Conclusions and recommendations
Health Inequality
1.Comorbidities pose a risk for BAME people to experience coronavirus more severely and, at times, with adverse health outcomes. To tackle comorbidities, primary prevention should be prioritised. We are concerned that the decision to disband Public Health England could result in a gap in the prevention work that is already underway. We recommend that the NHS Health Check, which is currently for 40 to 70-year olds, should be extended to people from a BAME background from the age of 25 years for at least the next two years. We also recommend that the Government’s obesity strategy is culturally appropriate. The Government must ensure that any work undertaken in this area is not lost when Public Health England is disbanded. (Paragraph 19)
2.Many reviews and reports have put forward recommendations to tackle health inequalities. Now is the time for action and the Government should finally act on these recommendations. The Government should prioritise implementing the entirety of the recommendations in the ‘Marmot Review 10 years on’, so that health inequalities are not further entrenched by the pandemic. (Paragraph 24)
3.It is vital that Government guidance is accessible to everyone so that individuals can stay informed and prevent contraction or transmission of the disease. To ensure that Government guidance is accessible for BAME communities, the Government must ensure its guidance is culturally competent. We recommend that by the end of Summer 2021, the Government implements the entirety of recommendations five and six from the Public Health England report: Beyond the data: Understanding the impact of covid-19 on BAME groups. (Paragraph 35)
4.We believe that current guidance is inadequately catering to the needs of BAME people and the publication of translated guidance has been slow and often less accessible than English-language versions. The Government should update the guidance on the virus itself, how it transmits, and prevention strategies, in a clear, accessible and culturally competent way. (Paragraph 36)
5.We welcome the Government’s Community Champions scheme; it is a step in the right direction. In order to ensure the scheme’s success, we urge the Government to liaise with BAME women and representatives of BAME women to encourage them to become Community Champions so that the scheme can successfully reach those who are marginalised. (Paragraph 37)
6.We welcome this step by the Government to record ethnicity on death certificates. However, we are disappointed that this has taken the Government so long. We agree with the Minister that the data would have been helpful, and we do not understand why collecting this data was delayed. This data will be valuable in assessing the impact of coronavirus on BAME people and will also add value to understanding wider health disparities. We urge the Government to ensure that the ethnicity data collected is disaggregated. We also recommend it is reported on a regular basis and in disaggregated form. In implementing this policy, we urge the Government to consider allowing the informant of a death to report the ethnicity of a deceased individual. (Paragraph 47)
7.We understand that data sharing is voluntary. However, we believe it is the Government’s responsibility to build trust among BAME communities so that they are comfortable in volunteering data. We strongly disagree with the Minister’s approach and the resistance to deploy resources for data collection; this does not show a sustained effort to capture “a full picture”. The Government should collect, and report, disaggregated data on clinical outcomes, for instance, the share of BAME people being tested, how many have tested positive and the share of BAME people being admitted to hospital. We believe that this is essential in assessing the impact of coronavirus on BAME people; any data collected should be disaggregated by ethnic group to allow for a much more granular analysis of the problems. The Government should collect, and report, disaggregated data on clinical outcomes, for instance, the share of BAME people being tested, how many have tested positive and the share of BAME people being admitted to hospital. We believe that this is essential in assessing the impact of coronavirus on BAME people; any data collected should be disaggregated by ethnic group to allow for a much more granular analysis of the problems. This data collection should begin immediately. (Paragraph 51)
8.We recommend that the Race Disparity Unit extend the Ethnicity Facts and Figures website to include a section on the BAME impacts of coronavirus specifically reporting the disaggregated share of BAME people being tested; the disaggregated share of BAME people infected and the disaggregated share of BAME deaths from the virus. The Government must ensure that this data is disaggregated by ethnicity to allow for a much more granular analysis of the situation. (Paragraph 52)
Employment
9.We welcome the Minister’s commitment to consider occupation as part of the work she is doing to take the PHE review forward; it is vital that the Government examines the interaction between ethnicity, occupation and outcomes of coronavirus. We recommend that the Minister for Equalities as part of this work also consider the economic impacts for BAME workers, especially for those who work in shutdown sectors. (Paragraph 70)
10.There is a link between the occupation of a person and their exposure, vulnerability and risk of contracting the virus. We fear that work on formally establishing this link has been significantly delayed. No clear assessments have been made on whether BAME workers in shutdown sectors have experienced a loss of income. We believe that the Equality and Human Rights Commission’s inquiry into the experiences and treatment of ethnic minority workers in lower paid roles in the health and social care sector should be the start, but not the extent, of its work in assessing the relationship between coronavirus, occupation and inequality. We recommend that the Equality and Human Rights Commission extends the terms of reference for the inquiry and commits to considering occupation as a risk factor in a wider range of sectors. We recommend that the inquiry focus should investigate the economic impacts of coronavirus for workers and determine if there is a causal link between occupation and exposure, infection and mortality rates. (Paragraph 71)
11.Previous Governments have done much work to improve the zero-hours contract policy, however, this work has not gone far enough. The coronavirus pandemic has sharpened the focus on the systemic issues with the zero-hours contracts policy, including the disproportionate number of BAME people on zero-hours contracts. The pandemic has highlighted the unequal way that zero-hours contracts operate: employers can deny furlough to employees and instead reduce their working hours to zero. In some cases, workers on zero-hours contracts are ineligible for Statutory Sick Pay. We recommend that the Government extends the eligibility criteria for Statutory Sick Pay to ensure all workers on zero-hours contracts can claim Statutory Sick Pay. (Paragraph 87)
12.We are deeply concerned by the impact of the zero-hours contracts on BAME people, particularly throughout the course of the pandemic. While in some cases and for some people, the zero-hours contract policy can be a suitable employment option, the pandemic has clearly demonstrated the need to review the way the zero-hours contract policy operates and its impact on BAME people. The long-term impacts of zero-hours contracts, including the poor quality of jobs, should also be considered in the review. We recommend that the Commission for Race and Ethnic Disparities reviews the zero-hours contract policy and considers the disproportionate impact on BAME workers during the pandemic. This review should be conducted by the end of 2021 and the findings should be reported in early 2022. (Paragraph 88)
Reviewing Universal Credit
13.There are known barriers to applying to Universal Credit. These have been thrown into sharp focus by the pandemic. Given that the country has now exited two national lockdowns and continues to be subject to covid-19 restrictions, it is critical that the Government ensures that those who need Universal Credit can access it. The Government should immediately address issues with digital connectivity particularly given the continuing uncertainty over the level of covid-19 restrictions, which means a significant minority could become further isolated from vital support. The Government should develop a Universal Credit mobile application so that people can access the service on their phones. (Paragraph 103)
14.The Government does not know enough about how Universal Credit is operating for different groups. The Government does not know, for example, how many BAME claimants there are and if they are negatively affected by the Universal Credit application system. We recommend that the Government should make the equality survey that is a part of the Universal Credit application mandatory for applicants and claimants so that the ethnicity data of applicants and claimants can be improved. (Paragraph 104)
15.We further recommend that the Department for Work and Pensions reviews and publishes a report on the barriers to accessing the Universal Credit application system by January 2023. The Department should use the diversity data to assess how BAME people are accessing the Universal Credit system, and it should specifically consider the barriers caused by a limited English proficiency to ensure that Universal Credit is accessible for BAME communities. (Paragraph 105)
Housing
16.The guidance that the Government has produced for those in overcrowded housing is substandard. There was no clear guidance in one place from the Government on how to overcome the practical challenges of living in overcrowded, and in some cases multigenerational, accommodation. This continues to be the case nine months after the country first entered lockdown. We recommend that the Government should, within the next four weeks, publish clear, culturally competent guidance with practical recommendations on how to self-isolate for people living in overcrowded, and/or multi-generational, accommodation. The Government should liaise with BAME groups on how to cascade this guidance. We further recommend that the Government by the end of summer 2021 produce a strategy to reduce overcrowding due to its poor health impacts. (Paragraph 115)
17.Poor housing conditions have adverse impacts on health; living in poor quality housing is an aggravating factor in experiencing coronavirus severely. Pre-existing housing inequalities may have exacerbated the impact of coronavirus on BAME people. We welcome the Social Housing White Paper 2020 that the Government published in November 2020. We recommend that the Government publish and implement a strategy to improve housing conditions in social housing and privately rented accommodation by the end of Summer 2021. (Paragraph 122)
No recourse to public funds
18.Since the coronavirus pandemic is recent and emerging there is very limited in-depth evidence that provides an account of the impact of the no recourse to public funds policy. Much of the evidence that stakeholders have provided to us is anecdotal and substantive evidence is required. However, early evidence provides the consensus that there are severe impacts of the no recourse to public funds policy that need to be addressed. We recommend that the Government suspends the no recourse to public funds policy for the duration of the pandemic. We recommend that the Home Office conducts an inquiry into the impact of the no recourse to public funds policy on BAME people and publishes a report by the end of summer 2022. (Paragraph 133)
Published: 15 December 2020 Site information Accessibility statement