London’s public health chief Professor Kevin Fenton has called for landmark reforms to support BAME communities during the Covid-19 pandemic.

One year after coronavirus first arrived in the UK and the World Health Organisation warned of a “public health emergency of international concern”, and Covid-19 has proved to be the greatest public health challenge in nearly a century.

As the fatality rates continue to rise, however, a growing mental health crisis is also starting to emerge. In December, leading psychiatrist Dr Adrian James declared the coronavirus crisis the greatest threat to mental health since the second world war, with figures showing that as many as 10 million people are thought to need new or additional mental health support as a direct result of the crisis.

The pandemic has also shone a light on structural racism in healthcare, which has disproportionately affected ethnic minority groups over the past year. According to a recent study from Mind, existing inequalities in housing, employment, finances and other issues have had a greater impact on the mental health of people from BAME groups than white people during the pandemic, with the charity raising concerns that some communities will experience long-term repercussions as emergency government measures come to an end.

Now, London’s public health chief has confirmed there is “no doubt” that the pandemic has has disproportionately impacted and, in some cases, worsened health inequalities among BAME groups in the UK.

Speaking as the Association of Directors of Public Health London published a blueprint on supporting BAME communities in London during and beyond the Covid-19 pandemic, Professor Kevin Fenton highlighted how structural factors such as housing and employment had compounded the negative effect of the virus upon people from ethnic minority groups.

“Geography, deprivation, housing, employment, occupational exposure, mental and physical health are all factors skewed to negatively impact the health of BAME communities,” he said.

“The impact of these longstanding social and economic inequalities and the increased clinical risk of Covid-19 complications and death, paired with structural racism, discrimination, stigma, fear and mistrust make for an incredibly complex problem to solve.”

As one of the worst-affected areas in England by Covid-19, and the most diverse, the ADPHL report highlighted grave health inequalities among BAME Londoners. According to Covid data, people from Black ethnic groups were most likely to be diagnosed with Covid-19, with death rates highest among Black and Asian groups. People of Bangladeshi ethnicity were also found to have around twice the risk of death than people of white British ethnicity, while people of Chinese, Indian, Pakistani, other Asian, Caribbean, and other Black ethnicity had between 10 and 50% higher risk of death when compared with white British people.

The report also proposed reforms based on building trust and cohesion, co-producing services with minority ethnic communities, improving ethnicity data collection and research, embedding public health work in social and economic policy, and diversifying the workforce and encouraging systems leadership.

“Developing a deeper understanding of possible links between racism and health and addressing it is central to eliminating racialised health disparities,” the public health chief said. “Covid-19 has shone a light on health disparities, and now is the time for us to recognise the connection between structural racism and racialised disparities in health — and make change happen.”

With a client base of 70% women from Black, Asian, Minority Ethnic and refugee backgrounds, The Maya Centre welcomes the report from the Association of Directors of Public Health London, and supports the drive for further research and policy to reduce racialised health inequalities.

“The ADPHL report is a vital step forward in addressing racism in public health,” says Emma Brech, Chief Executive Officer of The Maya Centre. “However, we also need much stronger insight into the impact upon minoritised women who have been disproportionately affected by the Covid-19 pandemic. We know that low-income migrant and refugee women in particular may be trapped at home without their usual support networks, fearful about seeking help and therefore at significantly higher risk of abuse and exploitation. We also know these same women will have all sorts of resilience and resource which are of huge benefit to other women struggling with Covid-19 – so we welcome the emphasis on community outreach,  co-production and empowerment as a means of addressing health – and social – inequalities.”

Photograph: Niklas Halle’n/AFP/Getty Images.