David Goodhart is Head of Demography at Policy Exchange and author of The Road to Somewhere: The New Tribes Shaping British Politics.
The crisis brings us together, the crisis pulls us apart. The familiar distinctions of class and status and region and race have weakened, temporarily, as we all face the same extraordinary new conditions of life ushered in by Covid-19.
You might even say that it is a One Nation conservative crisis. It has reinforced the authority of the nation state and, in the furlough scheme, underlined the centrality of national social contracts. Borders, rootedness, the local, family life, have all loomed larger and helter-skelter globalism has been taken down a peg or two.
But it is also a crisis whose epicentre has been the public care economy, and the powerful ethos of the public sector professional has become even more assertive in recent weeks. The ethos is risk averse, moderately egalitarian, sees more public spending as the answer to almost every problem and blames society (and usually Conservatives) for all differences in life chances.
In the early days and weeks of the crisis, the conservative impulse seemed to dominate but, as the weeks have passed, and as the differential impact of the Coronavirus has become clearer, the public sector ethos has pushed back. We are now being invited to extend our sympathies not so much to people in general, and the old in particular, which is a unifying force, but to sub-sets of the population who may be suffering disproportionately, above all the key workers in the health front-line and elsewhere, poorer people and ethnic minorities.
This is not in itself divisive if some groups really are suffering disproportionately. And Covid does inevitably hold up a mirror to some of the uglier aspects of our society: the failure to invest for the future, the income and status inequality, the poor health and diets of many people on lower incomes.
But the fact that the virus is not only ageist, fattist and sexist but also, apparently, racist, has provoked a fresh wave of complaint about structural racism from anti-racism activists. Should this be taken seriously?
There are two separate questions to consider here.
First, is it really the case that ethnic minority citizens, or at least some of them, do have an elevated risk of catching and then dying from the virus?
Second, if they do, how should the causal weight be allocated between three big factors?
Genetic/medical: the fact that some minorities are significantly more likely to suffer from diabetes, hypertension and heart disease, and maybe vitamin D deficiency too, all of which are thought to increase the risk of death from the virus.
Cultural factors: the fact that minorities are more likely to live in multi-generational households and take part in collective religious rituals, at least prior to lockdown, which exposes them to a higher risk of catching the virus.
Social-demographic factors: the fact that most minorities live in high density urban areas (London in particular), that some groups are more likely to be in people facing jobs whether as a hospital doctor or a bus driver, and some groups are relatively poor and live in crowded accommodation.
So, first, what do we know about the elevated risk for minorities? The issue began to be raised at the end of March/early April as a result of the first wave of deaths among doctors, almost all of whom were non-white.
The Intensive Care National Audit and Research Centre produced a survey that found one third of patients in intensive care were from non-white ethnic groups, compared with the UK population share of around 13 per cent.
The Institute for Fiscal Studies produced a report on May 1st finding that, after adjusting for various things, the death rate for people of black African descent was 3.5 times higher than for white British people, 1.7 times higher for black Caribbeans and 2.7 times higher for Pakistanis.
The Office for National Statistics chipped in on May 7th finding that the risk of death for black people was 1.9 times higher than for whites, and for Bangladeshi and Pakistani males was 1.8 times higher. (British Chinese women mysteriously have a lower death rate than the white British despite a higher likelihood of being more exposed to people who had been close to the epicentre of the virus.)
There clearly is an issue here, as the experience of the US also underlines. But to accurately measure ethnic minority risk, and how disproportionate it might be, is very hard. The IFS report was produced before the large number of deaths in care homes had been recorded, which are around 97 per cent white.
The raw numbers also have to be adjusted for many things, some of which pull in opposite directions. Minority populations tend to be younger which should mean lower numbers, but they are also much more likely to live in London, Birmingham and other big urban centres that have seen the majority of deaths (60 per cent of the black population of England and Wales live in London and 50 per cent of the Bangladeshi population, compared with just 8 per cent of the white British majority).
There is also a more basic fuzziness. Ethnicity is not recorded on death certificates, so the ONS says it uses the self-reported ethnicity of the deceased, but it is not clear how it gets hold of this. Although the official forms we fill in are always asking about ethnicity, the relevant authorities often do not have the data about minorities that they need because the Information Commissioner has ruled that ethnicity (unlike gender) is sensitive information, and therefore can only be used with permission of the individuals concerned, which is a bit tricky if they are dead.
We also do not know what proportion of the UK population is non-white: it was 13 per cent at the 2011 census but could now be 15 or 16 per cent.
Some elevated risk for some minorities seems almost certain, even if we cannot be at all certain about the extent of it. But what about the likely causes? The truth is that nobody can yet confidently allocate blame across those three factors of genetics, cultural and social factors.
That has not stopped many people and organisations—the TUC, the Runnymede Trust, the Guardian—confidently asserting that genetics and culture have little or no explanatory role and that poverty and “structural racism” is the main culprit. (Doreen Lawrence, who has just been appointed to lead the Labour Party inquiry into the subject, is unlikely to disagree.)
Poverty almost certainly does have some role to play. The ONS reports that males in low skill, elementary occupations are twice as likely to die as the wider working age population, but it is not clear whether that is because of greater likelihood of exposure because of the nature of their work, or because of underlying health vulnerabilities.
Black Africans (33 per cent) and black Caribbeans (27 per cent) are most likely to work in either the health service or a key worker job, with Indians (22 per cent) and the white British (21 per cent) coming next, some way ahead of Pakistanis, Bangladeshis and other whites (mainly east Europeans). But Pakistanis and Bangladeshis are far more likely to live in overcrowded accommodation (making it harder to isolate), 18 per cent and 30 per cent respectively in London, compared to just two per cent of white British households in London.
There is an extensive literature on the link between poor health and low income/status. Michael Marmot has written about the so-called social gradient, the idea that, as socio-economic status rises, so do health prospects and life expectancy.
His studies of Whitehall civil servants found a steadily rising gradient in the risk of heart disease as you go down the hierarchy. Men at the bottom were four times more likely to die, and less than a third of the gradient disappeared when factors such as smoking and cholesterol were factored out. This finding, which was also found to hold outside Whitehall, is based on the idea that low status in a hierarchy produces constant stress and anxiety—especially for men, who tend to derive more status from work than women—and this produces higher levels of cortisol, which damages the immune system.
The social gradient is colour blind but, if a high proportion of people in the lowest status jobs are non-white, then it will impact on them disproportionately. But for the structural racism claim to hold it would have to be shown that white discrimination is responsible for non-white people being held in those low status jobs.
Thirty or forty years ago that might have been the case. But today, the assumption that all minorities have a similar experience at the bottom of the pile (reinforced by the BAME acronym) is deeply anachronistic. Chinese, Indian and mixed race ethnic groups all earn on average more than the white British average, while the different black groups earn between 5 and 10 per cent below that average. The outliers at the bottom are Pakistanis (16.9 per cent below average) and Bangladeshis (20.2 per cent).
And the lagging ethnic groups are likely to catch up or overtake in the near future as all big minorities record higher university attendance than the white British and better performances, sometimes hugely better performances, in the secondary school Progress 8 scores (measuring pupil progress between 11 and 16).
Moreover, the highest social class ‘higher managerial and professional jobs’ (in the eight category social class schema for the UK) already has a slightly higher representation of ethnic minorities than white British. The idea of ethnic minority Brits being second class citizens who are only now being recognised for their work and sacrifice in the front line, the assumption behind the famous You Clap For Us Now video, is simply not consistent with this data on the relative openness of British society and visibility of minorities at all levels.
Low income/status, and its associated conditions, will surely play some role in the elevated risk to some minority groups as will pre-existing health vulnerabilities. According to Shikta Das, an epidemiologist at University College London, the top two local authorities for Covid deaths, Brent and Harrow, which are also heavily south Asian, are both in the top three local authorities for diabetes in the whole of the UK.
Obesity is likely to be a contributing factor too—doubling the Covid death rate for those in their fifties, according to new research from Edinburgh and Liverpool universities—and a serious curse in this country, especially at the bottom end of the income scale. And 73 per cent of England’s adult black population are overweight or obese, 10 percentage points more than the white British population.
All of these factors will be weighed up in the review that the Government first proposed in the middle of April and then gave more details about early in May, announcing that it would be led by the British Caribbean Kevin Fenton, who is Director of Health and Wellbeing at Public Health England.
He is due to report at the end of the month, and should probably apply the precautionary principle and recommend that some minority groups join the list of those who need to take special care. Some NHS trusts have already been taking such steps.
The response of the Government on this issue has, so far, been pretty sure-footed which may have something to do with the fact that both the cabinet and Number Ten itself has many more black and Asian faces than in the recent past, which means that there is less nervousness around race issues and therefore less deferring to the anti-racist activist world with its “race is purely a social construct” certainties.
Indeed, one of the ironies of the crisis, and the focus on minority risk, is that it has underlined just how much progress this country has made in recent years. Trevor Phillips, the former equalities commissioner, now owner of a data company, wrote a paper for Imperial College on the issue in late March and was in touch with Munira Mirza, Head of the Number Ten policy unit, before the issue surfaced in the media.
Our TV screens are graced with the BBC’s Faisal Islam interviewing Rishi Sunak almost every week. The crisis has revealed that 40 per cent of NHS consultants are non-white, and most are minority Brits.
Twenty or thirty years ago the argument between supporters of the structural racism claim on the one hand and representatives of government on the other hand would have had non-whites lined up on one side and whites on the other. Now the argument counts prominent minority voices in both camps.
On the structural racism side we have Sadiq Khan, and (among many others) three members of the House of Lords, Doreen Lawrence, Sayeeda Warsi and Simon Woolley, the latter two insisting in a Guardian article that we should “not overplay cultural and genetic factors”.
On the other side we have Munira Mirza, Tony Sewell, Trevor Phillips and others, saying that we should not jump to conclusions and be prepared to follow wherever the evidence takes us. This surely represents progress.