Notes on: Commission on Race and Ethnic
Disparities: The Report (The Sewell Report)
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/974507/20210331_-_CRED_Report_-_FINAL_-_Web_Accessible.pdf
Dave Harris
[This is a massive report and I'm going to just
make notes about the main conclusions and whatever
points strike me from the data as I go through.
There are some characteristic recurring arguments
to note:
1. The usual 'binary' between 'ethnic minorities
or BAME' and 'white' is too simple and conceals
important variations within each group,eg between
black African and black Caribbean,or Indian groups
on the one hand, and white Roma or white working
class boys on the other.
2. When we consider more detailed or 'granular'
comparisons, it is much harder to sustain simpler
explanations, especially of a persistent and
constant racism affecting inequality in the UK.
For example. black Africans do better than black
Caribbeans in the education system, but white
working class boys do worse, while Chinese
students do better than any of them -- so what
sort of racism is that?
3. It is easy to get the wrong idea about racism
in the UK if we rely on
subjective/personal/individual data alone -- one
example is the alleged rise in racialised hate
crime in the UK seen in incidents recorded by the
police but not in the results of the National
Crime Survey (which they think is more reliable).
However, they also cite, uncritically, police (?)
records of knife crime increases (c 146 -- see
below)
4. They do play with absolute numbers and
percentages to make their case and you have to be
careful -- for example the number of cases in
perinatal mortality is indeed very low, but the
relative differences between white and ethnic
minority mothers is still very noticeable (which
they do not conceal, to be fair). They say
that in 2019, '80% of those proceeded
against for religiously or racially motivated
hate crimes were White, 9% Black and 7% Asian',
(142) but do not give the figures as proportions
of the population. They do not consider any of the
subjective material on the experience of mothers
from ethnic minorities, although it is that that
makes the headlines (eg Birthrights Report)--
it could be addressed through their general
scepticism about subjective data but it would be
good to see a specific case.
5. They do vary in their critical use of
quantitative data and are particularly uncritical
about surveys on attitudes or opinion polls
generally. They do not comment on some of the
reports,including one that exonerates the police,
for example.
6. They do acknowledge the weight of racism in the
section on health, but rather indirectly -- it
produces stress and mental instability, they are
prepared to concede, and this might be responsible
for the higher incidence of mental illness among
black groups (223). That data in turn is then
linked to work on the unsettling experiences
affecting migrants of all ethnic groups -- but
black Caribbean groups in particular are not
recent migrants. Further, the whole discussion of
mental illness follows a section on
disproportionate use of restraining orders. They
mention racism as a possible factor in involvement
in gangs together with negative stereotyping as a
factor affecting juries --but these are very brief
mentions
7. They do have a clear agenda in openly opposing
BLM activism, and critics have pointed to Sewell's
past support for Academies as well (which come out
well)
They did not investigate anti-Muslim prejudice and
anti-Semitism specifically. They saw that historic
experience of racism was still important and
'there was a reluctance to acknowledge that the UK
had become open and fairer… The data also revealed
many instances of success among minority
communities. These often been ignored or had been
seen to be of little interest (to the media)' (6).
They were often 'led upstream to family breakdown
as one of the main reasons for poor outcomes.
Family is also the foundation stone of success for
many ethnic minorities' (7). They wanted 'to
remove obstacles for everyone, rather than
specific groups'.
'The spirit of BLM was the original trigger for
our report', but they want to describe a new
period, a year of participation, a fundamental
shift where the U.K.has become a more open society
even though it may 'be only half open to some,
including the white working class'. For full
participation, communities must grasp those
opportunities however. Some groups are more
optimistic than others, such as the new African
communities.
'As their Caribbean peers sit in the same
classrooms, it is difficult to blame racism in
education for the latter's underachievement'. This
is a comparison referred to several times and is
important to their argument
They note that 'young black men are 24 times more
likely to die of homicide than their white
counterparts', that more black and Asian people
need to participate in health trials to get better
data, that there is no strong case for
decolonising the curriculum or bringing down
statues and instead 'we want all children to
reclaim their British heritage' (8), for example
to see how Britishness influences the
Commonwealth… And how the Commonwealth… influences
what we now know as modern Britain, including…
well-known British words… [that] are Indian in
origin… [and] the Caribbean experience which
speaks to the slave. Not only being about profit
and suffering but how culturally African people
transformed themselves'.
They want to end the term BAME because the group
is 'held together by no more than what it is not'.
They are not impressed by unconscious bias
training and are more impressed by 'conscious
attempts to foster talent from a wide range of
backgrounds'.
They no longer think 'the system is deliberately
rigged against ethnic minorities' although there
are impediments and disparities which are varied
although 'few of them are to do with racism'. That
term is just a catchall explanation that needs to
be explicitly examined.
Instead 'geography, family influence,
socio-economic background, culture and religion
have more significant impact on life chances than
the existence of racism. That said, we take the
reality of racism seriously and we do not deny
that it is a real force in the UK'. This is
another key point referred to frequently.
We should only apply institutional racism as a
term 'when deep-seated racism can be proven on a
systemic level, and not be used as a general
catchall phrase for any micro at in, witting or
unwitting'.
This is a roadmap for racial fairness. There are
obstacles and practical ways to overcome them,
'but that becomes much harder if people from
ethnic minority backgrounds absorb a fatalistic
narrative'. Their recommendations should give 'a
further burst of momentum to the story of our
country's progress to a successful multicultural
community'
Introduction
The UK is not yet a post-racial society and
prejudice and discrimination still exists, as does
outright racism, but the UK is still relatively
open and has come a long way, more than other
European countries, even though there are still
'some "snowy white peaks" at the very top of the
private and public sectors' (9). There is an
onward march of minorities into positions of power
and responsibility though.
The roots of advantage and disadvantage are
complex and 'as much to do with social class,
family culture and geography as ethnicity', as
confirmed by data over five years collected by the
Race Disparity Unit and a number of other reviews,
including Lammy, focusing on education,
employment, crime and health. They look at
ethnicity, socio-economic background, geography,
'culture and degree of integration'(10), and found
that 'most of the disparities we examined, which
some attribute to racial discrimination, often do
not have their origins in racism'.
However, 'the concept of racism has become much
more fluid, extending from overt hostility and
exclusion to unconscious bias in
microaggressions'. Ethnic minorities now have
higher expectations and will not tolerate
behaviour that would have been endured or shrugged
off before, but there is also an increasingly
strident form of antiracism that tries to explain
all minority disadvantage as white discrimination.
However things like different experiences of
family life and structure can explain many
disparities. Early experiences, family structures,
although we must not stigmatise single mothers —
but the impact of family breakdown does have an
effect on the life chances of children.
When it comes to health, 'ethnic minorities do
better overall than the white population and
actually have better outcomes for many of the 25
leading causes of death' (11).
Recommendations include: 'build trust, promote
fairness, create agency, achieve inclusivity'
building trust includes challenging racist and
discriminatory actions, increasing the care
quality commission's inspection processes, using
artificial intelligence to strengthen the equality
act, building new partnership between police and
communities, training police officers with better
practical skills. Promoting fairness means trying
to understand the factors that drive success of
high performing groups in education, looking at
what advances fairness in the workplace, checking
ethnic pay disparities and pay gaps especially in
the NHS, trying to establish an office for health
disparities, preventing harm and reducing crime,
building social and cultural capital through
physical and cultural activities, getting the
police to use body worn video to 'increase
legitimacy and accountability of stop and search'
(13). Agency is to be increased by helping pupils
make better choices about their future potential,
when they apply to HEI, opening up
apprenticeships, encouraging innovation for
would-be entrepreneurs, improving safety and
support for children at risk, especially from
criminal exploitation, and supporting families.
Inclusivity is to be achieved by teaching an
inclusive curriculum, 'to tell the multiple nuance
stories of the contributions made by different
groups' '[with 'high quality teaching
resources produced by independent experts'],
introducing a local residency requirement for
recruitment to the police, matching candidates for
the police with the needs of the communities they
serve in, using data to improve information
gathering and preventing misuse, and
dis-aggregating the term BAME.
These are spelled out later and include things
like considering online abuse, involving the
College of Policing to develop standards for
community safeguarding, and enabling stop and
search data to be scrutinised, developing more
monitoring for recruitment, developing the
multiagency action to safeguard young people,
gathering evidence based practice from
universities and employers.
The Report goes on to argue that 'the idea that
all ethnic minority people suffer a common fate
and a shared disadvantage is an anachronism' (27)
although this is still a perception, as in the
nationwide BLM marches, and the persistence of
intergenerational mistrust. They found instead
'that the big challenge of our age is not overt
racial prejudice, it is building on and advancing
the progress won by the struggles of the past 50
years… We cannot accept the accusatory tone of
much of the current rhetoric on race, and the
pessimism about what has been and what more can be
achieved'.
There are cases where ethnic minority communities
have been left down, like Grenfell or Windrush, or
disproportionate suffering in covid, but they can
be rectified. There are also examples of what an
open Britain stands for, such as the 2012
Olympics. And there is evidence of some progress,
for example that 'the ethnicity pay gap [based on
median hourly earnings of all ethnic minority
groups and the white group] is down to just 2.3%
and the white Irish, Chinese and Indian ethnic
groups are on average earning notably more than
the white British average' (28). Very much depends
where you are in the UK. 'One advantage that
ethnic minorities have is that they are
disproportionately based in London — around 40% of
the U.K.'s ethnic minority population live in
London (compared with just 9% of the white British
population)'.
'The numerically largest disadvantage group is low
income white boys, especially those from former
industrial and coastal towns, who are failing at
secondary school and are the people least likely
to go to university. Unlike many other reports on
race and ethnicity we have included the white
group in our deliberations. For a range of
outcomes white working class children trail behind
their peers in almost all ethnic minority groups,
although the extent of these disparities vary by
area' (29).
'Overt and outright racism persists in the UK' but
it looms larger in our minds because it is visible
and the rise of social media means it can go
viral. Overall 'making anonymous abuse harder
online is a complex issue but should be a public
policy priority'. Social media can amplify racist
views. 'While 13% of white people say they have
been subject to racist or prejudiced insults on
social media, the figure rises to 19% for people
from the Pakistani ethnic group and 22% for black
people'. It is frequently reported. This tends to
'point our attention in negative directions'. Lots
of public debate 'is ill informed or uninformed —
for example it's believed that hate crime is
worsening, sometimes because of Brexit, or because
of racism online, even though there is only 'a
small proportion of cases involving physical
violence'.
Hate crime figures may be rising 'because of
improved police recording processes and a greater
awareness of what constitutes a hate crime'
[reference to Home Office publication here] which
may lie behind the increase of 131% of police
recorded race -related hate crime. However,
responses to the Crime Survey 'which is considered
more reliable than police recorded crime' show a
reduction in racially motivated hate crimes [of
about 30%], which may indicate 'another example of
overly pessimistic narratives'. A classic
comparison between subjective and objectiove data
-- another key point in the Report.
Another such pessimistic narrative is on race and
health, where the increase in age-adjusted risk of
death from Covid in black and South Asian groups
'has widely been reported as due to racism, but
'many analyses have shown that the increased risk…
Is mainly due to an increased risk of exposure to
infection… The fact that black and South Asian
people are more likely to live in urban areas with
higher population density and levels of
deprivation; work in higher risk occupations… live
with older relatives. If it were systemic racism
operating through their lives, 'this would be
reflected in overall mortality figures across the
life course' but 'black and Asian groups have had
lower mortality rates from all causes, and data
from Scotland suggests Asian ethnic groups have
higher life expectancy than white ethnic groups'
(30) despite living in deprived neighbourhoods.
This shows that we need to look at underlying risk
factors rather than just race and ethnicity, and
avoid fatalistic narratives.
In particular, there is evidence to think that
'"Britain is doing much better on race than on
class"' [attributed to S Katwala, the head of the
British Future think tank], and this is because
race discourses are dominated by full-time
academics and media persons. However 'many
disadvantaged black and Muslim groups do feel
defined by their race, whereas fewer middle-class
professionals from Indian and Chinese ethnic
groups feel the same. The rise of identity
politics has led to pessimism, as have 'single
issue identity lobby groups… [which]… tend to have
a pessimism bias in their narratives… and they
tend to stress the "lived experience" of the
groups they seek to protect with less emphasis on
objective data' (31). This inevitably affects
public debate about race, emphasising
discrimination and minimising 'minority
self-reliance and resilience'.
The research they commissioned looked at
educational outcomes and ethnic groups which
included 'sex, ethnicity and socio-economic
status', with the latter defined as 'parental
education, occupation and family income'. They
think that educational success should be
celebrated and replicated. They think that
'evidence shows that… Black African, Indian and
Bangladeshi pupils perform better than white
British groups, once socio-economic status is
taken into consideration'. 'Immigrant optimism'
may be responsible — recent immigrants see
education as a way out of poverty and spend more
time on it because they lack financial capital.
Other researchers found higher aspirations among
ethnic minority kids compared with white ones,
especially boys. Tthe exception is Black Caribbean
boys who have lower expectations of going to
university [56% ,73% for girls, 61% white
boys, 69% white girls] (32) . This may be 'an
internal drive or a response to external
discrimination' — whatever it is it produces
agency.
BAME is reductionist and disguises huge
differences, and assumes that the whole issue is
about majorities versus minorities. It also
conceals discrepancies within that group. Among
the new terms we shall employ are white ethnic
minorities which also feature a diversity of
groups such as 'white Irish, Gypsy, Roma,
travellers and Eastern Europeans' (32). The term
BAME itself is not that popular among ethnic
minorities. We need more granular data
accordingly, including differences within racial
or ethnic groups, 'such as urban middle-class
Gujaratis versus rural Mirpuri' (33).
There is misleading and imprecise language about
race and racism and 'linguistic inflation' with
terms like institutional, structural and systemic.
There is a tendency to 'conflate discrimination
and disparities' and a tendency to use the term
racism 'to account for every observed disparity'
which exaggerates its effects and can put people
off and increase tension.
Institutional racism in particular is a problem.
MacPherson defined it as a collective failure of
an organisation to provide an appropriate and
professional service, and was worried in
particular about the underreporting of racist
crime which showed a lack of trust in the police,
and a set of practices and behaviours that were
commonplace which harmed ethnic minority groups,
but this is 'largely no longer the case'. The term
'is now being liberally used, and often to
describe any circumstances in which differences in
outcomes between racial and ethnic groups exist in
an institution, without evidence' (34) this has
'dulled its credibility… Undermined the
seriousness of racism… led to insufficient
consideration of other factors'. We need robust
assessment and evidence and we have to show that
groups had been treated differently because of
their ethnic identity.
What would this evidence look like? We would need
surveys of individual prejudice and 'tests of
aggregate prejudices, such as curriculum vitae
studies' (35). If prejudice took the form of
'social pressure' where people believe the others
are prejudiced and they are expected to
discriminate, surveys would be required to see the
extent to which beliefs about these expectations
exist. There have been more more surveys about
attitudes towards racism and hate crimes and much
better recording, although social media has
permitted more proliferation of negative messages
and attitudes and toxic messages.
Accusations of racism that are hard to prove 'open
to interpretation or even vexatious' have also
multiplied. Subjective definitions are
problematic. We can have situations where it
depends on how people perceive the actions and
there is no consistency. It is now 'possible for
any act, including those intended be well-meaning,
to be classified as racist'. It's obviously harder
to measure the true extent of racism. Perceptions
do matter, trust has to be earned, and processes
have to be seen to be fair. Limits might be
suggested by 'assessing the intent of the
perpetrator as well as the perception of the
victim' while continuing to hear victims voices.
We need 'clear standard definitions of the terms'
instead of using them interchangeably. As it is,
referring to systemic institutional or structural
racism can also just relate to the feelings of not
belonging, rather than actions behaviours and
incidents and organisational levels.
We need 'more objective foundations… observable
metrics… quantitative and qualitative evidence'
(36). We should use different terms: 'explained
racial disparities, where there are persistent
ethnic differential outcomes which can be the
result of other factors such as geography class or
sex; unexplained racial disparities where there is
no conclusive evidence about the causes;
institutional racism where institution is racist
and has policies, attitudes or behaviours that are
discriminatory; systemic racism where there are
interconnected organisations or wider social
groups which exhibit racist or discriminatory
processes attitudes or behaviours; structural
racism "to describe the legacy of historic racist
or discriminatory processes, policies, attitudes
or behaviours that continue to shape organisations
and societies today"' NB the other definitions
above are close indirect quotes].
'White privilege' [and white fragility] is also
controversial. It is American and it can alienate
people who don't feel privileged or fragile. The
implication is that it is white people's attitudes
and behaviours that cause disadvantage and
suggests that being an ethnic minority in the UK
is to be treated unfairly 'by default'. 'The
evidence we have studied does not support this…
and that it is counter-productive and divisive'.
They prefer the term '"affinity bias"' to describe
'psychological comfort from looking like the
majority of people around you'. Racism is not just
about words. We must investigate evidence and give
good resources to the Equality and Human Rights
commission.
The UK has 'acute geographical inequality' on a
scale that is seldom appreciated, for example half
the population of the UK 'live in areas where
prosperity is no better than the poorest parts of
the old East Germany or the poorest states in the
USA' (37) and there is evidence the country is
splitting between these areas in London and the
south-east, especially the ex-industrial and
mining areas and towns on the coastal periphery.
This is 'overwhelmingly a white British problem',
but a section of the South Asian population who
live there are also affected and find themselves
placed below the white British group. Nevertheless
the English region with the worst life
expectancies is the north-east, one of the
whitest, the local authorities with the highest
number of deprived neighbourhoods are all in the
North, and all except one 'have a disproportionate
representation of the white British population'
(38). 9.1% of white British people live in the 10%
of the most deprived neighbourhoods — this is
relatively low, but absolutely high (4 million
people). There's a sense of stagnation and being
left behind, low ambitions, poor attainment low
pay.
The social mobility hotspots are in London and the
south-east. The areas where income deprivation
affects children most are 'all overwhelmingly
white British. Areas targeted for improvement in
social mobility are overwhelmingly white. This
sort of data underpins the view of the social
mobility commission 'that its recommendations
should focus on improving outcomes for all — not
centre on specific ethnic groups alone' (39).
28% of people in black households were on
persistent low income, 25% of Asian households and
12% of white households, but there has been
movement towards the white British median. It is
less so with wealth and property ownership [with a
gap of nearly 10 times between black African and
white British, less so with Pakistani]. Property
is the main source of wealth. Home ownership has
the Indian ethnic group in front with 74%. Black
Caribbean households have double the rate of
ownership of African ones, 40% as opposed to 20%.
Overcrowding is more common among ethnic minority
households. Pakistani and Bangladeshi people were
overrepresented in the most deprived
neighbourhoods in England, 31% of the population.
Over half the households in Pakistani Bangladeshi
and black groups were in receipt of state support
especially child tax credit.
Family structure has changed in the last 50 years.
They are not passing judgement or saying that two
parents are always better than one. Lone parent
families with the right support can provide a good
start in life, but they do need more support.
There is a prevalence of family breakdown. Overall
15% of families will lone parent, but 63% of black
Caribbean children were growing up in lone parent
families and 62% in black and other ethnic groups.
Indian ethnic groups lowest at 6%. Asian families
seem more family oriented. Differences in
socio-economic status are relevant with higher
rates among poorer people. There is some
literature pointing to negative incomes tied to
family background, especially in the USA --
'"family strain"'. The government should aim to
develop new initiatives.
Different groups vary in their attitudes to
integration and mixing as well. Some ethnic
minority groups seem to 'actively hold back
integration' (43). More than half Pakistani and
Bangladeshi women are economically inactive (25%
white women), 17% of Bangladeshi women 9% of
Pakistani women were unable to speak English, and
tended to live more separately from the
mainstream, and are also more likely to marry
people from their ancestral home, representing a
'"first-generation in every generation"' syndrome.
The answer is to do much more to support families.
According to recent polling, 93% of Britons
disagree that you have to be white to be British,
while 89% would be happy for their child to marry
someone from another ethnic group. Some believe
there are still tensions between ethnic groups
[not necessarily white groups?] (69%, with 20%
thinking there is a great deal of tension). 55% of
adults believe that BLM protests have increased
racial tension, including 44% of ethnic minority
Britons (45).
Racism means both attitudes and behaviours that
would not have been racist in the past and this is
one reason for 'rising sensitivity…
microaggressions and safety, and stretching the
meaning of racism without objective data to
support it'. The most successful groups, Indian
and Chinese, see fewer obstacles and less
prejudice. Those who do less well, black people
and Muslims tend to see and experience more of
both. Black African people are 'considerably more
positive' than black Caribbean. 76% of black
people believe there is white privilege, 59% of
all ethnic minorities, 29% of white people. Nearly
half of ethnic minority Britons 'do not think
their race has been an obstacle to their personal
advancement'. The majority agree that race
relations have improved, three times as many as
those who believe race relations have got worse.
British Future polling suggests there is no big
divide on the things that concern us.
Comparison with international experience involved
a report comparing the condition of minorities
worldwide [the Minority Rights Group
International, 2016] and found that treating
minorities fairly is a universal challenge but
that the UK manages it comparatively well because
of 'the welfare system and robust
antidiscrimination laws'. The European survey on
being black in the EU showed that experience of
racial harassment varied from 63% in Finland, 51%
in Ireland, down to 21% in Britain, the second
lowest result, and the UK has the lowest figure
for black respondents who experienced
discrimination in jobseeking, education, health,
housing and public or private services (46) thus
'the U.K. has improved race relations more rapidly
than in other countries', including being more
active in collecting data.
There is still a powerful current of unease and
anger, seen in last summer's BLM protests. There
is still a sense of detachment and unease and
sensitivity, 'a scholarly consensus that a
"psychological asymmetry" unavoidably
characterises majority – minority relations across
different cultures, including in the UK', and
younger ethnic minority people may identify more
strongly than older generations with multiple
identities rather than assimilation. Strong ethnic
identities should not be seen in themselves as an
obstacle. 'People are evidently capable of
juggling multiple identities'. It is important 'to
evoke positive emotions of trust and affection in
the country's minorities', to emphasise that every
individual is treated fairly and not on the basis
of their ethnicity, that 'we respect ethnic
identities but also share a common, unifying civic
identity as British citizens' and we must
'reinforce the symbols of Britishness' (47)
that signal that. [Not promote better economic and
geographical unity after all than? Or as well?]
They are quite confident about the data. They
remind us that differences or disparities 'are not
always sinister do not always arise from
discrimination'.[Yes they do -- class
discrimination] They are aware that some data
collection lacks precision and is not as granular
as it might be especially in terms of ethnicity.
For example the Census still uses the big five
classifications which can hide different outcomes
between different subgroups. This is especially
relevant in the crime and policing data. Ethnic
groups can move between censuses. The most
disaggregated categories possible should be used.
Further subdivisions might be made in white other
to distinguish between West and East Europeans,
and black African, to distinguish between sub
Saharan African people and Somalis, 'now a
substantial group in their own right' (49).
When reporting data so we should focus on net
disparities not gross ones. Most ethnic minority
groups are younger and more urban and this needs
to be recognised when looking at raw data on
crime, using, for example regression analysis
which adjusts for relevant factors. We should also
use relevant benchmarks, for example to prevent 'a
more negative picture of minority achievement than
is justified' — there are 'different histories,
periods of residence in the country, class and
educational backgrounds and average ages, so there
are many reasons, apart from discrimination why
you would not expect that representation in a
given profession, say should match each group's
share of the general population' (50).
Statistics might be used more responsibly 'in the
sometimes emotional field of race and ethnicity'.
For example the reporting of hate crime figures
'make clear that recent increases are in incidents
reported to the police and more reliable national
survey evidence suggests that actual hate crime
incidents are falling' [as above]. There might
need to be a special 'set of ethnicity data
standards'. Users 'should note the limitations of
the analysis especially when data is provided for
an aggregated group which can mask differences in
outcomes for detailed groups. Users should avoid
binary analysis 'for example comparing White and
other than white'. Generally, 'every level of
disaggregation adds analytic value providing that
it remains possible to draw meaningful
comparisons' (50) [this is one reason why they
want to disaggregate the term BAME].
In terms of policy generally, they need to reform
the old tendency which has followed a binary
distinction between white and BAME [a useful
political split though] ; seeing all racial and
ethnic disparities as negative; and has formulated
policy to target aspects of minority disadvantage.
They think the best way is to 'make improvements
that will benefit everyone, targeting
interventions based on need not ethnicity'. So for
example if not enough black people are getting the
professional jobs after graduating, we need to
examine the subjects studied in the careers advice
they are receiving and improving that will improve
prospects for everybody. This will be ' fair, it
will be more effective than diversity training for
teachers'. If we focus diversity and inclusion
training on white discrimination, we may alienate
those very people. 'Far better to focus on the
biases, nepotism, in-group favouritism and
motivated reasoning that people of all races are
susceptible to'. Of course diversity and inclusion
training has moved the dial. A paper they like has
spelled-out the implications recommending that
diversity training should not police
misunderstandings but build relationships and deal
with the inevitable disagreements.
As a result they take an optimisation rather than
a maximisation approach, not seeing how far they
can address minority outcomes even if majorities
are discriminated against, but trying to produce a
balanced outlook optimising outcomes for all
groups and encouraging an open climate of debate.
We must not call too many fouls or award too many
penalties. The traditional focus has been on
giving help to marginalised groups, which made
sense when ethnic minorities were heavily
advantaged and all the prejudice came from white
people, but the position is more complex and some
ethnic minority groups are doing better on average
than white people. Now, discriminating in favour
of one group means discriminating against others.
Instead we should have things like name blind CVs,
more diverse recruitment channels, family friendly
policies enabling labour market participation for
ethnic minority women. We should encourage more
general participation in employment health trials
or university participation, assuming that 'we are
getting it right for marginalised groups then we
are getting it right for the majority', and one of
the best changes here has been the development of
comprehensive schools and self managed academies,
especially the major improvements that resulted in
London which have brought up standards generally
as well as for black students.
Education
This is an 'emphatic success story of the British
ethnic minority experience', in some cases
producing 'remarkable social mobility,
outperforming the national average'. However other
groups have had lower than average educational
outcomes. We need to explain these disparities in
terms of different 'social, economic and cultural
factors, [especially]...., Parental career, income
and achievement, geography, family structure and
attitudes to education]. 'Strong earlier support,
good schools and evidence-based interventions' are
crucial as is 'a wider understanding of the UK'.
In terms of strong GCSE passes in English and
maths, the white British group is 10th in
attainment, outperformed by Chinese and Indian
ethnic groups, indicating a close relation to
socio-economic status and if we control for that,
'all major ethnic groups perform better than white
British pupils except for black Caribbean
pupils'(55).
The black Caribbean group is the least likely to
attend university after the white British group.
Better guidance is needed on selection and the
promotion of alternatives, especially technical
and vocational education and apprenticeships.
Patterns in attainment vary throughout schooling:
at early years white British groups are fifth out
of 18 ethnic groups, at key stage 2 10th, at GCSE
10th, at A-level 8th. Chinese and Indian groups
show the highest attainment at A-levels, white
Gypsy Roma and Irish traveller groups the lowest.
40% of the overall development gap emerges by the
age of five. Poverty affects leaving school
without level 2 attainment. Family geography and
properties seem to be the 'three major sources of
disparity' (60) [there is an increasing use of the
measure of eligibility for Free School Meals —
FSM]. Disparities between ethnic groups appear in
terms of meeting the expected standard of
development, again with Indian and Chinese ethnic
groups at the top and Gypsy and Roma ethnic groups
at the bottom, the gaps between those eligibile
for FSM and others is also apparent [49% and 78%
among white Irish pupils, 53% and 76% with White
British achieving the expected standard at five
years]. Family composition seems to be important,
especially families with one parent, although
deprivation seems more important. Stability and
resilience is the crucial thing and this can be
provided by different types of family unit.
At secondary level, average GCSE attainment 8
score for black Caribbean and mixed white and
black Caribbean pupils was five points lower than
the average for white British pupils, while scores
for Indian Bangladeshi and black African pupils
were above white British average.. Ethnicity,
socio-economic status and sex are all related to
attainment, but ethnic disparities remain once
these are the differences are taken into account.
Taking FSM, 14% of white British pupils were
eligible, 19% of Pakistani, 23% of Bangladeshi and
25% of black African — 29% of mixed white and
black Caribbean, 28% of black Caribbean. The
causals seem to include reduced ability to help
with homework and remote learning [!], and higher
crime rates in more deprived neighbourhoods,
together with an increased risk of health and
developmental problems. Generally, the variation
in attainment due to family income, parental
education level and parental occupation status in
terms of obtaining a strong pass in GCSE English
and maths is larger than the gap between the
ethnic groups [the specific measure was between
children of parents with no qualifications and of
those with a degree. The more general measures,
socio-economic status was lowest of all for
Pakistani and Bangladeshi ethnic groups (64)] [all
this from a particular analysis from Strand --one
of several conducted for the Commissionusing
official stats] .
Nevertheless, 'overall, pupils from ethnic
minorities perform better than white British
pupils when accounting for socio-economic status'
(66), except for black boys of high socio-economic
status and Pakistani girls of high economic status
who seem to have lower achievement compared to
their white British pupils of the same status [the
potential causes of these difference can be found
in Strand's report].
Strand thinks that the '"immigrant paradigm" might
be responsible, the devotion to education
resulting from seeing education as a way out of
poverty, embraced especially by more recent
immigrants [not black Caribbean and mixed white
and black Caribbean pupils, then — these been
disillusioned? Why are they 'the least likely to
be optimistic?]. Apparently Indian and Pakistani
migration, also a long established can be
mitigated by '"selective assimilation theory"'
(70), reflecting their higher status in their
countries of origin and their diverse areas of
settlement — other Pakistani migrants living in
poorer areas of inner cities have remained more
segregated.
Black Caribbean lack of optimism 'is largely due
to their circumstances and context of
disadvantage' and can be remedied by educational
initiatives. Racial biases can be displayed by
schools teachers and the curriculum, especially
'"underlying bias of teachers"' [according to a
respondent to the commission]. However it's hard
to judge how important this is 'on a national
level', but divergences 'suggest that other
factors may be more influential' and 'if there is
a racial bias… It has limited effects and other
factors such as family structure, cultural
aspirations and geography may offset this
disadvantage' (69). Educational aspirations of
pupils and parents, academic self-concept,
frequency of completing homework may also be
important and there is research on all of these.
Overall, 'the level of success experienced by many
ethnic minorities in the UK is outstanding and
should be recognised as such' (70), but it is
recommended that more research is required
especially on the high performing pupils
communities, and factors there might be
'replicated to support all pupils'.
Geography is important and in some places poorer
pupils are two years behind their peers by the
time they take the GCSEs in predominantly white
areas [including Plymouth], far fewer in London
even though there are higher levels of ethnic
minority representation. The same goes with FSM
pupils. Gaps in primary school attainment of
increased.
Overall the gap is not the same in the UK as in
the USA — it is 'approximately eight times
smaller' (71)
Attainment gaps at GCSE and A-level at age 19 have
increased recently, but have improved for FSM and
non-FSM children [a confusing bit here, apparently
they peaked in 2015 and 2017]. The gap might have
widened because non-FSM children have improved
their attainment disproportionately. They want to
agree with the OFSTED line that 'with very few
exceptions, good education to one kind of child is
exactly the same as good education for another,
irrespective of their sex, ethnicity, religion or
other characteristics. Good curriculum, good
teaching, good behaviour, good pastoral support,
strong school culture and high aspirations matter
for all children'. Persistent underachievement
should be met with improving the school's core
offering 'so that all children can do well' rather
than targeted interventions. Even stuck schools
can improve after a focus on 'strong behaviour and
discipline, and ambitious well taught curriculum
and early reading in primary's, often with the
support of a strong multi-Academy trust' (72)
[OFSTED findings]. Individual group based
intervention can be minimised. They take as a case
study the Delta Academies trust who provided
evidence of considerable improvement and
identified themes which hold back disadvantaged
white British students: 'multi-general
disaffection and low aspiration, instant
gratification, parental debt and poor planning low
aspirations, failing to see the perceived benefits
of education, poor behaviour, well-meaning
professionals will address symptoms, low literacy
levels in the communities' [looks like a very
old-fashioned cultural deprivation stuff--ignores
socio-economic really] (73) Delta turned round a
particular school and nearly doubled the numbers
of disadvantaged pupils getting a strong pass
Teachers are mostly white British. There are
different opinions on the importance of teacher
diversity. UNESCO thinks it important, evidence on
ethnic teachers is scarce, gender doesn't seem to
have a unidirectional effect: 'children tend to
value teachers, whether men or women, who are
consistent, and evenhanded and supportive of them'
(75) another factors might be important such as
the quality of teacher training, school
improvement and the core school offering. Teachers
and ethnic minorities can bring valuable lived
experiences that can face 'pushback'. There can be
missed opportunities to teach more inclusive
portrayals of British culture. There are problems
diversifying the curriculum. All teachers should
'revel in the rich diversity of their peers'
[weak]. Governors should be more diverse, better
data collected, and clear expectations set.
Poor behaviour and discipline are a problem,
experienced by three quarters of teachers, two
thirds of whom say they have considered leaving
the profession because of it. Permanent exclusion
can be necessary but should only occur in cases
where the behaviour of the child is a risk to
safety. There are about 400,000 temporary
exclusions every year and 8000 permanent
exclusions. The main reason is 'persistent
disruptive behaviour, making up about 30% of all
temporary exclusions and the most common reason
for permanent exclusions (still only 35% though)
(76). 2018 to 2019 15 (0.2%) permanent exclusions
were due to racist abuse, and 4889 (1.1%)temporary
exclusions. There ethnic groups, white gypsy and
Roma pupils and Irish traveller pupils at that
highest temporary exclusion rates followed by
mixed white and black Caribbean pupils and black
Caribbean pupils Chinese and Indian groups had the
lowest temporary exclusion rates, and the same
pattern is seen with permanent exclusions.
There's been a recent review to recommend that
exclusions are used appropriately, and the Timpson
Review 'found no evidence of systemic or
institutional racism, but instead pointed to
complex factors' including local combinations of
'differences between schools, poverty and
childhood trauma', specifically '"overlapping
vulnerabilities such as poverty, SEN, and family
environments and poor mental health"', which
generally agrees with the findings of the
Commission. However, even when controlling for
these factors, 'permanent exclusion rates continue
to remain high for black Caribbean and mixed white
and black Caribbean' (77), who were 1.7 times more
likely to be permanently excluded, three times
more likely before the data is adjusted (78).
However, this 'cannot be reduced to structural
racism and individual teacher bias', because again
black Caribbean pupils are more affected than
black African pupils, with rates of 25 in 10,000
compared to 7 in 10,000.
We still need to investigate what the key issues
are here, and to urge the government to make
funding available to equality and diversity hubs,
teacher training, a practice improvement fund,
alternative provision effective interventions,
training for governing bodies and Academy trusts,
better information on children relief schools,
OFSTED research on patterns to exclusions and
off-rolling, better support. The 'ethnic
disproportionality in the identification of SEN'
(79) needs particular investigation. There needs
to be better public reporting, less emotive, and
better research on behaviour in schools, and
better funding, focused on need.
We need to build social and cultural capital
especially after covid and the inspiration
for this has 'existed in our ethnic minority
communities for decades: extra hours education'
(82). More than half of privately educated
children in London come from ethnic minority
backgrounds. They have engaged in extra hours of
formal and non-formal education and this 'social
capital… Should not be underestimated', providing
new friendships, new skills like playing musical
instruments, understanding heritage and culture.
It seems a particular feature of schools in the
UK. The government should support this
supplementary education, and there is evidence
that it helps FSM kids and those taking GCSEs
(83). Schools should offer a longer school day via
school clubs, holiday revision sessions and
extracurricular activities, as an offer for all.
US studies suggest the same.
Places to study away from distraction have become
important, and schools can provide them.
Extracurricular activities have led to
improvements in behaviour and confidence in social
skills, and there is evidence that schools that
provide them do better in reading [an OECD survey]
(84). Academies and free schools have been useful
here. Some case studies cite the use of breakfast
clubs and homework support, after hours sports
clubs and so on. Increased costs are recognised,
and the project must be carefully researched
[problems are listed 86 – 87 including transport].
This will expose more children to the benefits
offered in private schools, and help pupils 'see
life through another lens' (88) especially if they
get the chance to debate, act, master an
instrument and play a sport, access 'rich cultural
capital'. It will also get them off the dangerous
streets.
The curriculum must feature '"shared knowledge"',
a US term, which addresses how to teach the
historic past to create a sense of belonging,
people from different backgrounds can identify
themselves in British history. Michael Young [!]
Is cited on the need to provide powerful knowledge
(89). Local and regional knowledge of the UK is
required as well as that of the Commonwealth and
former colonies which have defined Britishness.
One case study looks at the connection between the
Royal Mint and the West India Committee to provide
accounts of important black people that have lived
in the UK, while another looks urban change in
Liverpool looking at migration. All the inputs
into British culture need to be studied, leading
to understanding Britain as a '"rich and layered
collection of communities"' (91) with a diverse
literature and language. It is not just a matter
of imperial imposition, because there are
different directions of travel, and 'episodes of
both shame and pride'. Different ethnic groups and
socio-economic groups should see themselves '"in a
positive and celebratory manner"'. Teachers may
need support to do this. There should be balance.
Pupils should be prepared to take on fake news and
to discuss clashing opinions and truth. School
leadership is important and should emphasise
'political neutrality and transparency', and this
should be more research on 'whether schools are
teaching in an impartial way'(92)
An appointed panel of independent experts should
produce the resources required and they should be
embedded within subjects they should produce
lesson plans teaching methods and reading
materials and a national library online should
accompany. Expert should include head teachers,
Subject Association representatives examining
bodies, national museums and representatives from
relevant ethnic minority stakeholder groups.
In 2020 white students were least likely to go to
university (33%) followed by students from mixed,
black Asian and Chinese (39, 48, 53 and 72). Only
13% of Male white British pupils eligible for FSM
progress to higher education, except in London
where it is nine percentage points higher than
anywhere else (93) Compare this with 67% of black
African young people who have gone to HE, (59% of
those eligible for FSM). Even black Caribbean
pupils are more likely to progress to university,
although they are also most likely to attend low
tariff universities — only 18% of black entrants
went to high tariff providers. Black Caribbean
pupils are the least likely to progress to the
more elite high tariff universities — 5% compared
to an overall national figure of 11% (95).
Once at university ethnic minority students except
Asians 'are more likely to drop out, have lower
levels of attainment and lower earnings after
graduating'. 16% of black students do not
continue, even in STEM subjects (96). Black
students have the lowest percentage of first class
degrees at 15% (white students 32%, Asian students
23%). Median earnings show the same pattern —
black African, Bangladeshi, black Caribbean and
other black ethnic groups less than the median,
the white ethnic group median earnings, and mixed
Indian and Chinese ethnic groups above the median
[33K]. This could be the result of entering low
tariff universities, or the result of poor advice
on which courses to take. Apparently 'about 40% of
black African people and 39% from the Bangladeshi
ethnic group are overqualified for their roles,
compared with 25% of white workers' [citing a
Joseph Rowntree Foundation study] (97). Those in
high skilled operations made more use of formal
support services and have likely studied subjects
with a clear career trajectory. Being first in the
family to go to university can affect career
prospects. Everyone asked for better careers
advice. Insider information was variable,
especially at A-level.
Overall, there seems to be an overinvestment in
university degrees that are not leading to high
status professional jobs, and there should be more
routes instead. There might be a circle between
academic self-concept and relative lack of success
in education, so the commission supports
traineeships and apprenticeships. 'It is vital
ethnic minority young people do not see the future
only through a higher education lens' [but beware
being channelled?] (100) Case studies include the
Sutton trust, PwC. and Rolls Royce.
Apprenticeships seem to be better understood in
white British families, while ethnic minorities
tend to have 'an exaggerated respect for the
academic route' and 'a mixture of prejudice and
ignorance about apprenticeships' (102), a mixture
of 'minority bias' and a misguided public policy.
There must be consideration of lifelong learning
in alternative routes. The increase in tuition
fees has put off mature students and alternatives
should be reactivated.
Policing
Hate crime is distressing and can produce serious
psychological effects among individuals and the
wider community. 'Although it is often believed
that hate crime is rising sharply, the most
reliable data shows that it may be declining'.
76,070 race -related hate crimes were recorded by
police in 2019 to 2020, up by hundred and 31%
compared to a decade before, but the crime survey
of England Wales showed that racially motivated
hate crimes went down 449,000 204,000 over the
same period. This is still a 'sizeable number of
incidents', and is unacceptable. It is impossible
to drive it down to zero (139). The most common
offence recorded by the police in 2020 was 'public
order offences, such as graffiti or verbal abuse,
more than 10,000 'violence without injury and 4500
violence with injury'. 1.1% of Asian people
experienced a hate crime, 1.1% of black people,
but only 0.2% of white people, these are
substantially less than the percentages
experiencing crime in general [between 13 and
20%]. There is an 'overrepresentation of black
people among perpetrators', even more so in the
USA.
[Bit misleading here -- 'In 2019, 80% of
those proceeded against for religiously or
racially motivated hate crimes were White, 9%
Black and 7% Asian' Old slippages between absolute
and relative figures here].
Fear of hate crime among minority communities is
greater than its likelihood of occurring — 16% of
Asian people and 13% of black people were very
worried about being attacked. This fear could
limit integration and stop involvement. There
needs to be visible action. Online abuse is also
significant. Ethnic minority female MPs seem
particularly vulnerable as do other celebrities
and public figures. Abuse can go viral. This
should be new online safety legislation and social
media companies should exercise the
responsibility. Anonymity should be rethought and
racially abusive content removed.
More generally, communities often overestimate the
level of crime in their areas, but generally,
'there is a need to acknowledge and welcome that
this country's overall crime rate has reduced'
(143). The majority of people do not commit crime
[or at least not entered into the criminal justice
system — those that were represented 0.25% of the
ethnic minority population aged 10 to 17, and
0.16% of the white population.. There are 'big
disparities' in the rates of stop and search, but
there are also disparities in crime, often violent
crime and factors behind this policy, as even
David Lammy noticed [he pointed to differences in
poverty and lone parents, school exclusion and
early arrest]. (144) police attitudes have changed
over the last 30 years, and they do face complex
changes. They have made 'great strides' towards
fair policing.
Ethnic minority people are more likely to be
victims of crime especially violent crime and
homicide. Black people were 11 times more likely
than white to be a victim of homicide, but the
principal suspect in the case was more likely to
be of the same ethnicity [for white people as
well], although there is a difference for women.
Women of mixed ethnicity were more likely to
experience domestic abuse compared to either black
or Asian ethnic groups, and white women more
likely than Asian or black. Black people are
disproportionately represented among both victims
and suspects — deprivation and younger age profile
might explain 'much of the disproportionality'
(146). Knife crime has been on the rise, although
this may indicate better recording] [reverse of
what was said for hate crime"!] . London has a
disproportionate level of knife offences. Ethnic
minorities are well represented in terms of
offenders [up to 2/3 depending on age and year],
and sharp instruments have been the most common
instruments for homicides. (147).
Ethnic minorities are overrepresented at the point
of stop and search, and with custodial sentencing
in prison population, especially black people.
They were arrested three times more often than
white people in 2020. Asian and other ethnic
groups had the biggest custody rates. The prison
population was 27% ethnic minority, almost twice
its percentage in the population. Ethnic minority
groups are overrepresented among those convicted
of serious crimes (148). Jury conviction rates for
ethnic minority and white groups are similar,
however. The circumstances surrounding crime can
vary, for example involvement with gangs — 34%
black young people, 5% white young people. This
can help contribute to negative stereotypes of
young black men.
Stop and search has been much discussed.
Politicians see it as important to disrupt crime,
but the police often cite drugs and disrupting
drug county lines [the implication is that most of
these aimed at detecting drugs are unsuccessful
and excessive, so policies directed at drugs are
likely to be particularly unwarranted].
Transparency is needed, especially as community
perception is already negative. The data shows
that there were 563,837 stop and searches in 2020,
11 stops for every thousand people, down from 25
per thousand a decade earlier. Black Caribbean
people were stopped at the rate of 39 for a
thousand people, down to Asians 30 per thousand,
down to Chinese 2 per thousand and white six per
thousand. The Metropolitan police had the highest
rate. The claim is that black people are nine
times more likely than white people to be stopped
and searched at the national level, but this is
not always accurate because there are differences
in the size and characteristics of local
populations and local policies. (151) [including
differences in reporting ethnicity and
geographical practices in different
neighbourhoods].
Between 2010 and 2019 rates of stop and search
decreased for all ethnic groups, the least for
black people. 76% of all stops resulted in no
further action, 13% in arrests, higher for white
people (52%). 72% of killings of youths under 25
years involved black victims. Black people were
four times more likely to be a victim and eight
times more likely to be a perpetrator in London
[used in defence of stop and search]. However care
should be taken in terms of how the policy is
carried out. There are many risk factors
associated with violent crime, including
'long-term experiences of racism' and childhood
experience.
Recent research on gang involvement notes that
there has been an impact on women and girls.
Poverty does not entirely explain involvement.
Young black males seem to be disproportionately
overrepresented although not all gangs are
involved in violent crime. Risk actors
identified by the police include child abuse and
neglect, past criminality, parental criminality,
drugtaking, truancy, living in high crime areas
and having delinquent peers. Some appear to be
'revenge attacks based on fairly trivial
incidents' (156). Gang membership may be 'an
expression of masculinity… Recognition and
status', the result of broken families. There may
also be a need to '"find refuge in a racist
society"' (157) including maintaining status
against other ethnic minorities. Girls may want
relationships with male gang members. There is a
notion of an alternative family or community'. We
need to counter this with developing attachment
and relationships to normal society [very old
stuff this], community leadership and role models,
more care. The Scottish Violence Reduction Units
seem to be effective by adopting a public health
approach, a broad range of interventions combined
with tougher sentences. There have also been some
positive outcomes of increasing stop and search in
reducing drug offences and county lines (161).
Agency should be stressed. Stop and search could
be improved by body worn cameras, by better
explanation to ethnic minority communities, by
better research and data collection.
Other factors that need addressing are deaths in
police custody [white people were 86% of those who
died in police custody, 14% from ethnic minority
groups], although 'a disproportionate number of
ethnic minority people have died following the use
of force' (164). An enquiry argued it was
difficult to prove that racism was a factor.
Police training might be improved including
developing good practice models, better
information for the public. Again case studies are
cited, one of which focused on de-escalation the
avoidance of unnecessary conflict, better
information about policing and so on the building
of trust.
The police should produce harm reduction policies
with drugs. Reducing punishments for drug
possession did not increase drug use. They
favoured alternative measures to decriminalisation
and cite a case study by Thames Valley Police
involving community resolution, a form of
treatment by a drug service provider. More
evidence is needed to test a range of
interventions 'to tackle the disproportionate
impact the criminal justice system can have on
young people' (186).
There should be a more diverse police service.
Barriers to recruitment and the culture of
policing should be understood. In particular there
was 'shocking racial abuse' directed at ethnic
minority police officers by other ethnic minority
citizens, some of them on social media platforms.
So : local residency for police (with local
variations) -- eg cadet programmes. Inclusivity
pilot projects -- and monitoring [and big roles
for CoP] [assumes no mobility between forces?]
Health
[Some recent controversies rage about this topic.
It is complex and specialist so I am going to
summarise only the headline issues. Lots of the
issues raised by Sewell in general figure here as
well]
'The Commission rejects the common view that
ethnic minorities have universally worse health
outcomes compared with White people; the picture
is much more variable. ... For many key health
outcomes, including life expectancy, overall
mortality and many of the leading causes of
mortality in the UK, ethnic minority groups have
better outcomes than the White population. This
evidence clearly suggests that ethnicity is not
the major driver of health inequalities in the UK
but deprivation, geography and differential
exposure to key risk factors... More needs to be
done to investigate why some ethnic minority
groups are doing better than others, exploring
whether it is due to differences in important risk
factors, family structures, better social
networks, or health behaviours such as drinking
alcohol and smoking....For some health conditions
there is variation within the broader ethnic
group. For example, the risk for many cancers had
significant differences for Indian, Pakistani and
Bangladeshi ethnic groups.' (200)
In Scotland, life expectancy is higher in the
larger ethnic minority populations and for the
white Scottish groups, 'despite higher levels of
deprivation' (201). 'Overall age standardised
mortality rates — which are closely correlated
with life expectancy — in 2019 were 26% lower in
black and salvation people than for white people,
again despite high levels of deprivation'. There
were significant intra-white differences according
to deprivation, with a difference of 10 years
[regionally]. However there is limited data on
'healthy life expectancy and it may be the case
that women in Pakistani and Indian ethnic groups
had shorter healthy life expectancy despite having
longer life expectancy overall'. Nevertheless, 'of
the 25 leading causes of premature mortality as
measured by years of life lost, people from South
Asian, black and Chinese ethnic groups have better
outcomes than white people in more than half'.
[Then details about these leading causes of death
which I will not cover. I will cut straight to the
chase about a current controversy – maternal
mortality]
The background is that in 2018, 'the stillbirth
rate in England reached its lowest level on
record… 4 still births per thousand births.... 209
women died during or up to 6 weeks after pregnancy
from causes associated with pregnancy… 2,280,459
women gave birth overall. 9.2 women per 100,000
[that is 0.0092%] died during pregnancy or up to 6
weeks after childbirth overall. [So we are looking
at absolute figures here again, before looking at
relative ones], and overall 'maternal deaths are
fortunately rare in the UK'.
However 'poor outcomes are higher for mothers and
babies from black and Asian ethnic groups,
particularly those born in Asia or Africa, and for
women living in the most deprived areas of the
country' (218). Again they want to remind us of
absolute numbers — 34 black women died among every
100,000 giving birth, and 15 Asian women, while 8
white women among every 100,000 giving birth [so,
relatively this still looks very alarming of
course, with more than four times as many black
women as white women dying]. This needs to be
better understood and explained and there is
long-term work being done on it. It should be a
priority.
The Report looks at inequalities that have 'arisen
over decades' and refers to unequal distribution
of determinants of health 'such as employment,
income, housing, social networks, education and
access to green space' [but they have already
argued that these also affect white working class
people as well]. They also refer to 'healthcare
inequalities' such as differential access to
services and treatment 'although they have a minor
role'. There may be 'differences in attitudes to
different forms of health care across ethnic
groups', such as 'higher avoidable hospital
admissions among South Asian groups in Scotland
compared to white Scottish groups, especially
among Pakistani men and women' (219) and primary
care might be needed to address this. There was
little variation in terms of hospital length of
stay or unplanned readmission.
[Activists want to talk about racist
discrimination, of course -- see the Birthrights Report].
Sewell does not consider this sort of work at all
but relies on more formal statistics: there
is 'little difference in measures of patient
satisfaction with received hospital care. 2018-19
the average satisfaction score out of a hundred
was 77 for black African people, 69 for
Bangladeshis, 73 for Pakistanis, 76 for white
British [what about black Caribbean?][ I looked up
the actual survey on
https://www.ethnicity-facts-figures.service.gov.uk/health/patient-experience/inpatient-satisfaction-with-hospital-care/latest
and found that the white Irish groups were the
most satisfied. The data did not include patients
receiving maternity or mental health treatment,
however. The score for black Caribbeans was 75,
about the same for all the black and mixed
groups]. The same sort of figures are found with
experience of GP services, 70% for black Caribs
but only 59% for Bangladeshis. [There is some
basic data on covid 19 but it is incomplete and
difference between the ethnic groups seems to be
produced by differences in risk of infection 'as
opposed to ethnicity alone, although there is some
evidence that messaging was too often aimed 'at a
single homogeneous ethnic minority group and
'participants reported that they felt this was
stigmatising' (221)]
In mental health terms, 'Black people are 8 times
more likely to be subjected to community treatment
orders than white people and 4 times more likely
to be detained' (222), especially for black
others, but this may be used for people whose
specific ethnicity is not known. Rates are lower
for black African and Black Caribbean groups,
lower still for Asian groups but still higher than
white groups and all except Indian and
Chinese. Is this evidence of racism? If we
benchmark it against 'disparity in the prevalence
of mental illness', a recent meta-analysis
concluded 'there were significantly higher risks
of diagnosed schizophrenia among ethnic minority
groups and that they were most pronounced among
black groups'. The relative risk for black
Africans was six (compared with White British and
for black Caribbean five. Other groups had less
elevated risks. Adverse social circumstances
'including racism and hardship' seem most likely
as causes, especially racism according to a recent
report which can lead to 'chronic stress' and
'weakened resilience'(223).
[So there is acknowledgement of racism here -- but
it is very brief and they go on to merge it with
the experience of migration]
There is some evidence that mental health
difficulties are experienced by any minority and
immigrant group 'including white minorities in
majority white countries' such as male Irish
travellers in Northern Ireland, or migrants to
Denmark from Greenland, or white men from
non-English speaking countries in Australia. There
are also genetic and epigenetic factors, childhood
environment such as family relationships again and
stressful life events, to which many ethnic
individuals may be more exposed.
Black and Asian people with mental health needs
'are less likely to be receiving treatment'
a study concludes, and less likely to have
contacted a GP. They were only slightly more
likely than white British people to be receiving
healthcare, while black Africans were less likely.
This lack of uptake 'may stem from fears that
mental health provision is discriminatory' (224),
and this lack of trust appeared in evidence given
to the commission. However, they do not think that
this evidence offers enough 'support the claims of
discrimination' and sees the problem instead as
'one of convincing vulnerable people in ethnic
minorities that mental healthcare provision is
neither a threat nor a punishment, but something
genuinely helpful' and should be met with targeted
public awareness problems [targeted this time not
universal] to reduce stigma and coercive entry.
There is a guide being produced.
There is also need for further and better data
which will involve better representation of ethnic
groups, and some is being generated. Such as Our
Future Health, which intends to study 'the most
diverse cohort ever recruited in the UK with up to
1 million participants from ethnic minorities'
(226). Other case studies give examples of
multiple language leaflets and special information
on covid. Generally, individuals and communities
should be encouraged to be more energetic and
improve their own health outcomes, for example
diabetes in South Asian groups, high blood
pressure in black groups and many cancers in white
groups which are associated with modifiable risk
factors — diet, physical inactivity, tobacco and
alcohol (228). We can learn from American case
studies.
We might need an Office for Health Disparities to
target health disparities, an independent body
working alongside the NHS, undertaking research,
including the barriers to participation and health
education, again with an expert panel providing
nationwide advice including community liaison
contacts. Lots of high-powered medics have
supported this.
Conclusion
'The reality is no longer captured by the old idea
of BAME versus White Britain.... We were
established as a response to the upsurge of
concern about race issues instigated by the BLM
movement. ... our experience has taught us that
you do not pass on the baton of progress by
cleaving to a fatalistic account that insists
nothing has changed.... nor do you move forward by
importing bleak new theories about race that
insist on accentuating our differences. It is
closer contact, mutual understanding across ethnic
groups and a shared commitment to equal
opportunities that has contributed to the progress
we have made.... Too many people in the
progressive and anti-racism movements seem
reluctant to acknowledge their own past
achievements, and they offer solutions based on
the binary divides of the past which often misses
the point of today’s world.'
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