Why is Haref Important?

We now know that COVID-19 has had a disproportionate impact on ethnically marginalised communities. The reasons for this are complex, but it is obviously linked to the long-term inequalities that exist across the whole of society, including in our health and care systems. This is why Haref started as a project: to specifically tackle these health inequalities locally.

Some ethnic groups experience significantly higher levels of ill health and premature death than the rest of the population and some minority communities are more likely to be in poverty, and that poverty is a significant factor in poorer health outcomes. We also have services that are not easy to access or designed to accommodate the needs and cultural differences within diverse communities.

Haref has been campaigning for health equality for ethnically marginalised communities for almost 20 years but when COVID-19 struck, the huge disparities in health and access to healthcare across different communities suddenly became more apparent. There was a lot of reporting in the mainstream media about how COVID-19 was disproportionally affecting people from marginalised communities. This was then further reinforced by the Black Lives Matter movement over the summer of 2020.

There are challenging times ahead for all of us. Haref will continue to fight for health equality, working with local organisations to respond quickly to issues arising in our communities, look at how we can build resilience, and develop plans around recovery from the current and long term effects of the pandemic.


Current issues identified by the Haref Network

The Haref Network is actively working to tackle a number of health-related issues currently affecting our local communities. These include:

  • Mental health was as key issue of concern for ethnically marginalised communities due to COVID-19, with escalating extreme stress, depression, fear and risk of suicide. 
  • There is also a lack of culturally appropriate mental health services
  • The existing inequalities have just been amplified and made worse by the pandemic in health, poverty, access to services and information.
  • There are particularly high concerns for asylum seekers with isolation, poor accommodation and overcrowding, lack of money, lack of social networks, scared they will be arrested if outside the house.
  • Young people are experiencing: hate abuse online; living in crowded households; no outlet for pressures; scared their parents may be affected working in care professions.
  • Everything being online is not the solution, due to digital exclusion with some people not having access to the internet, phones or computers.
  • People are experiencing hate crime/ discrimination and being targeted due to all the news that ethnic groups are more at risk


Trends in the UK

Report: Perspectives from the front line: the disproportionate impact of Covid-19 on Black, Asian and minority ethnic communities

This King's Fund report finds that the effects of longstanding health and socio-economic inequalities and institutional racism lie behind the disproportionate impact of Covid-19 on people from Black, Asian and minority ethnic backgrounds.

It is based on interviews with Black, Asian and minority ethnic NHS leaders, clinicians, community organisations and service users, and a survey of more than 100 members of the NHS Confederation’s Leadership Network.


Build back fairer: the COVID-19 Marmot review

Build back fairer: the COVID-19 Marmot review examines inequalities in Covid-19 mortality, focusing on ethnic minorities and certain occupations as well as paying continued attention to the socio-economic gradient in health.

It shows the effects that the pandemic, and the societal response to contain the pandemic, have had on social and economic inequalities, their effects on mental and physical health, and their likely effects on health inequalities in the future.


Report: Black and Asian deaths from Covid-19 are due to poverty and racism, not genetics or lifestyle

Doctors Unite provide an excellent report with evidence and statistics to show that the impact of Covid -19 on Black and Asian deaths is due to structural, institutional and everyday racism, and social class. 


Maternity and pregnant women

The Equality and Human Rights Commission (2016), ‘Healing a Divided Britain’, stated that Black African women had a mortality rate four times that of white women in the UK and that black and minority ethnic women and their babies are more at risk of poor outcomes in maternity.


Report: Ethnic inequalities in health-related quality of life among older adults in England: secondary analysis of a national cross-sectional survey

This report analyses health inequalities in older adults among all ethnic groups in England and found that health-related quality of life was worse for men, women, or both in 15/17 minority ethnic groups when compared to the White British group. Health inequalities were widest for the Gypsy or Irish Traveller, Bangladeshi, Pakistani, and Arab groups. 

Read: Ethnic inequalities in health-related quality of life among older adults in England


Report: The Health of People from Ethnic Minority Groups in England

This report looks at the differences in health outcomes for ethnic minority groups focussing on the variation between different ethnically marginalised communities in inequalities and health conditions. The report also goes into more detail about access to health services and reasons behind health inequalities.

Read: The Health of People from Ethnic Minority Groups in England


Report: Fair Society, Healthy Lives

The Marmot report explores how health inequalities stem from social inequalities. Marmot describes the social gradient in health whereby the lower a person’s social position, the worse one’s health is. Marmot proposes strategy and actions to reduce health inequalities. In 2020 this report was reviewed. The 2020 Marmot Review found that since 2010, growth in life expectancy has stalled and that the social gradient of life expectancy has steepened. Marmot provides updates on the policy objectives written in 2010.

Read: Fair Society, Healthy Lives

The Marmot Review 10 Years on


Report: The Medical Practice of Silencing

This report looks at testimonial injustice, which means that someone’s knowledge or opinion is dismissed, discounted, or not believed due to bias from the listener. In health care systems, this could look like not believing symptoms, underplaying patients’ reports of pain, barriers put up to prevent accessing specialist health care or delays in diagnoses.  Testimonial injustice is reported frequently by women from minoritised communities.

Read: The Medical Practice of Silencing


Report: Most GP surgeries refuse to register undocumented migrants despite NHS policy

Despite the NHS policy that anyone can register with a GP surgery regardless of immigration status and without proof of address NHS number, or ID, less than 24% of GPs surveys across England Scotland and Wales have said that they would register someone without proof of address, proof of ID or legal immigration status.62% would not and 14% were unsure. This has significantly impacted people’s ability to receive the Covid-19 vaccine, among other things.

Read report on GP surgeries