Public Health England is urgently trying to establish why non-white people appear to be disproportionally affected by the Covid-19 outbreak. Reports from intensive care wards in hospitals suggest more than a third of critically ill patients come from ethnic minority groups, despite only making up around 14% of the overall population.
Most scientists believe that black and Asian people are at greater risk of catching the disease because of social and cultural factors. Duncan Young, a professor of intensive care medicine at the University of Oxford, says: “There is a possibility of a genetic cause for the disproportionate number of ICU admissions in Asian and black patients, but as it is occurring across two different ethnic groups, this is not likely.”
Health risks
People with underlying health conditions are particularly hard hit by the virus. Some chronic problems, which affect all ethnicities, are especially common in minority groups, according to the British Medical Association.
It says there are higher rates of hypertension (high blood pressure), coronary heart disease, and diabetes among ethnic minority communities than within the general population.
The poet and writer Shamim Azad, who was born in Bangladesh, but has lived in the UK for the past 30 years, believes that diet and lifestyle factors, which could be linked to poverty and deprivation, may increase the risk for the Bangladeshi community.
“People often buy food which is high in carbohydrates, such as rice, because it’s their staple diet and also because it is cheaper than fresh produce. But eating mainly rice only three times a day is not healthy and it can make people prone to high blood pressure. In some cases, families are forced to prioritize food rather than sanitation, so we need to encourage our people to think about health issues in a more balanced way.”
Azad also notes that many British-Bangladeshi people do jobs where their physical presence is essential, such as working in small shops or on the transport network. She says this makes them more likely to catch the virus from outside than people who are working from home.
Imran Chowdhury, founder of the Centre for Policy Promotion and Prevention, is concerned that some Bangladeshis in the UK do not take enough physical exercise, which could be linked to a struggle to integrate.
“In some cases, integration is very limited and people live in areas, such as East London, where they only see other Bengalis. They don’t associate much with English people and there can also be cultural barriers caused by religion, language, and clothing,” he says.
Overcrowding
In London and other cities in the UK, many Asians live in extended families, sometimes in cramped conditions. A survey by the government in 2018 found that around 2% of white British households experience overcrowding, compared with 30% of Bangladeshi households -- the highest percentage.
Shamim Azad says: “One of the good things about our community is the way people take care of each other. You won’t find Bangladeshi people sleeping on the street or dying alone. Even unemployed people are brought under the family roof. But in such environments, social distancing is a problem, especially in poorer families, where women are in the kitchen all day and some people might even end up sleeping on the floor.”
Imran Chowdhury observes: “Often Bangladeshi people end up living in overcrowded situations because they have remained in family groups in flats which were provided by the local authorities a generation ago. Since then, their families have grown, so I wonder why people are still having five or six children. And why are they sometimes pressurizing those children to live with their parents, even when they are old enough to go out to work and start a family of their own?”
Blaming fate
Religious belief or superstition leads some Bangladeshi people to feel that their situation has been decided by fate and cannot be changed, according to Shamim Azad.
“People often cling to concepts like fate, or the will of God, when they have very few choices in life. They want something to hang onto and it affects the way people think, especially in poor countries. There’s a general lack of education. You have to spend money to learn science,” she says.
Imran Chowdhury says Bangladeshi people’s attitude towards medicine can be rather unsophisticated. “There’s a tendency to be taken in by village doctors, or quacks, and there can be a lack of trust in qualified medical professionals. If people do go to a doctor, they may feel that provided they get some medicine, everything will be fine. They don’t realize that they may need to make lifestyle changes in order to ensure better health outcomes.”
Preparing for prayer
There are reports that in parts of the UK, cultural habits may be protecting Asian Muslims from the spread of disease. Asian communities often have a relatively young average age, whereas Covid-19 tends to have a bigger impact on the older generation.
Furthermore, only about one in three Muslim women go out to work, and this could reduce the risk of the virus being transported back into their homes.
Chowdhury also believes that regular hand-washing before prayer may help. “I would say among the Muslim people, hygiene standards are generally good. If you pray regularly and follow the required ablutions, you’ll be washing your hands up to fifteen times a day, which is within the hygiene guidelines to combat coronavirus,” he notes.
Nevertheless, both Imran Chowdhury and Shamim Azad are worried about the social cost on Asian communities. The British Medical Association says the first twelve doctors to die from the virus in the UK were all from ethnic minority backgrounds.
Shamim Azad says: “Whenever there’s a war or disaster, people from ethnic minorities suffer the most, because we are on the front line. But the government should recognize how much we contribute to society. It’s especially sad when a doctor or a nurse dies. These people are so valuable to us, we’ve invested so much in them, and now we are losing them.” l
Duncan Bartlett is the Editor of the Asian Affairs magazine and has reported on Bangladesh for the BBC World Service.
