

    Multigenerational households have also been singled out as a source of transmission. This has fuelled division and stress for certain groups, the authors added.

    The Sage members said the Black Lives Matter movement may have created empowerment. The result is “greater use of cultural, religious and collaborative approaches to reducing risk and transmission of Covid-19 in black communities”.

    But the authors said Bangladeshi and Pakistani groups have not reported similar feelings. And establishing or rebuilding trust in these communities may take longer in the absence of an equivalent national movement.

    They write:

    It is essential that the public environment changes, particularly during the vaccination rollout and with the implementation of local interventions to prevent local transmission or surge testing in areas where new variants emerge.

    If Covid-19 becomes endemic in a local area, public communications and media should clearly state this is due to the structural driver of socio-economic disadvantage, and supportive messages should be given to avoid compounding stigma and exclusion, and thereby worsening health outcomes from Covid-19.

    By The Canary

    This post was originally published on The Canary.

  • A new book is aiming to show how we can have ‘life-changing’ conversations about race

    Confer Books publishes material that’s “designed to deepen our understanding of psychological, relational and emotional processes”. And on 4 March, it released a new title named, The Race Conversation: An essential guide to creating life-changing dialogue.

    This fascinating read dives into a world of new vocabulary coined to initiate conversations around race. And it seeks to discuss “the race construct” which keeps “the discomfort of race oppression out of white people’s minds and bodies”.

    Author Eugene Ellis is the director and founder of the Black, African and Asian Therapy Network (BAATN). It’s the UK’s largest independent organisation of its kind. Trained as a psychotherapist, Ellis focuses on “body-orientated therapies” such as body awareness, mindfulness, and healing. Narratives in the book explore “race and mental wellbeing” through an alternative non-verbal lens which doesn’t always involve speaking.

    Credit: Confer Books

    Ellis told The Canary:

    Since George Floyd’s killing, people with mixed families have been pressured to have [race] conversations they might not necessarily have had as a family before. A lot of people feel an ethical pull towards dismantling racism in their workplaces or institutions.

    Just last week, the reaction to Oprah Winfrey’s interview with Meghan Markle showed how rife racism is in Britain.

    “Being colour conscious”

    Opening the discussion with everyday racism, Ellis shows how today’s political and social climate has forced race conversations to the forefront. Whether we like it not, topics of race have become unavoidable as the media has suddenly taken an interest in pursuing race-related coverage.

    Ellis wrote:

    Talking about race had always been hard work, but, after George Floyd’s killing, it had somehow become hard work not to.

    Black Lives Matter protests took place across the world in the wake of George Floyd’s death at the hands of Derek Chauvin, a Minneapolis police officer. Millions gathered to protest for justice, with 15-26 million people in the US alone according to the New York Times.

    On 13 March, CNN reported that Floyd’s family accepted $27m after Minneapolis city council voted to settle the lawsuit.

    The report also said:

    Chauvin has pleaded not guilty to second-degree unintentional murder and second-degree manslaughter charges. He has also pleaded not guilty to third-degree murder, which was reinstated in the case on Thursday.

    For many People of Colour (POC), the global shift to support anti-racism has been a confusing time of feeling both liberated and overwhelmed. Ellis wrote:

    I went through a phase of dislocation and mourning, even paranoia as these narratives played out on the world stage

    Credit: Confer Books
    Mindfulness

    Examining the impacts of racism, the book talks about how trauma can occur “on a mental and physical level due to just existing in a racialised society”.

    Mindfulness is a technique that involves a “body-mind” connection. Ellis said it can be used as a way to “almost retune your body” to lessen the fear that arises when speaking in race conversations.

    And in this race conversation, he wants to include everyone’s experiences. He wrote:

    I also experienced first-hand that, even though white people embody conscious and unconscious race privileges, it doesn’t necessarily mean that they are free from pain and suffering.

    White guilt and suffering from racism are often shunned, but Ellis said:

    That’s a taboo area you can’t talk about but why? I genuinely believe that suffering is across the board. You can’t talk about it because the race construct says you can’t. For it [the race conversation] to move [forward] that aspect needs to come in.

    Another concept deployed in the book is how “the race construct” influences individuals to “attend to white people’s hurt and pain before the hurt and pain in people of colour”.

    “It was whiteness on display”

    It’s natural that frustration weaves its way into these conversations. In comparing ‘black rage’ and ‘white rage’, Ellis wrote:

    White rage steps forward when people of colour step forward to take control of their lives and their financial circumstances. It is predictable, brutal and unforgiving.

    People of colour understand that if they put their foot on the accelerator of their lives, they can only get so far before they run the risk of losing their reputation, their possessions or even their lives.

    The recent increase in news outlets covering topics of race has put a spotlight on racism in the US. This has also sparked people in Britain to dig deeper into racism here.

    Ellis said:

    The storming of the Capitol and the US elections… I was absolutely gripped by the whole thing. It was whiteness on display. It’s easy for us in the UK to say, ‘oh it’s not like that over here’. In the US racism is brash, big, bold and the UK is a little more subdued. There’s more of a conscious effort in the UK to keep it hidden.

    Some institutions have put in place initiatives at certain times to speak about race. In the book, Ellis refers to the “dreaded race day”. He said:

    For race or any oppression there should be conversations around that all the time. It shouldn’t be for one day; you need to reflect about it and that’s not enough time.

    Mental health services have a responsibility to engage in race conversations

    Mental health services that work with Black, Asian, Ethnic Minority and POC also have a responsibility to actively engage in race conversations.

    An article written for the Guardian addresses the problem that Black and Ethnic Minority communities “are more likely to develop mental health conditions but less likely to access counselling – or find it fit for purpose”.

    Ellis wrote about his thoughts on the problem which is “the internal discomfort of mental health professionals, and their profound feelings of not feeling safe during the race conversation”.

    In the book he mentions that POC who then seek mental health services notice this discomfort. He said:

    For a lot of people of colour, a big part of their mental health experiences are not necessarily [impacted by] their families but in society by political structures and systems of oppression. This needs to be included as a part of psychotherapy, training and counselling.

    Then if their client wants to talk about race, they will feel that the therapist is available for it and most of the time, that’s not how it feels.

    PAUSE … and breathe

    If creative language, thought-provoking theories, and an honest breakdown of how we can all participate in race conversations is what you’re after, then this is the read for you. Its forward-thinking narrative aims to normalise conversations about race, highlights the significance of historical oppression, and proposes different solutions to healing from race-related trauma.

    “PAUSE … and breathe” is noted throughout the chapters and is a respectful reminder to all that taking a break from race conversations is ok; in fact it’s healthy.

    Confer UK and Ellis are holding a live webinar specifically for psychotherapists to talk about “racial divides in our society” on 20 March, and they’ll be running another event in June as a part of their Summer Programme 2021.

    You can find other publications from this author here.

    Featured image Confer Books / Thomas Allsop via Unsplash

    By Aaliyah Harris

    This post was originally published on The Canary.

  • BBC attempts to ‘modernise’ leads to all white news board

    As part of our #FactOfTheMatter series, The Canary can show that the BBC has appointed an all-white News Board. Director of news and current affairs Fran Unsworth appointed the new board as part of the BBCs plan to ‘modernise’ the organisation. Not only does this break the BBC‘s own policy on representing ethnic minorities, but the BBC won’t admit to any wrongdoing. In fact, it claims it’s not broken any policy because two are only ‘acting’ members.

    A source at BBC News sent The Canary the image below of the new board as they were concerned with its lack of diversity. And we understand why.

    Introducing the ‘modern’ BBC:

    Unsworth has cut the number of board positions from 11 to eight, and in the process removed one of two BAME representatives at the time. Former editorial director Kamal Ahmed was made redundant in the restructure and as a result the board is not represented by anyone from communities of colour.

    Staff questioned whether ethnicity stopped their progression

    The BBC‘s own report into its diversity found that not only was there a lack of representation of BAME employees, but that staff questioned whether their ethnicity was the reason they hadn’t progressed.

    The report found:

    • The absence of a robust and targeted programme to track and progress high potential BAME talent across the business.
    • A comprehensive and detailed leadership Development and training programme that fully supports the progression of BAME talent.
    • An inconsistent approach across the BBC’s policy and procedures, which permits non- compliance – without compliance, action cannot be taken. Action needs to be taken to ensure greater accountability and to tackle perceptions of favouritism.
    • Inconsistent approach to recruitment protocols which result in restricted pockets of excellence.
    • ƒIn the absence of a consistent constructive and meaningful feedback system BAME employees are left questioning if their ethnicity is the real barrier to their progression.
    The BBC broke its own policy

    When the report was published, nine recommendations were made, which the BBC said that it had accepted “unconditionally”.

    The report recommended that:

    • By the end of 2020 the executive committee and divisional senior leadership teams should each have at least two BAME members.
    • The BBC would introduce a policy that ensures shortlists for all jobs at band E and above to include at least one BAME person.
    • Dramatically increase BAME representation across our interview panels backed by performance monitoring.
    • All development and leadership programmes to have significant BAME representation as part of their overall cohort. Inclusive leadership should be added to part of all leadership programmes.
    • Accountability for Diversity and Inclusion targets and BAME career progression should be incorporated into senior leadership team objectives and progression reviews. Progress should be outlined as part of future annual reports. Build a solid and sustainable BAME mid and senior leadership pipeline. As part of this, there should be development programmes for candidates, backed by robust succession planning across the BBC. This should be in place by the end of the financial year.
    • The Executive Committee should undertake a review of staff rotation to broaden the experience and knowledge base and explore what else can be done to make the BBC workforce more agile.
    • Develop specific action plans based on further analysis of all divisions with less than 10% BAME representation or below par employee survey results including, Radio, Newsrooms, Newsgathering, English Regions and the World Service.
    • Cultural awareness training should be compulsory for all team managers. This should be in addition to the current mandated Unconscious Bias training programme.
    • The BBC should introduce a ‘Statement of Intent’ on Diversity and Inclusion. All staff would be required to abide by it. The statement should be published alongside the BBC’s Annual Report.

    By appointing the new board, the BBC has broken its own policy, as it doesn’t have a minimum of two BAME members – or any for that matter.

    The Canary contacted the BBC for comment and received the following response:

    The final membership of the BBC News Board has not been announced. Two out of the eight posts – a quarter – are currently vacant.

    The ‘vacant’ positions the BBC is referring to are acting HR director Kirsty Lee and acting senior controller, news international services Mary Hockaday. The BBC has confirmed that they’re ‘acting’ members of the board but has not confirmed if it’s actively recruiting for these roles. Because of this, it’s not clear when the BBC will be able to finalise the News Board.

    Regardless of whether the board has ‘acting’ members is not the point. The point is that the BBC has not only failed to implement the recommendations from its own investigation but that in the process it’s cultivating an environment that its staff are concerned about.

    Featured Image Tara Hunt – Flickr

    By Emma Guy

    This post was originally published on The Canary.

  • ‘Colour-blind’ coronavirus vaccine distribution is putting ethnic minorities at risk

    Doctors have warned that the UK’s “colour-blind” vaccine distribution strategy is putting ethnic minority communities at higher risk of falling ill and dying with coronavirus (Covid-19).

    “Unequal impact”

    Writing in the Journal of the Royal Society of Medicine, they say the current prioritisation “disregards the unequal impact of the pandemic on minority ethnic groups”. And it’s worsening racial inequalities that the pandemic has exposed.

    The Joint Committee on Vaccination and Immunisation (JCVI) has largely recommended an age-based approach, saying age is the single biggest risk factor for coronavirus. It recently considered but rejected a move to prioritise people in higher-risk occupations, saying this may slow down the rollout.

    Different ethnic groups are not specifically mentioned in this list. But the JCVI said there should be “flexibility” at a local level. And attention should be given to “mitigating health inequalities, such as might occur in relation to access to healthcare and ethnicity”.

    Higher risk

    People from minority ethnic communities are more likely to live in multigenerational, crowded households, where transmission may be higher. They also make up a higher proportion of those working in high-risk, low-paid occupations. These workers are less likely to be able to work from home and are exposed to more people, meaning they have a higher risk of infection.

    The authors write:

    The invisibility of these vulnerable groups from the priority list and the worsening healthcare inequities and inequalities are putting ethnic minorities at a significantly higher risk of Covid-19 illness and death.

    The UK’s colour-blind vaccination model disregards the unequal impact of the pandemic on minority ethnic groups, rendering it an enabler of structures that are known to systematically disadvantage BAME (Black, Asian and Minority Ethnic) communities.

    Lead author professor Azeem Majeed of the Department of Primary Care and Public Health at Imperial College London said:

    Prioritising essential workers for vaccination will preserve the healthcare system, accelerate reopening of society, help revive the economy and enable the operation of essential community services.

    A targeted approach

    The authors say ineffective vaccine allocation strategies “likely play a role in the high levels of vaccine hesitancy observed across ethnic minorities”. Strategies that could alleviate barriers to getting the vaccine could include ensuring people do not experience financial loss by taking time off work and travelling to get a jab, and administering the vaccine in easily accessible community settings.

    Majeed added:

    Dismissing the racial and socioeconomic disadvantages that ethnic groups face may result in devastating impacts lasting far beyond the end of the pandemic.

    Controlling further outbreaks and, ultimately, ending the pandemic will require implementation of approaches that target ethnic minorities as well as ensuring vaccine allocation strategies are effective, fair and justifiable for all.

    Dr Habib Naqvi, director of the NHS Race and Health Observatory, said:

    We have sadly witnessed the consequence of not acting on early evidence presented into Covid-19 ethnicity and health inequalities.

    The impact of the virus on BME communities has been disproportionate and bleak.

    Now is the time to urgently learn from recent lessons, and act on improved granular data, including a clear focus on localised approaches with resources and support which both engage and tackle lower levels of trust and confidence in the vaccine programme across diverse communities.

    Disparities

    A Department of Health and Social Care spokesperson said:

    The independent JCVI’s advice on Covid-19 vaccine prioritisation was developed with the aim of preventing as many deaths as possible, with older age being the single greatest risk of death. We are following the JCVI recommendations so that we save lives.

    We have invested millions into research into ethnic disparities and Covid-19 and established a new NHS Race and Health Observatory to tackle the specific health challenges facing people from ethnic minority backgrounds.

    By The Canary

    This post was originally published on The Canary.