It is “impossible to square” some of the conclusions of the Commission on Race and Ethnic Disparities report with the evidence it considered, a source with close knowledge of the Commission tells the New Statesman, claiming the Commission made “selective use” of evidence in its findings.
The source, who wishes to remain anonymous, expresses concern that “a huge amount of motivated reasoning was going on as this evidence was being heard and interpreted” and that “inconvenient evidence” was dismissed.
The Department of Health and Social Care’s (DHSC) submission to the review, seen by the New Statesman, prominently features a September 2020 report by the ethnicity sub-group of the Scientific Advisory Group for Emergencies (Sage) that investigated what was driving higher coronavirus rates and deaths among ethnic minorities, and cites it in the conclusions of its submission to the race report.
The Sage paper is a comprehensive review of coronavirus health data, “the strongest evidence of unexplained racial and ethnic differences in health outcomes due to the detailed control variables used in the studies”, according to the DHSC submission.
But the paper is not cited as formal evidence in the Commission’s final report.
The Sage paper notes that disparities in “social determinants of health are likely to be driven by broader issues of structural racism”. The Commission, while declining to cite the Sage research, instead talks about “overly pessimistic narratives” about race and health and states that the increased risk of coronavirus death among black people in the UK is “mainly due to increased risk of exposure to infection”.
The Commission’s report does not include the growing body of evidence on the direct role that racism can have on health outcomes, both in terms of bias in treatment and the health impact of exposure to racism, even though it received evidence highlighting these areas of research.
The DHSC submission to the Commission cites “growing evidence from the USA, the UK and other countries that exposure to racism can affect health”, and research – which is referenced in the Sage sub-group paper – on how racism and psychosocial stress can have direct biological effects.
This area is not mentioned in the Commission’s findings, nor does the Commission consider evidence of the direct role of racial bias in contributing to lower standards of care for ethnic minorities, despite hearing evidence from David Williams, a Harvard professor of public health and world expert in the direct role of racial bias in health outcomes.
“Anyone who reads this who has spent even a small amount of time with academic literature on these topics will laugh at how simplistic this is. It’s just not a serious analysis,” the source with close knowledge of the work of the Commission tells the New Statesman.
They express concern that some Commissioners began the review “fighting against this idea that all ethnic disparities are explained by white discrimination”, believing that racism amounts only to “shouting taboo words on the streets”.
“That’s not what structural racism is. If that’s what you think racism is, then racism has nothing to do with it. But if you think structural racism is patterns of advantage and disadvantage, then it has extremely high explanatory power.”
The government has been contacted for a response.