Material deprivation is driving Covid-19 disparities among ethnic minority groups

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Deprivation among society at large is 'driving' Covid-19 disparities among minority ethnic groups - predominantly South Asian and Black African or Caribbean populations - and could be considered the main cause of disproportionate infection rates, hospitalization and deaths experienced by these populations, according to new analysis from the University of Leicester.

The study, supported by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC) comes a day after a government-commissioned review concluded race and racism have become less important factors in explaining social disparities in the UK.

Researchers at the University of Leicester used UK Biobank data of 407,830 South Asian, Black and White individuals to model a hypothetical intervention whereby 50 per cent of the general population were lifted out of material deprivation status (the 'grade' of deprivation was measured by the highly regarded Townsend score that is made up of four domains: unemployment, non-car ownership, non-home ownership and household overcrowding).

By moving the 50 per cent most deprived in the general population sample out of material deprivation, over 80 per cent of the extra, 'excess' risk of Covid-19 outcomes for South Asian and Black populations was eliminated.

Even just by moving 25 per cent of the sample out of deprivation, between 40-50 per cent of additional risk to South Asian and Black populations was alleviated.

The striking results of this large, unprecedented analysis dispute several existing studies, some of which maintain that poorer health among ethnic minority populations could be the driving factor for Covid-19 disparities.

Cameron Razieh, Lead author of the analysis and Epidemiologist at the University of Leicester specializes in ethnic minority health conditions. He explains:-

"The method of analysis we used in this study upholds that inequalities in health or health behaviors in people living with high deprivation are, in the most part, the result of the high deprivation itself.

"If we take this as truth, then we can conclude that high levels of deprivation are helping drive Covid-19 ethnic disparities. Reducing deprivation within the whole population could therefore play a pivotal role in reducing ethnic inequalities in Covid-19 outcomes observed in South Asian and Black communities."

Professor Kamlesh Khunti, joint senior author of the study who also works as Director of the UK NIHR Applied Research CollaborationsEast Midlands (ARC EM) said:

"Material deprivation is a universal underpinning determinant of health inequalities within and between populations.

"Quantifying the extent to which material deprivation reduces risk is important but even more imperative is to now ask how we can reduce social inequality and increase social mobility.

"There is a rapidly closing window to use research evidence such as this to give those most in need a fighting chance to better manage their health."

The data from this study calls for improved assistance to be provided to the poorest communities.

In what we hope is the final stretch of this pandemic we must now pull together - backed by research - to ensure that for those most at risk of Covid-19 outcomes, there is still light at the end of this very long tunnel.

History may judge harshly if we do not get this right despite the evidence elucidated."

Tom Yates, Joint Senior Author, Professor of physical activity, sedentary behavior and health, University of Leicester

Source:
Journal reference:

Razieh, C., et al. (2021) Ethnic minorities and COVID-19: Examining whether excess risk is mediated through deprivation. European Journal of Public Health. doi.org/10.1093/eurpub/ckab041.

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