Inequalities in COVID19 mortality related to ethnicity and socioeconomic deprivation

Rose, T. C.; Mason, K.; Pennington, A.; McHale, P.; Taylor-Robinson, D. C.; Barr, B.

Background: Initial reports suggest that ethnic minorities may be experiencing more severe clinical outcomes of coronavirus disease 2019 (COVID19) infections. We therefore assessed the association between ethnic composition, income deprivation and COVID19 mortality rates in England. Methods: We performed a cross-sectional ecological analysis across upper tier local authorities in England. We assessed the association between the proportion of the population from Black, Asian and Minority Ethnic (BAME) backgrounds, income deprivation and COVID19 mortality rates using negative binomial regression models, whilst adjusting for population density, proportion of the population aged 50-79 and 80+ years, and the duration of the epidemic in each area. Findings: Local authorities with a greater proportion of residents from ethnic minority backgrounds had statistically significantly higher COVID19 mortality rates, as did local authorities with a greater proportion of residents experiencing deprivation relating to low income. After adjusting for income deprivation and other covariates, each percentage point increase in the proportion of the population from BAME backgrounds was associated with a 1% increase in the COVID19 mortality rate [IRR=1.01, 95%CI 1.01 to 1.02]. Each percentage point increase in the proportion of the population experiencing income deprivation was associated with a 2% increase in the COVID19 mortality rate [IRR=1.02, 95%CI 1.01 to 1.04]. Interpretation: This study provides evidence that both income deprivation and ethnicity are associated with greater COVID19 mortality. To reduce these inequalities governments need to target effective control measures at these disadvantaged communities, ensuring investment of resources reflects their greater need and vulnerability to the pandemic. Funding: National Institute of Health Research; Medical Research Council