People of black and south Asian ethnic background have a greater risk of death from Covid than white people, figures have confirmed, revealing such differences are not driven by pre-existing health conditions but largely down to factors such as living arrangements and jobs.
Since the pandemic began, it has been clear that people of some ethnic backgrounds are at greater risk from the coronavirus than others, with previous data from the Office for National Statistics (ONS) suggesting black people have a fourfold higher risk of dying from Covid than white people.
Now the ONS has released an update to its analysis, separating black African and black Caribbean as well as the Bangladeshi and Pakistani ethnic groups, and digging deeper into whether pre-existing health conditions could explain the differences.
The results reveal that in all ethnicities, males have a higher rate of death than females, and white people have a lower risk of death than all other ethnic groups apart from Chinese.
Among males in England and Wales, those of black African background had the highest rate of death involving Covid-19, with a rate 2.7 times higher than that of white males, while for females the highest rate was among those of black Caribbean ethnic background, at almost twice that of white females.
The report also shows that males of Bangladeshi ethnic background have a higher risk of death from Covid than those of Pakistani background – this was not the case for females.
The report used hospital data, together with self-reported health or disability, to explore whether differences in mortality rate between people of different ethnicities could be down to differences in the prevalence of pre-existing conditions such as diabetes, respiratory failure and heart failure.
But the results suggest the higher risk of death among people of black and ethnic minority (BAME) backgrounds is more to do with having a higher risk of infection, rather than having a worse outcome when infected.
“Our statistical modelling shows that a large proportion of the difference in the risk of Covid-19 mortality between ethnic groups can be explained by demographic, geographical and socioeconomic factors, such as where you live or the occupation you’re in,” said Ben Humberstone, the deputy director of the health and life events division at the Office for National Statistics.
“It also found that although specific pre-existing conditions place people at greater risk of Covid-19 mortality generally, it does not explain the remaining ethnic background differences in mortality.”
However, looking only at those in the community in England, the rate of death from Covid among males of black African background fell from 3.8 times higher than white males to 2.5 times higher when all these factors were considered, suggesting other factors were also at play.
Dr Michael Head, a senior research fellow in global health at the University of Southampton, said there were likely to be many factors influencing why mortality rate from Covid was higher among BAME populations than white people, but that the latest report chimed with data from the ONS showing public-facing occupations such as working in the social care sector or being a bus driver had a higher risk of death from the disease.
“These workers are proportionately more likely to be from a BAME population. The occupational exposure will partly explain the higher mortality rates among black and Asian individuals,” he said.
“Other factors will include living conditions, number of people per household, and there is likely to be some kind of genetic risk too. We are still trying to understand the key drivers between these differences in mortality, and it is incredibly important that we continue to do so.”