We need a national strategy to tackle health inequalities
Covid-19 has had a disproportionate impact on Black, Asian and minority ethnic communities and disadvantaged groups in our society. Action is required, but it’s sadly lacking so far
Ten years since the first Marmot report on health inequalities across the UK, one would have hoped that progress would have been made. However, the update published earlier this year shows that a decade of austerity has taken its toll on almost all social determinants of health, and so health inequalities are actually widening.
Unsurprisingly, these health inequalities are a key driver of the disproportionate impact of Covid-19. And this will only deepen and get worse as this government continues to fail to take responsible action.
The Lawrence review, An Avoidable Crisis, into Covid and its disproportionate impact on Black, Asian and minority ethnic communities, heard a range of issues leading to health inequalities, such as the government’s failure to implement targeted public health strategies and that some people are not being taken seriously when seeking care, or facing untrue stereotypes about pain thresholds which affect clinical decisions.
That’s why the review called for a national strategy to tackle health inequality as a matter of urgency and for the government to take urgent action to protect ethnic minorities this winter.
Shockingly, disabled people and those with long-term health conditions have accounted for three in every five Covid-related deaths
And the Public Health England report, Beyond the Data, concluded that the “health inequalities known to affect Black, Asian and minority ethnic communities in England may be increasing the risk of transmission … and the risk of mortality …” and that “policy initiatives will need to be sensitive to BAME communities to ensure existing health and economic inequalities are not widened due to the extraordinary measures taken during the pandemic”.
Shockingly, disabled people and those with long-term health conditions have accounted for three in every five Covid-related deaths. Yet many disabled people have seen a significant reduction in the support and care on which they depend, and this comes after a decade of cuts to social care which have left the system simply unable to cope with the pandemic.
Inclusion London’s interim report into the impact of Covid on disabled people showed that one in four disabled people had problems getting hold of protective equipment, while nearly 40% had issues with personal assistants, care workers, direct payments, housing beneﬁts and care packages.
Although only eight local authorities introduced the ‘care easements’ allowed for by the Coronavirus Act officially, there is mounting evidence about a significant reduction in support. In August, Mencap found that during the lockdown, 69% of people with a learning disability had their social care cut or reduced. In October, the Equality and Human Rights Commission (EHRC) reported that disabled and older people had experienced difficulties in accessing care.
The EHRC also reported an estimated 4.5 million people in the UK have become unpaid carers since the start of the pandemic, a rise of almost 50%. Those who have become unpaid carers are more likely to be women, younger and have young children. They face competing demands, which challenge their physical and mental health and wellbeing, and place additional strain on their relationships, finances and ability to do paid work.
Covid has exacerbated inequalities. And the government’s failure to address this by undertaking fully its Public Sector Equality Duty (PSED) so that it ensures it is promoting and advancing equality in all its actions, is clear. It took them four months to publish the Equality Impact Assessment, which should be used much more effectively to shape and inform policy, into the Coronavirus Act.
As such, it seems unlikely that the government can claim to be meeting its PSED, let alone be seeking to address the significant health inequalities or their consequences. To date, there is little evidence that it is.
Marsha de Cordova is Labour MP for Battersea and shadow women & equalities secretary