WHAT THE CHARITY SECTOR SHOULD TAKE AWAY FROM THE PHE REPORT ON DISPARITIES IN THE RISK AND OUTCOMES OF COVID-19
A Statement from #CharitySoWhite
We write this statement under the shadow of ongoing state violence perpetrated against the black community in the US. This is a global moment and we stand in solidarity with all those fighting for racial justice.
The rush by philanthropists, charities, and brands across the UK to assert their own credentials has resulted in mixed emotions for many of us. If such outrage and expressions of support are reserved solely for deaths in the US, we diminish the pain felt by black communities over the senseless deaths we have seen here in the UK.
At the emergence of this pandemic, we launched our position paper. Despite many framing Covid-19 as a great social equaliser, we knew it would have a disproportionate impact of Covid-19 on BAME communities. Public Health England’s (PHE) report is simply a reminder of what we already know. Ahead of its publication, we had concerns that structural racism and socioeconomic inequalities that disproportionately affect BAME communities would be left out of the report. Predictably, our concerns have been vindicated.
While we wanted to speak to the points raised in the report, the truth is that the time for discussions is long past. As we learn more about the disproportionate impact of Covid-19, and as we watch events unfold in the US and here in the UK, the voluntary and community sector (VCS) must ask whether they have truly done all they can to fight for social change in this country or whether it has simply sought the path of least resistance.
The charity sector has the ability to shift the needle on oppression and racism across our society. Author and activist Arundhati Roy has argued that this pandemic could be a portal to something better. We share these sentiments and ask VSC organisations to take steps today to make that future possible. This statement is not a standard response to the PHE report but rather a call to action to all of us who want to realise the world as it should be.
We are ready to fight. We hope you are too.
“Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.” — Arundhati Roy
OUR TAKEAWAYS FOR THE CHARITY SECTOR
BAME health inequalities have been exacerbated by Covid-19
People from Black ethnic groups were most likely to be diagnosed.
People of Bangladeshi ethnicity have twice the risk of death as White British people.
People of Chinese, Indian, Pakistani, Other Asian, Caribbean, and Other Black ethnicity are at 10% - 50% higher risk of death.
Death rates in the most deprived areas are more than double those in the least deprived areas.
Whilst the report does address the risks faced by certain occupations and how this intersects with ethnicity, it makes no mention of how the ostensible disregard for BAME employees for many employers who have failed to provide adequate personal protective equipment (PPE) will have led to deaths.
When we speak of structural racism we think of the tragic death of rail worker Belly Mujinga, whose employer insisted she work in close proximity with passengers without PPE despite knowing of her respiratory condition.
This report highlights the significant, detrimental impact that Covid-19 has had on BAME communities in the UK. Many of these figures were public knowledge prior to the report’s publication. A more nuanced, in-depth analysis of the figures and crucially, the reasons behind them, would have been more useful as we find ourselves several months into this pandemic.
Data analysis should reflect the complexity of BAME lives
Too often, we speak of social issues in silos, focusing on single areas. This is a flawed and simplistic approach. The charity sector is often guilty of taking this approach, and PHE’s report follows suit.
By focusing on single issues we cannot truly tackle the complexity of the injustices we are fighting. Whilst the report acknowledges the limitations of time and available data, comorbidities and the effect of occupation have long been associated with increased risk and outcomes. Analysis of these intersections is critical, and yet we still lack it. We call for this analysis to be made a priority.
For too long the term BAME has been used as a broad brush for the “other” in our society. It erases the complexities and unique experiences of the different diasporas that the term covers, notably the much more acute discrimination black communities face. We see the limitations of this outdated term in the PHE report. Despite ethnicity shown to be a determinant of greater risk, this is where the breakdown stops, and further analysis is desperately needed.
A glaring omission is the complete absence of consideration of the LatinX community. The LatinX community are the eighth largest minority group in the country, with concentrated populations in areas most impacted by the virus including Lambeth and Southwark. Their inclusion on data forms has been recently campaigned for by groups including CLAUK, LatinXcluded, and CitizensUK. Without this information, we can not understand our impact.
Ultimately, focusing on specific issues risks pitting us against each other. #CharitySoWhite has always taken an intersectional stance. While we are fighting for all charities to take an anti-racist stance, we stand in solidarity with other groups fighting for their rights. This is not us vs. them. This is all of us.
Without acknowledging our prejudices, and naming racism, our work will be ineffective
Assimilation language places the burden on vulnerable individuals rather than the systems around them. The report highlights language and cultural differences as likely barriers for BAME communities in accessing healthcare. It simultaneously overlooks the ongoing impact of government policies such as the hostile environment and the No Recourse to Public Funds (NRPF) policy that we know prevent the vulnerable from seeking help.
We must recognise the role unconscious bias has in our society. We must acknowledge that the prejudice BAME individuals face from healthcare professionals who are simply not listening or not willing to believe what they are hearing due to racialized perceptions can have fatal consequences.
Ignorance leads to lack of trust and disengagement. Somalia is not in Central or West Africa, as was wrongly stated in the PHE report. This inexcusable error may have affected the figures the report cites in relation to Central and West Africa. We are also disappointed to see the use of the term “lower skilled workers”. Being lower paid or lower valued does not equate to being lower skilled. We have seen how crucial workers under this designation are in the Covid-19 response.
In our position paper, we detailed the well-documented role that racism, structural inequalities, and historically unjust policies have in the disproportionate impact on BAME communities. PHE’s report conspicuously avoids listing racism as a reason or contributing factor. Without acknowledging this glaring omission, we will fail to address the root cause for the difference in risk and outcomes we are seeing.
Race and ethnicity data must be used with care
While identifying demographic groups such as race or ethnicity to gauge and tackle inequalities in healthcare provision is useful and necessary, it is critical to acknowledge the risks involved in grouping people this way in a medical context.
PHE’s report fails to acknowledge or account for these concerns, despite increasing calls for them to do so. Angela Saini has detailed the stereotype threat, that using these categories carelessly can reinforce damaging myths around perceived biological differences between these groups.
Race and ethnicity data cannot be used in a vacuum as it is in this report. By avoiding detailed analysis of the structural discrimination and systemic inequalities that BAME communities face, we are presented with a very incomplete picture.
Lived experience is a valuable source of understanding. The report makes no attempt to reflect on lived experience despite engagement with more than one thousand different individuals and organisations as part of the review.
In response, we call for the charity sector to exercise care and caution in using race and ethnicity as a data point. The nuanced reasons behind these figures must be presented in their entirety, or we risk engaging in biological racism.
The time to act was months ago
PHE’s report details no clear or coherent action plan on what next steps the government will take to protect BAME communities in this pandemic.
This report was published with limited notice despite being significantly delayed.
That it was reportedly pushed back due to fears around stoking racial tensions, despite these tensions being well-established, is unconscionable.
We understand that there are further reports that may be released but there is no immediate timeline on when or if they will be made available to the public.
The report’s delayed publication, its lack of analysis beyond what is already in the public domain, and the absence of recommendations or an action plan is not only disappointing, but dangerous. The heightened risk that BAME communities face has been public knowledge long before this report was published. This report represents a missed opportunity for desperately needed learning for the public, private, and charity sectors.
WHERE DO WE GO NEXT
The charity sector must critically assess whether it is fit for purpose in our ongoing fight for social change and for justice. We have too often been found wanting, and we must either acknowledge our failings or stand aside for those better able to reach the goals we set for ourselves. We must fight against becoming the “white moderates” that Dr. King warned us about.
As a group of volunteers who work full-time in the charity sector, every day we put our livelihoods on the line to fight for change. We have struggled to understand why so many people in the sector have been so quick to list barriers, and to find reasons to avoid addressing the urgency that is needed.
In the coming weeks, #CharitySoWhite is engaging with BAME communities and organisations to build a vision for the future of the charity sector. We will be defining what a racially just charity sector could look like and what needs to happen for us to get there.
If you are ready to act, get in touch. This won’t be a chance for a photo-op, or something you can tick a box with later, but it will be an opportunity for us all to finally get to work.
We are #CharitySoWhite and we want the charity sector to take the lead in rooting out racism in our society.
