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Editorials

Racism and health

Paramjit Gill and Virinder Kalra
British Journal of General Practice 2020; 70 (697): 381. DOI: https://doi.org/10.3399/bjgp20X711845
Paramjit Gill
Warwick Medical School, University of Warwick, Coventry. Email:
Roles: Professor of General Practice and GP
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  • For correspondence: p.gill.1@warwick.ac.uk
Virinder Kalra
Social Sciences Building, University of Warwick, Coventry.
Roles: Professor of Sociology
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  • Racism and health
    Praneel Contractor, Tushar Hari and Dennis Hathey
    Published on: 02 September 2020
  • Published on: (2 September 2020)
    Racism and health
    • Praneel Contractor, Medical student, University of Buckingham Medical school
    • Other Contributors:
      • Tushar Hari, Medical student, University of Buckingham Medical school
      • Dennis Hathey, Medical student, University of Buckingham Medical school
    We read with interest the article by Paramjit Gill and Virinder Kalra, “Racism and health”.1 The authors discussed the impact of COVID-19 pandemic experienced by people from black, Asian and minor ethnic (BAME) backgrounds, emphasizing the issue of excess mortality within the BAME community.
     
    According to the authors, the reason for this disproportionate mortality is due to rampant structural racism. Data from the United States reveal that the mortality rate for black Americans is 2.7 times greater than the white population and this highlights the common issue shared by the two nations.2 Another study also revealed that black babies are more likely to survive when they are treated by black doctors.3 These results acknowledge the prevalence of structural racism as a cause of disproportionate mortality.
     
    Although the authors were right to say that structural racism should not be ignored, it is equally important to acknowledge the weight of epidemiological and physiological risk factors that contribute to their increased mortality. For instance, certain groups of the BAME community have 6 times the risk of diabetes compared to other groups.4 Diabetes has been well-established as a comorbidity that worsens complications from the SARS-CoV-2 viral infection and is a factor among others that plays a role in the disproportionate BAME morta...
    Show More
    We read with interest the article by Paramjit Gill and Virinder Kalra, “Racism and health”.1 The authors discussed the impact of COVID-19 pandemic experienced by people from black, Asian and minor ethnic (BAME) backgrounds, emphasizing the issue of excess mortality within the BAME community.
     
    According to the authors, the reason for this disproportionate mortality is due to rampant structural racism. Data from the United States reveal that the mortality rate for black Americans is 2.7 times greater than the white population and this highlights the common issue shared by the two nations.2 Another study also revealed that black babies are more likely to survive when they are treated by black doctors.3 These results acknowledge the prevalence of structural racism as a cause of disproportionate mortality.
     
    Although the authors were right to say that structural racism should not be ignored, it is equally important to acknowledge the weight of epidemiological and physiological risk factors that contribute to their increased mortality. For instance, certain groups of the BAME community have 6 times the risk of diabetes compared to other groups.4 Diabetes has been well-established as a comorbidity that worsens complications from the SARS-CoV-2 viral infection and is a factor among others that plays a role in the disproportionate BAME mortality rate.
     
    The paper also addresses potential strategies to address these inequalities, such as the need for strong and diverse organisational leadership, as BAME staff are “overlooked and under-represented” in these roles. This is supported by Southernhealth which states that “BAME colleagues are not equally represented at more senior levels”.5 Another intervention mentioned was to train staff on recognizing and reducing racism. We feel that this needs to be supplemented by group sessions for the BAME community to reflect on their personal experiences and share it with others to raise awareness. The NHS is one of the most diverse organisations in the world and so increasing awareness amongst employees will prove beneficial to the BAME community. We as a society must acknowledge the existence of racism within the healthcare sector and continue to put in efforts to minimize this disparity.
     
    References
    1. Gill P, Kalra V. Racism and health. Br J Gen Pract 2020: 70(697):381-381.
    2. Razaq A, Harrison D, Karunanithi S et al. BAME COVID-19 DEATHS - What do we know? Rapid Data & Evidence Review.  CEBM. 2020 [cited 31 August 2020]. Available from: www.cebm.net/covid-19/bame-covid-19-deaths-what-do-we-know-rapid-data-evidence-review.
    3. Lakhani N. Black babies more likely to survive when cared for by black doctors – US study [Internet]. the Guardian. 2020 [cited 31 August 2020]. Available from: www.theguardian.com/world/2020/aug/17/black-babies-survival-black-doctors-study.
    4. Member briefing: Public Health England review on disparities in the risk and outcomes of COVID-19. Nhsconfed.org. 2020 [cited 31 August 2020]. Available from: www.nhsconfed.org/resources/2020/06/phe-review-disparities-in-risk-and-outcomes-of-covid19. 
    5. Draycott P. Tackling all forms of racism and inequality following the death of George Floyd.   Southernhealth.nhs.uk. 2020 [cited 31 August 2020]. Available from: www.southernhealth.nhs.uk/about/news/tackling-all-forms-of-racism-and-inequality.
     
    Show Less
    Competing Interests: None declared.
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British Journal of General Practice: 70 (697)
British Journal of General Practice
Vol. 70, Issue 697
August 2020
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Racism and health
Paramjit Gill, Virinder Kalra
British Journal of General Practice 2020; 70 (697): 381. DOI: 10.3399/bjgp20X711845

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Racism and health
Paramjit Gill, Virinder Kalra
British Journal of General Practice 2020; 70 (697): 381. DOI: 10.3399/bjgp20X711845
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