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		<title>ethnic minorities - UnHerd</title>
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		<description>think again</description>
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					<title>Conservatives need multiculturalism</title>
					<link>https://stage.unherd.com/2021/09/conservatives-need-multiculturalism/?edition=us</link>
											<comments>https://stage.unherd.com/2021/09/conservatives-need-multiculturalism/?edition=us#comments</comments>
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					<dc:creator>
						<![CDATA[Blake Smith]]>
					</dc:creator>
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							<![CDATA[Canada has always been a “mosaic” of diverse communities. Credit: Sam Panthaky/AFP/Getty]]>
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						<unherd:twitter_bio>
							<![CDATA[<p><strong>Blake Smith </strong>is a Harper-Schmidt Fellow at the University of Chicago. A historian of modern France, he is also a translator of contemporary francophone fiction and a regular contributor to <em>Tablet</em>.</p>
]]>
						</unherd:twitter_bio>
						<unherd:twitter_handle>blejksmith</unherd:twitter_handle>
															<unherd:author_bio>
						<![CDATA[is a Harper-Schmidt Fellow at the University of Chicago. A historian of modern France, he is also a translator of contemporary francophone fiction and a regular contributor to <em>Tablet</em>.]]>
					</unherd:author_bio>
										<pubDate>Wed, 15 Sep 2021 00:00:00 +0000</pubDate>
					<updated>Wed, 15 Sep 2021 00:00:00 +0000</updated>
							<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[America]]></category>
		<category><![CDATA[Canada]]></category>
		<category><![CDATA[Conservatism]]></category>
		<category><![CDATA[Don't miss]]></category>
		<category><![CDATA[Doomerism]]></category>
		<category><![CDATA[Ethnic conflict]]></category>
		<category><![CDATA[ethnic minorities]]></category>
		<category><![CDATA[Michael Cuenco]]></category>
		<category><![CDATA[Multiculturalism]]></category>
		<category><![CDATA[Pierre Trudeau]]></category>
		<category><![CDATA[Quebecois]]></category>
		<category><![CDATA[USA]]></category>
					<guid isPermaLink="false">https://old.unherd.com/?p=213819</guid>
																												<description>
								<![CDATA[Only diversity will order our fracturing societies]]>
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								<![CDATA[<p>It may seem perverse to suggest that thoughtful American conservatives might look for inspiration to Canada. But the American Right is at an impasse.</p>
<p>Many conservative voters, and brightest intellectuals, have become disillusioned with the Republican Party’s long-standing combination of laissez-faire economics, aggressive foreign policy and “family values” targeting abortion, gay marriage and other social issues. The Trump presidency revealed that traditional Republican political elites still hold too much of this platform, even as their base rejected it — and them. Meanwhile Trump’s alternative agenda, pitched initially as a rejection of both “globalism” and culture-war issues, collapsed amid blustering incompetence.</p>
<p>Canada is often cast as a more progressive version of the United States: less nationalistic and religious, more accepting of diversity and more generous in its welfare programs. But according to Michael Cuenco, a sharp-eyed young political analyst, Canada offers important lessons for the American Right.</p>
<div class="ad-insert"></div>
<p>Cuenco draws on the work of those American thinkers who have most cogently articulated the case for a &#8220;pro-worker&#8221; post-Trump conservatism, such as <a href="https://www.tabletmag.com/contributors/michael-lind" target="_blank" rel="noopener">Michael Lind</a>, but departs from them in critical ways.</p>
<p>His most original, and provocative, proposal for a new conservatism relies on a heterodox rereading of Canadian immigration policy, which is often cited as a model by reform-minded Americans on the Right. In a <a href="https://americanaffairsjournal.org/2021/02/a-tale-of-two-immigration-systems-canada-and-the-united-states/" target="_blank" rel="noopener">two-part series</a> of articles for <a href="https://americanaffairsjournal.org/2021/05/immigration-and-citizenship-the-canadian-model-and-the-american-dream/" target="_blank" rel="noopener"><em>American Affairs</em></a> this spring, Cuenco noted that American conservatives have long envied Canada’s “points system”, whereby the majority of immigrants are classed and selected on the basis of their potential economic contribution.</p>
<p>In this way, Canadians can avoid having to make what Americans would describe as a difficult choice between having a robust social safety net or an open labour market, between high levels of immigration or civic peace. But, Cuenco insists, America has failed to recognise that the Canadian system also requires what he calls a “civil religion” — one that is founded on a politically useful untruth.</p>
<p>The “civic religion” that enables this peculiarly effective immigration policy, Cuenco argues, is “multiculturalism”. However, this “noble lie” was told not to facilitate immigration, but to ensure social cohesion by smothering potentially dangerous domestic tensions. Indeed, it was conceived by prime minister Pierre Trudeau, father of the current prime minister, to contain and gradually dissipate the threat of francophone separatism. People insisting on their personal rights or identities may seem to be resisting hegemonic power, but they are really demonstrating that their characters and worldviews have been thoroughly shaped by it. The conservative mission, rightly understood, would not be to bemoan the hidden &#8220;religious&#8221; dimension of contemporary liberalism or undo false consciousness of its believers, but to better direct that process of shaping.</p>
<p>Against Quebecois claims to being one of the two founding nations of Canada (the French and the English), Trudeau promoted the idea that Canada had always been and must remain a “mosaic” of diverse communities. By emphasising a “multi” rather than “bi” cultural perspective, French Canadians’ particular status could be diluted, and the hegemony of the English-speaking political and economic leadership class (the so-called “Laurentian elite”) secured.</p>
<div class="ref-ar"><a href="https://stage.unherd.com/2021/09/why-woke-capitalism-works/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://stage.unherd.com/2021/09/why-woke-capitalism-works/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://stage.unherd.com/wp-content/uploads/2021/09/2screenshot_2021-09-03_at_15.36.39-e1630682574780-1.jpg?w=300" /></a><div class="content"><a href="https://stage.unherd.com/2021/09/why-woke-capitalism-works/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested article</span></a><a href="https://stage.unherd.com/2021/09/why-woke-capitalism-works/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Why woke capitalism works</h5></a><p class="author"><a href="https://stage.unherd.com/2021/09/why-woke-capitalism-works/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Tomiwa Owolade</a></p></div></a></div>
<p>In Canada — and, one might argue, throughout the Western world — the official political culture of the past two generations has increasingly become a kind of pageant of “difference” in which citizens are solicited to remember the far-flung origins of their compatriots, the important contributions of immigrants, the richness of their “communities” and other such clichés. One might see this sort of compulsory “multiculturalism” as a cynical means for reducing genuine differences in groups’ worldviews and long-standing historical grievances — which have the potential to generate irresolvable conflict — into a pacific dramaturgy where different identities are paraded.</p>
<p>But that’s a good thing, says Cuenco. In his formulation, Canada’s civic religion of multiculturalism makes for a political culture that is “Left in theory, Right in practice”.</p>
<p>There are many contemporary thinkers who wish to overcome the political division of Right and Left, and share Cuenco’s ambition to bring together progressive and conservative critics in defence of the working and middle classes. But Cuenco proposes something more interesting and more radical than a horse-shoe shaped coalition of the discontented.</p>
<p>He argues that the polices and values of one side (the Left) must be placed in service of the ultimate aims of the other (the Right). What we need, he proposes, is a group of elites who both recognise the legitimacy of populist resentment and the need to convert its demands not only into feasible policies but also into the language of liberal and progressive values.</p>
<p>And so Cuenco offers us a new articulation of the classic defence of liberal democratic civil religion proposed by <a href="https://www.tabletmag.com/sections/arts-letters/articles/the-religion-of-liberal-democracy" target="_blank" rel="noopener">Emile Durkheim</a>, who argued that our form of government promotes human rights as a kind of worship through which we affirm and renew our membership in a national collective — one that is made all the more binding because we imagine ourselves to be autonomous individuals.</p>
<div class="ref-ar"><a href="https://stage.unherd.com/2021/08/anti-racism-is-an-american-dream/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://stage.unherd.com/2021/08/anti-racism-is-an-american-dream/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://stage.unherd.com/wp-content/uploads/2021/08/GettyImages-50591767-scaled-e1629467545105.jpg?w=300" /></a><div class="content"><a href="https://stage.unherd.com/2021/08/anti-racism-is-an-american-dream/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested article</span></a><a href="https://stage.unherd.com/2021/08/anti-racism-is-an-american-dream/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>The Godfather of Critical Race Theory</h5></a><p class="author"><a href="https://stage.unherd.com/2021/08/anti-racism-is-an-american-dream/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Tomiwa Owolade</a></p></div></a></div>
<p>This “noble lie” by which liberal states seem to dissolve themselves into a shapeless mass of isolated individuals — through their emphasis on <em>rights</em> — is in fact the religion by which such states master fractious societies and persevere in being. What could be more conservative?</p>
<p>By returning to Durkheim and casting multiculturalism as a civic religion, Cuenco also reveals a number of paradoxes on the Right and Left. Thinkers on the Left usually understand themselves as pursuing the transformation of society in line with a substantive vision of equality, as radicals opposed to supposedly dominant ideologies and institutions. Yet these are the very values that have shaped America since its foundation — values which are hegemonic throughout all major political, cultural and economic institutions. From Marxist professors to progressive human resource managers, the Left is a party of order and tradition.</p>
<p>On the Right, meanwhile, conservative intellectuals, particularly those of a populist bent, insist today that America must be saved from the excesses of the Left, which include everything from the Civil Rights movement of the Sixties to the Progressive era of the early 20<sup>th</sup> century. The views of many (indeed most) living Americans, along with vast portions of American history, and their ideological foundations, appear to such ostensibly America-loving conservatives as unworthy of conservation. A number of venues on the post-Trump right, such as <em>American Mind</em> and <em>American Greatness</em>, have recently called for an “<a href="https://ibw21.org/commentary/an-american-caesar-how-the-right-wing-is-embracing-dark-ideas-once-considered-unthinkable/" target="_blank" rel="noopener">American Caesar</a>” or “<a href="https://amgreatness.com/2021/08/01/the-salazar-option/" target="_blank" rel="noopener">Salazar Option</a>” by which a dictator might sweep away America’s supposed internal enemies, and with them, much of what defines America.</p>
<div class="ref-ar"><a href="https://stage.unherd.com/2021/04/britains-schools-arent-racist/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://stage.unherd.com/2021/04/britains-schools-arent-racist/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://stage.unherd.com/wp-content/uploads/2021/03/GettyImages-587485292-scaled.jpg?w=300" /></a><div class="content"><a href="https://stage.unherd.com/2021/04/britains-schools-arent-racist/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested article</span></a><a href="https://stage.unherd.com/2021/04/britains-schools-arent-racist/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>How racist are Britain&#039;s schools?</h5></a><p class="author"><a href="https://stage.unherd.com/2021/04/britains-schools-arent-racist/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Tom Chivers</a></p></div></a></div>
<p>In contrast to such puerile fantasies, Cuenco urges the American Right to see the real conservative potential of the policies and values of the Left. Reducing income inequality and reigning in the tax-evasion of our financial elites would reduce the political power of the latter to shape American media, culture and politics around their peculiar and increasingly racialised understanding of ethics. It would provide capital for programmes of reindustrialisation and infrastructure development that was promised, but never achieved, by Trump in his first campaign. Likewise, reorganising the US immigration system along Canadian lines, coupled with the renewal of a civic religion that gives a progressive veneer to a calculus about the probable economic impact of any would-be immigrant, would soothe culture wars over immigration and national identity.</p>
<p>Success on both fronts requires conservatives to make peace with the state, bureaucrats and experts — and to distinguish their specific critique of our current elite’s depredations from an overly sweeping and inherently self-defeating opposition to the very existence of elites.</p>
<p>It also requires conservatives to learn, as Pierre Trudeau did, to take up the language of the Left, and instrumentalise it towards the end of holding society together — rather than trying to drag it back into a vanished past or impotently raging at its continued disintegration.</p>
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															<post-id xmlns="com-wordpress:feed-additions:1">213819</post-id>				</item>
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					<title>Why are minorities so hard hit by Covid-19?</title>
					<link>https://stage.unherd.com/2020/05/why-are-minorities-so-hard-hit-by-covid/?edition=us</link>
											<comments>https://stage.unherd.com/2020/05/why-are-minorities-so-hard-hit-by-covid/?edition=us#comments</comments>
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					<dc:creator>
						<![CDATA[Saloni Dattani]]>
					</dc:creator>
					<unherd:creator_img>https://stage.unherd.com/wp-content/uploads/2020/03/saloni.jpg?w=96</unherd:creator_img>
																<unherd:article_ranking></unherd:article_ranking>
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							<![CDATA[Minorities are overrepresented in some of the most dangerous jobs for COVID (Photo by Tolga AKMEN / AFP) (Photo by TOLGA AKMEN/AFP via Getty Images)]]>
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						<unherd:twitter_bio>
							<![CDATA[<p><strong>Saloni Dattani</strong> is a PhD student in psychiatric genetics at King&#8217;s College London.</p>
]]>
						</unherd:twitter_bio>
						<unherd:twitter_handle>salonium</unherd:twitter_handle>
															<unherd:author_bio>
						<![CDATA[ is a PhD student in psychiatric genetics at King's College London.]]>
					</unherd:author_bio>
										<pubDate>Mon, 11 May 2020 23:05:56 +0000</pubDate>
					<updated>Sat, 16 May 2020 10:25:21 +0000</updated>
							<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[BAME]]></category>
		<category><![CDATA[Coronavirus]]></category>
		<category><![CDATA[COVID-19]]></category>
		<category><![CDATA[ethnic minorities]]></category>
		<category><![CDATA[Vitamin D]]></category>
					<guid isPermaLink="false">https://old.unherd.com/?p=36467</guid>
																												<description>
								<![CDATA[A combination of social conditions and health factors has turned coronavirus into a disaster for black and Asian Britons]]>
							</description>
																		
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								<![CDATA[<p>Around the world, people are dying from Covid-19 in staggering numbers. As of today, there have been more than 250,000 confirmed deaths from the disease, and the emerging data suggests that the suffering disproportionately falls not only on the elderly, but also on ethnic minorities, the poor and marginalised. These groups suffer and die from the coronavirus much more than we would expect given their share of the population.</p>
<p>In <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.reuters.com/article/us-health-coronavirus-brazil-poor-idUSKBN22D549%26amp;sa%3DD%26amp;ust%3D1589201908396000&amp;sa=D&amp;ust=1589201908423000&amp;usg=AFQjCNEGQk2kHduof7D5_xQfKaM20Wj06w">Brazil</a>, in India and in <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.economist.com/middle-east-and-africa/2020/04/23/migrant-workers-in-cramped-gulf-dorms-fear-infection%26amp;sa%3DD%26amp;ust%3D1589201908396000&amp;sa=D&amp;ust=1589201908423000&amp;usg=AFQjCNFGCmjlOnkikpcG80DrQCVmF3wFbA">the Arabian Gulf</a>, migrants or the native poor have been devastated by the coronavirus. In Sweden, suburbs containing large immigrant populations are <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.thetimes.co.uk/article/ethnic-minorities-bear-the-brunt-of-swedens-coronavirus-deaths-gh62g8hxp%26amp;sa%3DD%26amp;ust%3D1589201908396000&amp;sa=D&amp;ust=1589201908423000&amp;usg=AFQjCNHP7s50ZuWhi0MnTq_Zb6kYq5epWg">believed</a> to be the hardest hit. In <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.bloomberg.com/news/articles/2020-04-08/black-hispanic-new-yorkers-are-dying-at-high-rates-of-covid-19%26amp;sa%3DD%26amp;ust%3D1589201908397000&amp;sa=D&amp;ust=1589201908424000&amp;usg=AFQjCNFeOWwCxA4Wkq38uhiEi3lNDd10vA">New York city</a>, black and Hispanic residents make up a disproportionate number of deaths, and in <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.moh.gov.sg/docs/librariesprovider5/2019-ncov/situation-report---28-apr-2020.pdf%26amp;sa%3DD%26amp;ust%3D1589201908397000&amp;sa=D&amp;ust=1589201908424000&amp;usg=AFQjCNH63Rrfuvh4nobCz5oEOfZa6ZYRTw">Singapore</a>, migrant workers living in dorms make up the majority of the country&#8217;s cases.</p>
<p>In <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.bbc.com/news/uk-51768274%26amp;sa%3DD%26amp;ust%3D1589201908397000&amp;sa=D&amp;ust=1589201908424000&amp;usg=AFQjCNHRTVXeRVhXoy6LLbnv5ByRYQbMgA">the UK</a>, the latest reports from the <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.ifs.org.uk/inequality/chapter/are-some-ethnic-groups-more-vulnerable-to-covid-19-than-others/%26amp;sa%3DD%26amp;ust%3D1589201908398000&amp;sa=D&amp;ust=1589201908424000&amp;usg=AFQjCNG44esUxFlr8UvRz1MYqq99VTaY2Q">IFS</a>, <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.icnarc.org/Our-Audit/Audits/Cmp/Reports%26amp;sa%3DD%26amp;ust%3D1589201908398000&amp;sa=D&amp;ust=1589201908424000&amp;usg=AFQjCNH3fcW-9Jh2GdtP8WX4ddCSceYXAg">ICNARC</a>, the <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://wellcomeopenresearch.org/articles/5-88%26amp;sa%3DD%26amp;ust%3D1589201908398000&amp;sa=D&amp;ust=1589201908424000&amp;usg=AFQjCNHdpsJ1l-skPveHesCzjRO-PvwIgg">Wellcome Trust</a> and the <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/coronavirusrelateddeathsbyethnicgroupenglandandwales/2march2020to10april2020%26amp;sa%3DD%26amp;ust%3D1589201908398000&amp;sa=D&amp;ust=1589201908425000&amp;usg=AFQjCNH7El6kXepw99c3rznSwk_zfOr9iw">ONS</a> all come to the same conclusion: ethnic minorities and the poor are the most vulnerable to being hospitalised, requiring critical care and dying from the disease. The ONS, which collects data on mortality from all-causes using death certificates, <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/coronavirusrelateddeathsbyethnicgroupenglandandwales/2march2020to10april2020%26amp;sa%3DD%26amp;ust%3D1589201908399000&amp;sa=D&amp;ust=1589201908425000&amp;usg=AFQjCNEuSKZxQtWjs1bkcdu-rOYz0k0RJQ">estimates</a> that black people in the UK are four times more likely to die of COVID-19 than white British people.</p>
<p>Although the Government has launched an official <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.theguardian.com/world/2020/apr/16/inquiry-disproportionate-impact-coronavirus-bame%26amp;sa%3DD%26amp;ust%3D1589201908399000&amp;sa=D&amp;ust=1589201908425000&amp;usg=AFQjCNEVD9ToCGHEBJA2e4Lhok_piOm5jg">inquiry</a> into the causes of these disparities, the likely reasons are already well-understood: ethnic minorities are more likely to come into contact with more people who are infected, they are more likely to work in essential services, more likely to live in dense areas, and more likely to live in crowded homes.</p>
<p>For example, some ethnic groups are <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.ifs.org.uk/inequality/chapter/are-some-ethnic-groups-more-vulnerable-to-covid-19-than-others/%26amp;sa%3DD%26amp;ust%3D1589201908400000&amp;sa=D&amp;ust=1589201908425000&amp;usg=AFQjCNFJjcpUfaRNwG-PwwoS64TXR6v69g">much more likely</a> to work in occupations that the Government has deemed essential during the lockdown: 32% of black African and 26% of black Caribbean people of working age are employed in these essential services, compared to 21% of white British individuals. That they come into contact with more people than they would if they were forced to stay at home means they have a higher chance of contracting the infection.</p>
<div class="ref-ar"><a href="https://stage.unherd.com/2020/03/the-scientific-case-against-herd-immunity/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://stage.unherd.com/2020/03/the-scientific-case-against-herd-immunity/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://stage.unherd.com/wp-content/uploads/2020/03/GettyImages-1204884025.jpg?w=300" /></a><div class="content"><a href="https://stage.unherd.com/2020/03/the-scientific-case-against-herd-immunity/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">More from this author</span></a><a href="https://stage.unherd.com/2020/03/the-scientific-case-against-herd-immunity/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Why the Government changed tack on Covid-19</h5></a><p class="author"><a href="https://stage.unherd.com/2020/03/the-scientific-case-against-herd-immunity/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Saloni Dattani</a></p></div></a></div>
<p>This is not all, however, since ethnic minorities and the poor are also affected by the behaviour of people around them, and are more likely to live in geographical areas where their neighbours also have a heightened risk of infection.</p>
<p>London and Birmingham, for example, have been hit hard by the disease, and Black and Minority Ethnic (BAME) people are overrepresented in these cities compared to the rest of the country. But even accounting for that, large urban areas like London and New York still exhibit substantial fragmentation in where ethnic minorities live, which is easily discernible using interactive graphics <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://demographics.virginia.edu/DotMap/%26amp;sa%3DD%26amp;ust%3D1589201908400000&amp;sa=D&amp;ust=1589201908426000&amp;usg=AFQjCNFUNprfxXXnrFRING7GqQsIQpdyAA">such</a> <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://mangomap.com/demographics/maps/50065/ethnicity%2523%26amp;sa%3DD%26amp;ust%3D1589201908401000&amp;sa=D&amp;ust=1589201908426000&amp;usg=AFQjCNGX48jr_WTITkX_tJX5gRcd3hUMBQ">as</a> <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.nytimes.com/interactive/2015/07/08/us/census-race-map.html%26amp;sa%3DD%26amp;ust%3D1589201908401000&amp;sa=D&amp;ust=1589201908426000&amp;usg=AFQjCNGA6kneU5rrXeZPa0j7wD7vSmLBEg">these</a>. This segregation has likely resulted in entire geographical <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.bbc.com/news/uk-51768274%26amp;sa%3DD%26amp;ust%3D1589201908401000&amp;sa=D&amp;ust=1589201908426000&amp;usg=AFQjCNFLfJoQC-7Nmu3guQG9WHF4Exc95A">pockets</a> becoming more vulnerable to the disease, which exacerbates the ethnic disparities that we see in ICUs and deaths.</p>
<p>In the US, prisons (which are disproportionately black) have seen an <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html%26amp;sa%3DD%26amp;ust%3D1589201908401000&amp;sa=D&amp;ust=1589201908426000&amp;usg=AFQjCNHsFnSLnO7xL8XqMdW7qmq-X2Y7hw">explosion</a> in coronavirus cases. <em>The New York Times</em> <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html%26amp;sa%3DD%26amp;ust%3D1589201908401000&amp;sa=D&amp;ust=1589201908427000&amp;usg=AFQjCNGhIW2IZicGpKk5sKib7Y6I8MeZlA">estimates</a> that the largest local outbreaks have occurred in jails in several counties and states, and that almost every state prison system has at least one infection among inmates or staff, where social distancing is difficult if not impossible.</p>
<p>It is not hard to see how the ethnic demographics of local outbreaks will be reflected in overall national statistics — they already are. An extreme example is of foreign migrant workers living in <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://time.com/5825261/singapore-coronavirus-migrant-workers-inequality/%26amp;sa%3DD%26amp;ust%3D1589201908402000&amp;sa=D&amp;ust=1589201908427000&amp;usg=AFQjCNHh0tYi8DVv046cYTPpabE_jh7Wyw">dormitories</a> in Singapore, where between 10 and 20 men typically inhabit each room. Out of the country&#8217;s more than 15,000 total cases, these workers make up <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.moh.gov.sg/docs/librariesprovider5/2019-ncov/situation-report---28-apr-2020.pdf%26amp;sa%3DD%26amp;ust%3D1589201908402000&amp;sa=D&amp;ust=1589201908427000&amp;usg=AFQjCNFPITASe3CBApoZpBZhwrbn2li66A">85%</a>, despite being only 3% of the population.</p>
<div class="ref-ar"><a href="https://stage.unherd.com/2019/08/the-truth-about-the-female-brain/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://stage.unherd.com/2019/08/the-truth-about-the-female-brain/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://stage.unherd.com/wp-content/uploads/2019/08/GettyImages-1143002529-1.jpg?w=300" /></a><div class="content"><a href="https://stage.unherd.com/2019/08/the-truth-about-the-female-brain/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">More from this author</span></a><a href="https://stage.unherd.com/2019/08/the-truth-about-the-female-brain/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>The truth about the female brain</h5></a><p class="author"><a href="https://stage.unherd.com/2019/08/the-truth-about-the-female-brain/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Saloni Dattani</a></p></div></a></div>
<p>Crowded conditions within households <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.medrxiv.org/content/10.1101/2020.04.04.20053058v1%26amp;sa%3DD%26amp;ust%3D1589201908402000&amp;sa=D&amp;ust=1589201908427000&amp;usg=AFQjCNFX1ESB7gq0WeWMJRnOX7rFN-Aizw">exacerbate</a> the spread of the disease between family members and flatmates. In the UK, less than 2% of white British households live in <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.ethnicity-facts-figures.service.gov.uk/housing/housing-conditions/overcrowded-households/latest%2523by-ethnicity%26amp;sa%3DD%26amp;ust%3D1589201908403000&amp;sa=D&amp;ust=1589201908427000&amp;usg=AFQjCNGb8wAELVKKEFjkFpfFd1TjyNrdew">housing</a> with more residents than rooms, while that figure is 16%, 18% and 30% among black Africans, Pakistanis and Bangladeshis respectively.</p>
<p>On top of all these risk factors, ethnic minorities are also <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.ifs.org.uk/inequality/chapter/are-some-ethnic-groups-more-vulnerable-to-covid-19-than-others/%26amp;sa%3DD%26amp;ust%3D1589201908403000&amp;sa=D&amp;ust=1589201908428000&amp;usg=AFQjCNH9dZddlA-M2AjfCNJ_4lhZo_0sdg">overrepresented</a> in health and social care roles, which <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://m-almagro.github.io/Covid_and_Within_City_Inequality.pdf%26amp;sa%3DD%26amp;ust%3D1589201908403000&amp;sa=D&amp;ust=1589201908428000&amp;usg=AFQjCNGpgb_hmM2s6YOlU7cpvVPv18jX5Q">expose</a> them to even higher risks of infection, from people they are caring for. Essential workers and healthcare staff, who are often in contact with both infected individuals and the general public, can <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://infectiousmatter.com%26amp;sa%3DD%26amp;ust%3D1589201908404000&amp;sa=D&amp;ust=1589201908428000&amp;usg=AFQjCNHWqzCewzXqrJQ-9qMudHf5G_STmw">spread</a> the disease in the general population much <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.springer.com/gp/book/9783319508047%26amp;sa%3DD%26amp;ust%3D1589201908404000&amp;sa=D&amp;ust=1589201908428000&amp;usg=AFQjCNGxa9agqWssO6Kjo_peounLexyUIw">faster</a> than if everyone had the <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://przeworskilab.com/wp-content/uploads/Modeling-impact-of-essential-workers.pdf%26amp;sa%3DD%26amp;ust%3D1589201908404000&amp;sa=D&amp;ust=1589201908428000&amp;usg=AFQjCNEJb8SraVLhKbHTSCGGa_qzEcBV6g">same</a> average number of contacts.</p>
<p>By now, you might be wondering why I haven&#8217;t mentioned medical conditions as a possible cause of ethnic disparities in deaths. After all, some ethnic minority groups are more likely to suffer from obesity, diabetes and cardiac disease.</p>
<p>Last week, a large cohort study led by Ben Goldacre and Liam Smeeth was <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.medrxiv.org/content/10.1101/2020.05.06.20092999v1%26amp;sa%3DD%26amp;ust%3D1589201908404000&amp;sa=D&amp;ust=1589201908428000&amp;usg=AFQjCNHITh2YVrhWk6G5CzyY_cbMFLHA9g">published</a> online. By collecting detailed NHS medical data from a sample of 17 million adults, the researchers were able to estimate the effects of various medical conditions on the risk of dying from Covid-19.</p>
<p>The ethnic disparities in deaths are so considerable that they do not go away when researchers account for the level of deprivation in the areas where people live, or when researchers account for age, smoking status, obesity, diabetes, cardiac disease, respiratory disease or even all of these conditions together.</p>
<p>The data suggests that, when it comes to an individual&#8217;s risk of dying from Covid-19, being black is associated with approximately as much risk as having chronic respiratory disease, even after accounting for the medical risk factors people could have.</p>
<p>But don&#8217;t obesity, cardiac conditions and respiratory illnesses increase an individual&#8217;s risk of dying from the disease substantially? How could it be that these conditions don&#8217;t account for all the extra risk that black people face from dying of Covid-19?</p>
<p>The answer is that these risk factors are related, primarily, to a person&#8217;s risk of dying <em>once they have contracted the virus</em>. But ethnic minorities and the poor are more likely to be infected by the virus in the first place, so the risk of death is magnified.</p>
<p>The cause of this disparity in risk factors is not entirely clear, but one popular <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.medrxiv.org/content/10.1101/2020.04.24.20075838v1.full.pdf%26amp;sa%3DD%26amp;ust%3D1589201908406000&amp;sa=D&amp;ust=1589201908429000&amp;usg=AFQjCNFPAZ5CbE87AvO2bMR-EkyX8AU8nw">theory</a> is that black people are disproportionately at risk once they have the disease because they are more likely to have insufficient vitamin D. But this, too, is confounded by the fact that they were more likely to be infected to begin with.</p>
<div class="ref-ar"><a href="https://stage.unherd.com/2020/05/where-will-we-make-our-post-covid-home/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://stage.unherd.com/2020/05/where-will-we-make-our-post-covid-home/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://stage.unherd.com/wp-content/uploads/2020/05/GettyImages-112766530-e1588868526717.jpg?w=300" /></a><div class="content"><a href="https://stage.unherd.com/2020/05/where-will-we-make-our-post-covid-home/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested reading</span></a><a href="https://stage.unherd.com/2020/05/where-will-we-make-our-post-covid-home/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Will Covid spell the end of city life?</h5></a><p class="author"><a href="https://stage.unherd.com/2020/05/where-will-we-make-our-post-covid-home/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Barney Norris</a></p></div></a></div>
<p>So we would observe ethnic disparities in deaths if there were disparities in exposure, even if there were no differences in people&#8217;s likelihood of dying once they had been exposed to the virus. To study the latter risk, we would need to look at the chances of dying once infected (that is, the infection fatality rate) in different ethnic groups. This is information that we lack in Britain, and can only approximate, given the absence of mass-testing.</p>
<p>For now, the unfortunate reality is that the UK still lacks face-masks, mass-testing, central quarantining, PPE and many other measures that could have helped avert these localised outbreaks and can still help reduce their impact. As I <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://stage.unherd.com/2020/03/the-scientific-case-against-herd-immunity/%26amp;sa%3DD%26amp;ust%3D1589201908407000&amp;sa=D&amp;ust=1589201908430000&amp;usg=AFQjCNFcBatc6w0nv-BMT91hKAo7qfWBWQ">explained</a> in March, early action was urgent. It could have prevented the virus from reaching many vulnerable areas entirely, where transmission and deaths can flare up quickly, amplifying the risks for everyone.</p>
<p>There is no way to turn back time now, of course, but there are still lessons to be learnt, actions to be taken, in order to stamp out the virus as far as possible and prevent another wave of disease.</p>
<p>We can reduce the risks from working in essential services with <a href="https://www.google.com/url?q=https://www.google.com/url?q%3Dhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7134482/%26amp;sa%3DD%26amp;ust%3D1589201908407000&amp;sa=D&amp;ust=1589201908430000&amp;usg=AFQjCNHIaKn_u8KcROKLtt_Z_XCM3LqZxA">widespread PPE</a>, reduce the risks from poverty with targeted transfers, and reduce the risks from living in vulnerable neighbourhoods with face-masks. We can even limit the risks from living in crowded households by providing centralised quarantining, for anyone who tests positive and for people they have been in contact with, once the lockdown has reduced the number of infected people sufficiently.</p>
<p>Apart from these lessons, the experiences of the last few months should force us to take seriously the importance of protecting the vulnerable from preventable suffering. In the case of an infectious disease, it is suffering that can all too easily spiral out of control.</p>
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