Covid19, tackling health inequalities and black community perspectives

On 8th July 2020 we were delighted to co-host, with Toynbee Hall and The Equality Trust, an evening event with Professor Sir Michael Marmot, Farzana Khan and Natalie Creary. This was our first large scale zoom event, over 1,000 people registered to attend on line, and the debate in the 'chat' channels was intense.

Michael's presentation and the subsequent debate and discussion are on YouTube here:

As coronavirus was beginning to arrive in the UK, in February 2020 and 10 years after his original seminal national review of health inequalities (Fair Society, Healthy Lives), Sir Michael Marmot and his team released their ten year update report. Their new report showed that health is getting worse for people living in more deprived areas in England, that for the first time in more than 100 years, increases in life expectancy have stalled, and for the poorest 10% of women they have actually declined. The review also showed that over the last decade health inequalities, the health gaps between people, have widened overall, and the amount of time people spend in poor health has increased since 2010. There has been an increase in the north/south health gap, with parts of the North East falling further behind and parts of London moving further ahead. In the ten years before, up to 2010, we had seen gradual progress, narrowing some of these gaps. What happened?

The review identified the widespread and deep cuts in most areas of public spending as the root cause of increases in health inequalities in England. Austerity really hit hard. When Michael came to talk to us in July we also asked him to reflect on the first months of the coronavirus pandemic. Ten year's of austerity undermined our capacity to respond to a major epidemic, and growing health inequalities had increased the vulnerability of key groups to the virus itself. It is clear that the pandemic will further compound health inequalities, with unemployment and economic losses mounting, an unresolved housing crisis and public services under intense pressure. For London the epidemic may have particularly extreme impacts, given our economies dependence on office jobs (will office workers ever come back?), on culture, entertainment and night life (massively hit by Covid safety restrictions), and for inequality overall in the city, given the very wide variations in rates of disease and death between different neighbourhoods and communities.

Public Health England’s inquiry into ‘Disparities in the risk and outcomes of COVID-19’ has shown disproportionate impacts on Black, Asian and minority ethnic groups. The Bangladeshi community faced around twice the risk of death compared to White British people. People from Chinese, Indian, Pakistani, Other Asian, Caribbean and Other Black communities have between 10 and 50% higher risk of death compared to White British communities. Death rates were also twice as high in the most deprived communities and unsurprisingly, people in low-income work have also been more severely impacted. Men working as security guards, taxi drivers, bus and coach drivers, chefs, sales and retail assistants, factory workers and men and women working in social care having significantly high rates of death from COVID-19. Health inequalities in action.

The powerful discussion between Michael, Farzana and Natalie, ably chaired by Sian Williams from Toynbee Hall covered a wide range of issues, from how the virus is effecting different communities, the links to poor housing and material deprivation, to the role of empowerment for communities and questions about who decides how data is generated, what analysis is conducted and for who's benefit. If you missed the evening it is well worth watching. 

Inequality harms us all, only together can we tackle it.

#FairerLondon #BuildBackBetter #HealthInequalities #NewEconomy

About the speakers

Professor Sir Michael Marmot MBBS, MPH, PhD, FRCP, FFPHM, FMedSci. Director of the International Institute for Society and Health. MRC Research Professor of Epidemiology and Public Health, University College, London. Michael Marmot has led a research group on health inequalities for the past 30 years. He is Principal Investigator of the Whitehall Studies of British Civil Servants, investigating explanations for the striking inverse social gradient in morbidity and mortality. He leads the English Longitudinal Study of Ageing (ELSA) and is engaged in several international research efforts on the social determinants of health. He chairs the Department of Health Scientific Reference Group on tackling health inequalities. He was a member of the Royal Commission on Environmental Pollution for six years and is an honorary fellow of the British Academy. Internationally acclaimed, Professor Marmot is a Vice President of the Academia Europaea, a Foreign Associate Member of the Institute of Medicine (IOM), and the Chair of the Commission on Social Determinants of Health set up by the World Health Organization in 2005. He won the Balzan Prize for Epidemiology in 2004, gave the Harveian Oration in 2006 and won the William B. Graham Prize for Health Services Research in 2008.

Natalie Creary is the Director of Black Thrive a partnership between statutory organisations, the voluntary sector and local communities who work collaboratively to reduce mental health inequality experienced by African and African-Caribbean communities in the London Borough of Lambeth. Together they work to improve access to, and the quality of mental health services and push conventional boundaries to dismantle the structural barriers that create and sustain inequalities in mental health. Their work emphasises the importance of prevention and seeks to address disparities across the social determinants of health. Prior to joining Black Thrive, Natalie worked on a range of initiatives in the public and voluntary sector and has also spent some time in academia; lecturing in Public Health and Health & Social Care. Her current research explores the impact of the social determinants on the health experiences of Black communities. Her work seeks to share the health narratives of communities; paying attention to how race, age, class, gender and sexuality intersect to shape their lived experience of health and wellbeing.


Farzana Khan is a writer, director, cultural producer and award-winning arts educator. Farzana is the Executive Director and Co-founder of Healing Justice London (HJL) Her practice works on building community health, repair and self- transformation rooted in disability justice, survivor work and trauma-informed practice working with communities of colour and other marginalised and underrepresented groups. HJL cultivates public health provisions for collective liberation and dignifying lives made vulnerable. Farzana has over 10 years of background in Youth and Community work particularly focused on arts-based education projects both in the UK and internationally. Farzana is the former creative and strategic director at Voices that Shake, bringing together young people, artists and campaigners to develop creative responses to social injustice. She ran this working at Platform London, a climate and social justice organisation working across arts, education, research and activism. She currently is a lead strategist on Climate and Resource justice with Thirty Percy Foundation. She is the co-founder of Resourcing Racial Justice.

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  • Alex Bax