Sewell report contradicts evidence on race and health inequality | Letter


As public health professionals and doctors, our role is to understand and address the “causes behind the causes” of health inequalities. Structural racism has long been recognised as a significant driver of these, so it is concerning that the Sewell report denies its existence (Report, 31 March). The report is based on flawed methodologies and contradicts decades of academic research, including the government’s own reviews; the authors omit “inconvenient” evidence from Sage regarding the importance of structural racism in Covid outcomes.

The report cites employment, income and location as factors that explain racial disparities in Covid-related deaths, but ignores the fact that systemic racism underlies these differences. The data shows that once these socioeconomic factors are accounted for, black men are still twice as likely to die from the virus than white men. Racism affects outcomes throughout life: black babies in the UK have over twice the risk of being stillborn and black mothers have four times the risk of death in childbirth. At the end of life, black Caribbean, Pakistani and Bangladeshi people live up to nine years fewer in full health compared with those of white backgrounds. Contrary to the report, such differences cannot be addressed by changing individual attitudes alone.

Debating the existence of structural racism is a dangerous distraction. Since 2010, life expectancy has stalled, society has become more unequal, and we spend more years living in poor health. Tackling the structural causes of this (including, but not limited to, racism) must be a priority.
Dr Chetna Sharma, Dr Emma Sherwood, Dr Gemma Slater and Dr Ahimza Thirunavukarasu
On behalf of 253 public health specialty registrars across England



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