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. 2020 Jun 24:5:88.
doi: 10.12688/wellcomeopenres.15922.2. eCollection 2020.

Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data

Robert W Aldridge  1 , Dan Lewer  1   2 , Srinivasa Vittal Katikireddi  3 , Rohini Mathur  4 , Neha Pathak  1   5 , Rachel Burns  1 , Ellen B Fragaszy  1   6 , Anne M Johnson  7 , Delan Devakumar  7 , Ibrahim Abubakar  7 , Andrew Hayward  2
Affiliations

Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data

Robert W Aldridge et al. Wellcome Open Res. .

Abstract

Background: International and UK data suggest that Black, Asian and Minority Ethnic (BAME) groups are at increased risk of infection and death from COVID-19. We aimed to explore the risk of death in minority ethnic groups in England using data reported by NHS England. Methods: We used NHS data on patients with a positive COVID-19 test who died in hospitals in England published on 28th April, with deaths by ethnicity available from 1st March 2020 up to 5pm on 21 April 2020. We undertook indirect standardisation of these data (using the whole population of England as the reference) to produce ethnic specific standardised mortality ratios (SMRs) adjusted for age and geographical region. Results: The largest total number of deaths in minority ethnic groups were Indian (492 deaths) and Black Caribbean (460 deaths) groups. Adjusting for region we found a lower risk of death for White Irish (SMR 0.52; 95%CIs 0.45-0.60) and White British ethnic groups (0.88; 95%CIs 0.86-0.0.89), but increased risk of death for Black African (3.24; 95%CIs 2.90-3.62), Black Caribbean (2.21; 95%CIs 2.02-2.41), Pakistani (3.29; 95%CIs 2.96-3.64), Bangladeshi (2.41; 95%CIs 1.98-2.91) and Indian (1.70; 95%CIs 1.56-1.85) minority ethnic groups. Conclusion: Our analysis adds to the evidence that BAME people are at increased risk of death from COVID-19 even after adjusting for geographical region, but was limited by the lack of data on deaths outside of NHS settings and ethnicity denominator data being based on the 2011 census. Despite these limitations, we believe there is an urgent need to take action to reduce the risk of death for BAME groups and better understand why some ethnic groups experience greater risk. Actions that are likely to reduce these inequities include ensuring adequate income protection, reducing occupational risks, reducing barriers in accessing healthcare and providing culturally and linguistically appropriate public health communications.

Keywords: COVID-19; Mortality; SARS-CoV-2; minority ethnic groups.

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Conflict of interest statement

Competing interests: ACH serves on the UK New and Emerging Respiratory Virus Threats Advisory Group. AMJ was a Governor of Wellcome Trust from 2011-18, is Chair of the Committee for Strategic Coordination for Health of the Public Research, and is a member of The Royal Society Data Evaluation and Learning for Viral Epidemics (DELVE) multi-disciplinary group.

Figures

Figure 1.
Figure 1.. NHS England COVID-19 deaths by ethnic group, adjusted and unadjusted by NHS region (error bars show 95% confidence intervals).
See this image and copyright information in PMC

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