Unequal impact of COVID-19: BAME disproportionality With the whole country and world waking up to the deeply entrenched structural equalities that have impacted the lives of our Black, Asian and other ethnic Minority communities, there is a collective appreciation that we need to go further to dismantle a system, and create new ones. Local and national evidence shows that people from a Black, Asian or minority ethnic background are disproportionately impacted by Covid-19. In response to this, the council implemented this working group to carry out a rapid 6-week programme to gather evidence of the impacts of Covid-19 and develop actions for supporting our residents during this time and beyond. Intensive work has been underway to understand and take action to address the direct and indirect health impacts of Covid-19 on our Black, Asian and other Ethnic Minority communities in Camden, and to ensure that individuals and communities are protected both now and through the next phase of the pandemic, but also to bring about wider systemic change. This document is us working in the open with you and shows the information that was provided by different service areas to the member-led working group for comment and to develop actions going forward. The Black, Asian and other Ethnic Minority Inequalities and Covid-19 Working Group has benefitted from evidence and the lived experience of our residents, VCS partners, professionals and Members in guiding and shaping the Council’s response from bureaucratic to relational. In this document you will find summaries of the data included in these presentation slides and the relevant links to documents.

The files in this dataset contains the full MEDLINE (Ovid), Embase (Ovid), CAB Abstracts (Ovid), PsychInfo (Ovid), CINAHL (EBSCO), Cochrane Library, Scopus, Web of Science, and Global Index Medicus search strategies for Covid-19, African/Black individuals and communities, and racism. Original search date: (2021-08)

BackgroundCOVID-19 has had a disproportionate impact on racial and ethnic minorities compared to White people. Studies have not sufficiently examined how sex and age interact with race/ethnicity, and potentially shape COVID-19 outcomes. We sought to examine disparities in COVID-19 outcomes by race, sex and age over time, leveraging data from Michigan, the only state whose Department of Health and Human Services (DHSS) publishes cross-sectional race, sex and age data on COVID-19.MethodsThis is an observational study using publicly available COVID-19 data (weekly cases, deaths, and vaccinations) from August 31 2020 to June 9 2021. Outcomes for descriptive analysis were age-standardized COVID-19 incidence and mortality rates, case-fatality rates by race, sex, and age, and within-gender and within-race incidence rate ratios and mortality rate ratios. We used descriptive statistics and linear regressions with age, race, and sex as independent variables.ResultsThe within-sex Black-White racial gap in COVID-19 incidence and mortality decreased at a similar rate among men and women but the remained wider among men. As of June 2021, compared to White people, incidence was lower among Asian American and Pacific Islander people by 2644 cases per 100,000 people and higher among Black people by 1464 cases per 100,000 people. Mortality was higher among those aged 60 or greater by 743.6 deaths per 100,000 people vs those 0–39. The interaction between race and age was significant between Black race and age 60 or greater, with an additional 708.5 deaths per 100,000 people vs White people aged 60 or greater. Black people had a higher case fatality rate than White people.ConclusionCOVID-19 incidence, mortality and vaccination patterns varied over time by race, age and sex. Black-White disparities decreased over time, with a larger effect on Black men, and Older Black people were particularly more vulnerable to COVID-19 in terms of mortality. Considering different individual characteristics such as age may further help elucidate the mechanisms behind racial and gender health disparities.

COVID-19 disproportionately affected minorities, while research barriers to engage underserved communities persist. Serological studies reveal infection and vaccination histories within these communities, however lack of consensus on downstream evaluation methods impede meta-analyses and dampen the broader public health impact. To reveal the impact of COVID-19 and vaccine uptake among diverse communities and to develop rigorous serological downstream evaluation methods, we engaged racial and ethnic minorities in Massachusetts in a cross-sectional study (April-July 2022), screened blood and saliva for SARS-CoV-2 and human endemic coronavirus (hCoV) antibodies by bead-based multiplex assay and point-of-care (POC) test and developed across-plate normalization and classification boundary methods for optimal qualitative serological assessments. Among 290 participants, 91.4% reported receiving at least one dose of a COVID-19 vaccine, while 41.7% reported past SARS-CoV-2 infections, which was confirmed by POC- and multiplex-based saliva and blood IgG seroprevalences. We found significant differences in antigen-specific IgA and IgG antibody outcomes and indication of cross-reactivity with hCoV OC43. Finally, 26.5% of participants reported lingering COVID-19 symptoms, mostly middle-aged Latinas. Hence, prolonged COVID-19 symptoms were common among our underserved population and require public health attention, despite high COVID-19 vaccine uptake. Saliva served as a less-invasive sample-type for IgG-based serosurveys and hCoV cross-reactivity needed to be evaluated for reliable SARS-CoV-2 serosurvey results. The use of the developed rigorous downstream qualitative serological assessment methods will help standardize serosurvey outcomes and meta-analyses for future serosurveys beyond SARS-CoV-2.

As of June 14, 2023, around 66 percent of all COVID-19 deaths in the United States have been among non-Hispanic whites, although non-Hispanic whites account for 60 percent of the total U.S. population. On the other hand, non-Hispanic Asians have accounted for just three percent of all deaths due to COVID-19 even though this group makes up almost six percent of the entire U.S. population. This statistic shows the distribution of COVID-19 (coronavirus disease) deaths in the United States, by race/ethnicity.

Since the beginning of the COVID-19 pandemic, almost *** out of five people of a Chinese background reported having experienced discrimination in Canada. They were the most commonly discriminated against visible minority group, followed by people of Filipino origin (**** percent) and Black people (**** percent). In comparison, about ** percent of people who did not belong to a visible minority group said they had experienced discrimination since the beginning of the pandemic.

BackgroundCOVID-19 has had a disproportionate impact on racial and ethnic minorities compared to White people. Studies have not sufficiently examined how sex and age interact with race/ethnicity, and potentially shape COVID-19 outcomes. We sought to examine disparities in COVID-19 outcomes by race, sex and age over time, leveraging data from Michigan, the only state whose Department of Health and Human Services (DHSS) publishes cross-sectional race, sex and age data on COVID-19.MethodsThis is an observational study using publicly available COVID-19 data (weekly cases, deaths, and vaccinations) from August 31 2020 to June 9 2021. Outcomes for descriptive analysis were age-standardized COVID-19 incidence and mortality rates, case-fatality rates by race, sex, and age, and within-gender and within-race incidence rate ratios and mortality rate ratios. We used descriptive statistics and linear regressions with age, race, and sex as independent variables.ResultsThe within-sex Black-White racial gap in COVID-19 incidence and mortality decreased at a similar rate among men and women but the remained wider among men. As of June 2021, compared to White people, incidence was lower among Asian American and Pacific Islander people by 2644 cases per 100,000 people and higher among Black people by 1464 cases per 100,000 people. Mortality was higher among those aged 60 or greater by 743.6 deaths per 100,000 people vs those 0–39. The interaction between race and age was significant between Black race and age 60 or greater, with an additional 708.5 deaths per 100,000 people vs White people aged 60 or greater. Black people had a higher case fatality rate than White people.ConclusionCOVID-19 incidence, mortality and vaccination patterns varied over time by race, age and sex. Black-White disparities decreased over time, with a larger effect on Black men, and Older Black people were particularly more vulnerable to COVID-19 in terms of mortality. Considering different individual characteristics such as age may further help elucidate the mechanisms behind racial and gender health disparities.

Vaccination rates and odds ratios by socio-demographic group among people living in England.

Coronavirus affects some members of the population more than others. Emerging evidence suggests that older people, men, people with health conditions such as respiratory and pulmonary conditions, and people of a Black, Asian Minority Ethnic (BAME) background are at particular risk. There are also a number of other wider public health risk factors that have been found to increase the likelihood of an individual contracting coronavirus. This briefing presents descriptive evidence on a range of these factors, seeking to understand at a London-wide level the proportion of the population affected by each.

Estimated prevalence of COVID-19 infection by select characteristics.

COVID-19 incidence, mortality, and vaccination rates by race, age, and sex, Michigan, June 2021.

This review summarizes the economic impacts of the pandemic on ethnic minorities, focusing on the city of Manchester. It utilizes multiple reporting sources to explore various dimensions of the economic shock in the UK, linking this to studies of pre-COVID-19 economic and ethnic composition in Manchester and in the combined authority area of Greater Manchester. We then make inferences about the pandemic's short-term impact specific to the city region. Greater Manchester has seen some of the highest rates of COVID-19 and as a result faced particularly stringent “lockdown” regulations. Manchester is the sixth most deprived Local Authority in England, according to 2019 English Indices of Multiple Deprivation. As a consequence, many neighborhoods in the city were always going to be less resilient to the economic shock caused by the pandemic compared with other, less-deprived, areas. Particular challenges for Manchester include the high rates of poor health, low-paid work, low qualifications, poor housing conditions and overcrowding. Ethnic minority groups also faced disparities long before the onset of the pandemic. Within the UK, ethnic minorities were found to be most disadvantaged in terms of employment and housing–particularly in large urban areas containing traditional settlement areas for ethnic minorities. Further, all Black, Asian, and Minority ethnic (BAME) groups in Greater Manchester were less likely to be employed pre-pandemic compared with White people. For example, people of Pakistani and Bangladeshi ethnic backgrounds, especially women, have the lowest levels of employment in Greater Manchester. Finally, unprecedented cuts to public spending as a result of austerity have also disproportionately affected women of an ethnic minority background alongside disabled people, the young and those with no or low-level qualifications. This environment has created and sustained a multiplicative disadvantage for Manchester's ethnic minority residents through the course of the COVID-19 pandemic.

According to a report conducted in the United Kingdom in 2020, 50 percent of white women and 46 percent of Black and minority women said they had experienced abuse based on their gender. Additionally, 42 percent of Black and minoritized respondents of color reported having experienced abuse based on their ethnic background. Black women and women of color were also more likely to be targeted by online abuse based on their religion and gender identity.

After October 13, 2022, this dataset will no longer be updated as the related CDC COVID Data Tracker site was retired on October 13, 2022.

As the Coronavirus-2019 (COVID-19) pandemic continues, multiple therapies are rapidly being tested for efficacy in clinical trials. Clinical trials should be racially and ethnically representative of the population that will eventually benefit from these medications. There are multiple potential barriers to racial and ethnic minority enrollment in clinical trials, one of which could be that inclusion and exclusion criteria select for certain racial or ethnic groups disproportionately. In this observational cohort study at a single health care system, we examined if there were differences in eligibility for treatment with remdesivir based on clinical trial criteria for racial and ethnic minorities compared to non-Hispanic Whites. 201 electronic medical record charts were reviewed manually. Self-identified Whites were older than other racial or ethnic groups. At the time of presentation, Black, Latinx, and White participants met inclusion criteria for remdesivir at similar rates (72%, 80%, and 73% respectively), exclusion criteria at similar rates (43%, 38% and 49% for Black, Latinx and White participants respectively). In this study, there was no difference in eligibility for remdesivir based on race or ethnicity alone.

The inequities of the COVID-19 pandemic were clear by April 2020 when data showed that despite being just 3.5% of the population in England, Black people comprised 5.8% of those who died from the virus; whereas White people, comprising 85.3% of the population, were 73.6% of those who died. The disproportionate impact continued with, for example, over-policing: 32% of stop and search in the year ending March 2021 were of Black, Asian and Minority Ethnic (BAME) males aged 15-34, despite them being just 2.6% of the population.

The emergency measures introduced to govern the pandemic worked together to create a damaging cycle affecting Black, Asian and Minority Ethnic families and communities of all ages. Key-workers – often stopped by police on their way to provide essential services – could not furlough or work from home to avoid infection, nor support their children in home-schooling. Children in high-occupancy homes lacked adequate space and/ or equipment to learn; such homes also lacked leisure space for key workers to restore themselves after extended hours at work. Over-policing instilled fear across the generations and deterred BAME people – including the mobile elderly - from leaving crowded homes for legitimate exercise, and those that did faced the risk of receiving a Fixed Penalty Notice and a criminal record.

These insights arose from research by Co-POWeR into the synergistic effects of emergency measures on policing, child welfare, caring, physical activity and nutrition. Using community engagement, a survey with 1000 participants and interviews, focus groups, participatory workshops and community testimony days with over 400 people in total, we explored the combined impact of COVID-19 and discrimination on wellbeing and resilience across BAME FC in the UK. This policy note crystallises our findings into a framework of recommendations relating to arts and media communications, systems and structures, community and individual well-being and resilience. We promote long term actions rather than short term reactions.

In brief, we conclude that ignoring race, gender and class when tackling a pandemic can undermine not only wellbeing across Black, Asian and Minority Ethnic families and communities (BAME FC) but also their levels of trust in government. A framework to protect wellbeing and resilience in BAME FC during public health emergencies was developed by Co-POWeR to ensure that laws and guidance adopted are culturally competent.

Two viruses - COVID-19 and discrimination - are currently killing in the UK (Solanke 2020), especially within BAMEFC who are hardest hit. Survivors face ongoing damage to wellbeing and resilience, in terms of physical and mental health as well as social, cultural and economic (non-medical) consequences. Psychosocial (ADCS 2020; The Children's Society 2020)/ physical trauma of those diseased and deceased, disproportionate job-loss (Hu 2020) multigenerational housing, disrupted care chains (Rai 2016) lack of access to culture, education and exercise, poor nutrition, 'over-policing' (BigBrotherWatch 2020) hit BAMEFC severely. Local 'lockdowns' illustrate how easily BAMEFC become subject to stigmatization and discrimination through 'mis-infodemics' (IOM 2020). The impact of these viruses cause long-term poor outcomes. While systemic deficiencies have stimulated BAMEFC agency, producing solidarity under emergency, BAMEFC vulnerability remains, requiring official support. The issues are complex thus we focus on the interlinked and 'intersectional nature of forms of exclusion and disadvantage', operationalised through the idea of a 'cycle of wellbeing and resilience' (CWAR) which recognises how COVID-19 places significant stress upon BAMEFC structures and the impact of COVID-19 and discrimination on different BAMEFC cohorts across the UK, in whose lives existing health inequalities are compounded by a myriad of structural inequalities. Given the prevalence of multi-generational households, BAMEFC are likely to experience these as a complex of jostling over-lapping stressors: over-policed unemployed young adults are more likely to live with keyworkers using public transport to attend jobs in the front line, serving elders as formal/informal carers, neglecting their health thus exacerbating co-morbidities and struggling to feed children who are unable to attend school, resulting in nutritional and digital deprivation. Historical research shows race/class dimensions to national emergencies (e.g. Hurricane Katrina) but most research focuses on the COVID-19 experience of white families/communities. Co-POWeR recommendations will emerge from culturally and racially sensitive social science research on wellbeing and resilience providing context as an essential strand for the success of biomedical and policy interventions (e.g. vaccines, mass testing). We will enhance official decision-making through strengthening cultural competence in ongoing responses to COVID-19 thereby maximizing success of national strategy. Evidenced recommendations will enable official mitigation of disproportionate damage to wellbeing and resilience in BAMEFC. Empowerment is a core consortium value. Supporting UKRI goals for an inclusive research culture, we promote co-design and co-production to create a multi-disciplinary BAME research community spanning multi-cultural UK to inform policy. CO-POWeR investigates the synergistic effect on different age groups of challenges including policing, child welfare, caring and physical activity and nutrition. WP1 Emergency Powers investigates these vague powers to understand their impact on practices of wellbeing and resilience across BAMEFC. WP2 Children, Young People and their Families investigates implications for children/young people in BAMEFC who experience COVID-19 negatively due to disproportionate socio-economic and psychosocial impacts on their families and communities. WP3 Care, Caring and Carers investigates the interaction of care, caring and carers within BAMEFC to identify how to increase the wellbeing and resilience of older people, and paid and unpaid carers. WP4 Physical Activity and Nutrition investigates improving resilience and wellbeing by tackling vulnerability to underlying health conditions in BAMEFC. WP5 Empowering BAMEFC through Positive Narratives channels research from WP1-4 to coproduce fiction and non-fiction materials tackling the vulnerability of BAMEFC to 'mis infodemics'.

Unequal impact of COVID-19: BAME disproportionality Section 1 (slides 1 – 3): The Public Health England (PHE) review confirms the risk of mortality as a result of covid-19 by ethnicity. Data on access to care and emergency response has been taken from our local VCS partner feedback and indications from local data.) Data on the care workforce by ethnicity was taken from our local data and the Section 2 (Slides 4 – 7) covers demographic information on Black, Asian, and other or mixed ethnic people delivering direct care in the wider social care sector from the Skills for Care 2019 Social Care Workforce Review (note: factors that need to be considered are age, sex, underlying health conditions, ethnicity, and pregnancy.) Information on Camden’s ASC workforce was taken from GLA 2016-based Ethnic Group Projections - mid-2020). Demographic information on people receiving ASC support in Camden has been taken from our local service data. Section 3: (slides 8-15) sets out information on Adult Social Care activity during Covid-19 and looks at data relative to ethnicity including the ASC cohort of Camden’s shielded residents. (Service held data NOT official statistics including qualitative feedback from communities) Section 4: (Slides 16 – 18) shows information related to the Adult Social Care outcomes framework which has provided some information gathered before Covid-19 on the experiences of people who are BAME and in receipt of social care support in Camden.

In 2024, **** percent of Black people living in the United States were living below the poverty line, compared to *** percent of white people. That year, the overall poverty rate in the U.S. across all races and ethnicities was **** percent. Poverty in the United States The poverty threshold for a single person in the United States was measured at an annual income of ****** U.S. dollars in 2023. Among families of four, the poverty line increases to ****** U.S. dollars a year. Women and children are more likely to suffer from poverty. This is due to the fact that women are more likely than men to stay at home, to care for children. Furthermore, the gender-based wage gap impacts women's earning potential. Poverty data Despite being one of the wealthiest nations in the world, the United States has some of the highest poverty rates among OECD countries. While, the United States poverty rate has fluctuated since 1990, it has trended downwards since 2014. Similarly, the average median household income in the U.S. has mostly increased over the past decade, except for the covid-19 pandemic period. Among U.S. states, Louisiana had the highest poverty rate, which stood at some ** percent in 2024.

Unadjusted COVID-19-associated hospitalization rates, by socioeconomic strata within census tracts—COVID-NET catchment areas in 14 states, March–April 2020.