Our work on the impact of COVID-19 within Black, Asian and minority ethnic communities
Over the past few months, it has become clear that the COVID-19 pandemic and its consequences are having a disproportionate impact on Black, Asian and minority ethnic communities. We take a look at the research and innovation funded by UK Research and Innovation (UKRI) that is taking place to investigate the causes, impact and bring about solutions.
Investigating higher rates of COVID-19 mortality within minority ethnic groups
Emerging evidence shows that, after taking account of age and other sociodemographic factors, Black, Asian and minority ethnic (BAME) people are nearly twice as likely to die of COVID-19 than white people. To address the urgent need for more detailed data on why this may be the case, UKRI teamed up with the National Institute for Health Research (NIHR) to launch a rolling call investigating the association between ethnicity and adverse outcomes.
Six new projects, which total nearly £3 million worth of funding, will see researchers work to introduce a new framework to ensure the representation of people from BAME backgrounds in clinical trials testing new treatments and vaccines for COVID-19, the creation of one the UK’s largest COVID-19 cohorts, and an alliance with key voices within Black, Asian and minority ethnic communities to create targeted, digital health messages to help BAME people gain equal access to healthcare.
Researchers are also collaborating with UK Biobank, a project part-funded by the Medical Research Council (MRC) which built up a genetic database of over half a million 40-70 year olds between 2006 and 2010, to investigate correlations between biological, behavioural and socioeconomic factors which may be able to help explain why COVID-19 is affecting different ethnic groups with varying severity.
Investigators from Queen Mary University of London, in collaboration with the MRC Lifecourse Epidemiology Unit at the University of Southampton, have already reported from their research carried out in collaboration with UK Biobank that the relationship COVID-19 infection and ethnicity is complex, and requires more dedicated research to explain the factors driving these patterns. They found no link between socioeconomic or behavioural factors, cardiovascular disease risk, or by vitamin D status for Black, Asian and ethnic minority populations.
Newly-funded research led by Professor Thomas Yates at the University of Leicester will also use the UK Biobank cohort to carry out statistical modelling to examine whether the increased risk of developing severe COVID-19 in minority ethnic groups is explained by differences in underlying health status, lifestyle behaviours such as physical activity, and environmental factors including measures of social inequality. This work will start to unpick why minority ethnic groups may be at increased risk and whether this increased risk is observed equally across the population.
The University of Aberdeen will lead on a project that will see the rapid completion of a tool called the INCLUDE Ethnicity Framework, enabling the designers of clinical trials to consider the factors that may reduce the inclusion of BAME participants, such as existing disease, culture, treatment being tested, and trial information and procedures.
The impact on ethnic minority healthcare workers
UK Research Study into Ethnicity and COVID-19 outcomes in Healthcare workers (UK-REACH) is one of the six new projects awarded funding by UKRI and NIHR that will calculate the risk of contracting and dying from COVID-19 for ethnic minority healthcare workers, with access to over two million healthcare records held by national healthcare organisations.
The study will seek to see what changes occur to the physical and mental health of a cohort of healthcare workers from Black, Asian and minority ethnic backgrounds over 12 months and will include non-clinical staff such as porters and cleaners that are essential to the day-to-day running of healthcare institutions.
The Economic and Social Research Council (ESRC) is also funding a study at King’s College London with the aim of identifying the impact of the COVID-19 pandemic on people from Black, Asian and minority ethnic backgrounds who work in health and social care.
Prior to COVID-19, a report by the NHS England Workforce Race Equalities Standard found that Black and ethnic minority staff working within the NHS experience considerably greater levels of workplace harassment and discrimination than their white counterparts, as well as lower pay, less control and poorer working conditions.
Since the outbreak, reports have shown that these adverse working conditions have been exacerbated for Black and ethnic minority workers, in addition to poorer access to Personal Protection Equipment and other COVID-19 protection measures. This study aims to identify and address these ethnic disparities to avoid the social, economic, and moral costs of excessive adverse mental health and discriminatory working environments.
Nursing narratives: offering BME health care workers “permission to narrate” is an Arts and Humanities Research Council-funded project using a Critical Race theory framework and an arts-based approach that centres emotion as a resource for memory and recovery,
“The story of BME nursing staff and the story of the pandemic are entwined with complex histories of racism which can only be fully understood through amplifying the experience and voice of those who have been marginalised,” says Project Lead, Professor Anandi Ramamurthy, Sheffield Hallam University.
The research will give health care workers space to recount their experiences of racism and the pandemic, visualising their traumas and those of communities worst affected by the crisis.
Mental health during the pandemic
As part of the ESRC’s response to the COVID-19 pandemic, a review was commissioned into the impact of social isolation on disadvantaged and marginalised populations. This study found that the effects of lockdown on income, relationships and mental health is having a disproportionate impact on all vulnerable demographics; disparities that are amplified in Black, Asian and minority ethnic groups.
These findings are echoed in another ongoing UKRI-funded study by scientists from University College London. Launched the week before the lockdown started, with help from the Nuffield Foundation and Wellcome, the research found that levels of depression and anxiety during lockdown are much higher amongst those from ethnic minority backgrounds than white ethnic groups.
Reports of loneliness during lockdown are reported as being almost 10% higher amongst those from Black and minority ethnic backgrounds, whilst thoughts of death have been almost a third higher than reported by white groups. The study recorded accounts of physical or psychological abuse during lockdown have been around 80% higher within ethnic minority groups. Similarly, reports of self-harming are 70% higher.
Cheryl Lloyd, Education Programme Head at the Nuffield Foundation said, “We know that people from some ethnic minority groups have higher mortality and infection rates than those from white ethnic groups, and these findings show that is also true when it comes to reporting poor mental health.”
A nationwide study, funded by the Arts and Humanities Research Council, will test how music and art can alleviate isolation and loneliness while boosting wellbeing in people living with dementia in care home settings, especially those from BAME populations during COVID-19 restrictions.
The project, ‘Culture-Box’ dementia study to tackle loneliness, especially those from BAME populations, will be conducted by the University of West London’s Geller Institute of Ageing and Memory and will deliver multi-sensory Culture Boxes to more than 1,000 residents in 40 care homes over the next 12 months. Including a mixture of music recordings, cameras and art activities, the boxes will be created by artists Emma Barnard, and Julian West in partnership with families to encourage creativity – something which has been shown to improve mood and engagement amongst those living with dementia.
The study will also share important information on virus transmission to protect the most vulnerable during the COVID-19 crisis, particularly focused on areas of socio-economic deprivation and amongst Black, Asian and minority ethnic populations.
Local and regional communication
To mitigate the disproportionate impact of COVID-19, doctors from the Royal Surrey County Hospital are designing culturally specific health messages for Black and South Asian communities.
The UKRI-funded project aims to control the spread of COVID-19 within these communities through the use of specific trusted communication channels. Researchers will work with local groups and community leaders to design and create culturally appropriate information to influence behaviour that reduces the transmission of COVID-19, such as perceived risks and susceptibility, proximity and social distancing, and infection control.
The information gained from the project will be shared with the Black and South-Asian community, community leaders and policymakers including NHS England and Public Health England.
The effects of COVID-19 on income and the economy
COVID-19 has placed unprecedented strain on many peoples' finances, whilst at the same time creating new pressures on financial institutions. According to the Institute for Fiscal Studies (which includes ESRC’s Centre for the Microeconomic Analysis of Public Policy), the number of people in debt is likely to increase significantly, further increasing these financial burdens on individuals and the wider economy. This is being felt more severely in more economically vulnerable demographics, such as small businesses and minority ethnic populations.
As part of UKRI’s work on this, Innovate UK has provided funding to One Africa Network to assist with the changes that COVID-19 has forced on the organisation’s operating model. One Africa Network is a social development initiative that inspires, supports and enhances the potential of Black and African entrepreneurs and small businesses in the Midlands.
Face-to-face events and activities are essential to One Africa Network’s operations, but have been impossible under the COVID-19 lockdown; a time when their members are most in need of support. UKRI’s funding is enabling One Africa Network to transform its approach and operating model, and continue to assist Black and African small businesses through this financially destructive pandemic.