12 April 2022
Author: Vasileios Antonopoulos(Cabinet Office, Race Disparities Unit)
Date: October 2020
A research synthesis using secure data has helped highlight the disproportionate impact of coronavirus (Covid-19) on ethnic minorities and influenced a series of government interventions. Bringing together analyst experts and a variety of new and existing data sources, the Cabinet Office’s Race Disparity Unit commissioned further research and analytical work to help clarify the scale and drivers of inequality between ethnic groups and identify evidence gaps.
At the request of the Prime Minister and the Secretary of State for Health and Social Care, the Cabinet Office’s Race Disparity Unit led this cross-government project to provide robust evidence to policymakers. This included analysis of data stored securely in the Office for National Statistics (ONS) Secure Research Service (SRS). Delivered in four quarterly reports, this research project has delivered meaningful analysis on the links between race and Covid-19 health inequalities.
This project drew on several sources of data and supported other ongoing research investigations, including openSAFELY and NHS Digital projects.
This project also used the Public Health Research Database (PHRD) – a newly linked data asset containing 2011 Census, Mortality, Hospital Episodes Statistics and GP Extraction Service (GPES) Data for Pandemic Planning and Research Data. Created in response to ongoing reporting challenges during the pandemic, the PHRD is a person level health-based research dataset for England and Wales, which includes a large proportion of the 2011 population. Crucially, the PHRD has enabled analysis of Covid-19 deaths by a range of previously unlinked sociodemographic factors, such as ethnicity, religion and disability.
Researchers at the Race Disparity Unit conducted a synthesis analysis by using a range of information from different datasets and surveys to provide robust evidence to policymakers. This involved identifying data gaps, and commissioning analysis by Public Health England on the relationship between ethnicity, pre-existing health conditions and Covid-19 infection and mortality. Researchers also worked closely with ONS analysts and supported research by helping academics access more data on infections and the socio-economic impacts of Covid-19.
The synthesis was published across four separate reports between October 2020 to December 2021. The analysis highlighted that, after adjusting for age, people from Black African, Black Caribbean, Bangladeshi and Pakistani ethnic backgrounds were at greater risk of death from Covid-19 during the first wave of infections. For the second wave, this decreased for Black African and Caribbean groups but increased for Bangladeshi and Pakistani ethnic groups, compared with the White British ethnic group.
The analysis also provided evidence about the risk factors associated with Covid-19 infection and severe outcomes. These included occupation, living in larger and/or multigenerational households with school-aged children and living in areas of poor air quality and high levels of deprivation.
Analysis of data about vaccination rates found that the proportion of individuals getting vaccinated over time increased for all ethnic groups, with the largest increase in uptake among Pakistani and Black African groups between April and October 2021.
All recommendations from the reports were accepted by the government and findings continue to influence the response to the pandemic, including most recently the initial and booster vaccine campaigns.
Since the first report was published in October 2020, the UK Government has released £23.75 million in funding under the Community Champions scheme. This has enabled local authorities to work with grassroots advocates to tailor public health communications and use trusted local voices to counter misinformation and encourage vaccine uptake. Faith leaders also helped promote vaccine uptake and vaccination centres were set up in places of worship.
The government suggested the recording of ethnicity as part of the death certification process should become mandatory, as this is the only way of establishing a complete picture of the impact of the virus on ethnic minorities. This would involve making ethnicity a mandatory question for healthcare professionals to ask of patients, and transferring that ethnicity data to a new, digitised Medical Certificate Cause of Death which can then inform ONS mortality statistics.
Publications and reports
- GOV.UK report, October 2020: Quarterly report on progress to address COVID-19 health inequalities
- GOV.UK report, February 2021: Second quarterly report on progress to address COVID-19 health inequalities
- GOV.UK report, May 2021: Third quarterly report on progress to address COVID-19 health inequalities
- GOV.UK report, December 2021: Final report on progress to address COVID-19 health inequalities
- International Association for Research in Income and Wealth conference paper, August 2021: Why do People From Ethnic Minorities Have a Higher Mortality Risk From COVID-19 in England?
Blogs, news posts, and videos
- GOV.UK news, October 2021: Race Disparity Unit Commended for Pandemic Research
- GOV.UK news, December 2021: Minister calls for at risk groups to get booster jabs
- Channel 4 article, February 2021: Latest evidence on the relationship between ethnicity and covid-19
- Guardian news article, October 2020: England to require ethnicity on death certificates to help tackle Covid-19
- GOV.UK news article, May 2021: Government report shows improving vaccine confidence among ethnic minority groups
- BMJ news article, February 2021: Covid-19: NHS England pledges extra funding to local areas to reduce vaccine inequalities
- Letter, 2021: Minister for Equalities' letter to the Prime Minister on the final COVID-19 disparities report
- BBC News article, October 2020: Ethnic minority Covid risk 'not explained by racism'
Presentations and awards
- Programme winner, ONS Research Excellence Awards 2021
- International Association for Research in Income and Wealth conference presentation, August 2021
About the ONS Secure Research Service
The ONS Secure Research Service (SRS) is an accredited trusted research environment, using the Five Safes Framework to provide secure access to de-identified, unpublished data. If you would like to discuss writing a future case study with us, please get in touch: firstname.lastname@example.org