Racism harms health and wellbeing and drives inequalities in London

Structural racism affects the health and wellbeing of ethnic minority communities in London and contributes to avoidable and unfair inequalities between ethnic groups, according to a new report published by the UCL Institute for Health Equity ( IHE).

Structural Racism, ethnicity and Health Inequalities in London examines published and unpublished reports, documents and research, as well as data on health and social determinants. The review was informed by an advisory committee and through consultation and collaboration with community groups.

The study findings highlight how people repeatedly exposed to racism during their daily lives or when using essential services have poorer physical and mental health.

The report also recognizes the many new and notable efforts to reduce structural and institutional racism in London, but reveals that the impacts of racism remain starkly evident, including through ethnic inequalities in poverty, housing, employment, remuneration and career development.

IHE researchers also highlighted known and marked inequalities between ethnic groups in maternal and child health and mental illness, as well as experiences with the criminal justice system and health services generally.

Following these findings, the IHE calls for greater accountability, particularly from leaders, institutions and employers, to prevent the unchecked continuation of racism and to improve the lives of those affected by it. are victims. The review’s approach and recommendations are also relevant to other locations in the UK and around the world.

Professor Sir Michael Marmot, director of the UCL Health Equity Institute and co-chair of the review’s advisory committee, said: “Racism is a scar on society. Social justice demands that we take the necessary steps to address them. It is a profound injustice if the conditions for good health are unequally distributed, depending on ethnicity. This is particularly true when this unequal distribution results from the harms of racism. Inequalities in the social determinants of health create health problems for the future.

The main findings of the review showed that:

• Nearly 70% of Bangladeshi and Pakistani children and 52% of black children grow up in relative poverty (after housing costs) in London, compared to 26% of children from white households. One of the main factors of health and well-being is income: children who grow up in poverty are less likely to live in decent housing, be able to eat nutritious food or have places to play or sleep. As a result, their educational attainment and lifelong prospects (such as income and employment) are negatively affected.
• Progress in education does not translate into good employment or income due to racism in the workplace: while many young Londoners from minority ethnic groups achieve high levels of education (result of their own efforts and progress by London’s schools and staff), this does not translate into good employment or income, manifesting itself in extremely high poverty rates among many ethnic minority groups: 59% of Bangladeshis , 53% of Pakistanis and 42% of black households in London live in poverty after paying for their housing (compared to 20% of white households). households).
• Ethnic inequalities are particularly visible in employment opportunities and pay levels: the unemployment rate among young people identified as black (aged 16 to 24) is more than double that of those who identify as white . Meanwhile, white Gypsies and Travelers have the highest unemployment rate of any ethnic minority group. Additionally, in London, 40% of ethnic minority workers have reported racism at work in the past five years, and nationally a third of employers do not have equality, diversity and of inclusion (EDI).

Professor Habib Naqvi, co-chair of the advisory board and chief executive of the NHS Race and Health Observatory, said: “We know that racism is a challenge that transcends borders and borders, and although this report is aimed at London, we let’s hope he does. have a wider impact across the UK. Racism has deep historical roots; it is omnipresent and embedded in the structure of our society. We find ourselves at a relevant moment in history. and eliminate the scourge of racism from our society and improve health for all.

Because health is largely shaped outside of the health care system, recommendations that improve living and working conditions, as well as the distribution of power, money, and resources that shape daily life (the social determinants of health), will therefore have a greater effect on promoting health equity. than focusing solely on health care services.

Sir Michael Marmot added: “Focusing on disease and healthcare services fails to address three impacts of racism on health. First, how racism directly harms health and well-being.

“Second, the reasons why certain ethnic groups are more likely to be in poverty, experience poor housing, suffer in the education and criminal justice systems, and experience low wages, racism and poor prospects job – all these reasons are harmful to health.

“Third, it does not address the racism that leads to worse experiences of health care and other services and, therefore, worse outcomes.

“Then there are the impacts of other dimensions of inequality. Being poor, disabled and belonging to an ethnic minority group is far worse for health than being alone among them.”

Accordingly, the review includes the following recommendations:

• Ensure all employers pay the London Living Wage and eliminate pay inequality by ethnicity.
• The Greater London Authority must develop and lead an anti-racism approach for all employers in London.
• Strengthen the application of legal requirements for non-discriminatory recruitment and help people access work and training by developing programs co-designed with affected groups.
• Reports of racism should be investigated by independent bodies, not employers.

Dr Cordelle Ofori, advisory board member and director of public health for Manchester City Council, explained that the review is particularly important for cities like Manchester, where communities affected by racial inequality make up more than 50% of the population.

Dr Ofori said: “Now is the time to build trust with communities, ensure services are anti-racist and culturally competent, and dismantle the policies and processes that ensure a significant group of the UK population continues to be underserved. why Manchester’s five-year action plan, Making Manchester Fairer, is so important as it aims to tackle health inequalities and other forms of inequity that impact people’s lives and communities in which they live.

The study’s recommendations build on numerous ongoing and developing programs that have been put in place to tackle racism in London. They include strong anti-racist leadership from London City Hall, the Greater London Authority, London boroughs, health and care organisations, public health, some employers, service providers and community organizations and leaders.

The report also sets out how legal and regulatory mechanisms can strengthen approaches to combating racism. The new government has pledged to do more. For example, the 2024 King’s Speech proposed new legislation covering the right to equal pay and ethnic pay gap reporting requirements, in addition to reform of mental health services.

Limitations of the study

There is a lack of data and evidence on ethnicity in many important areas, which limits the ability to account for ethnic health inequalities and social determinants of health and, more broadly, has hampered research. efforts to recognize and combat racism. The review therefore makes recommendations for further research and information and to ensure that communities with lived experience are at the heart of decision-making and policy development and implementation.