Structural racism leading to stark health inequalities in London, report shows

Structural racism is leading to stark health inequalities among people from some ethnic backgrounds in London, according to a review by one of the UK’s top public health experts.

More than half (52%) of black children and almost three-quarters (70%) of Bangladeshi and Pakistani children are growing up in relative poverty after housing costs in London, compared with a quarter (26%) of white children.

And unemployment among young black people aged between 16 and 24 is more than double that of white people the same age, the paper states. Gypsy, Roma and Irish Traveller young people have the highest rate, at 40%.

The review, conducted by the UCL Institute of Health Equity (IHE) led by Prof Sir Michael Marmot, found that people who are repeatedly exposed to structural racism during their daily lives experience worse physical and mental health as a direct consequence. It also says the ethnic inequalities in poverty, housing and employment result in poorer health outcomes for these ethnic groups.

It concluded that these economic inequalities, which can be attributed to structural racism, lead to poorer health outcomes for minority groups in London, as they are less likely to have access to decent housing, nutritious meals and other factors that affect a person’s health outcomes.

Marmot, the director of the IHE and author of a seminal review into health inequalities in the UK in 2010, said structural racism “is a scar on society” and public health institutions are failing by not directly addressing the effects racism has on a person’s health.

“Social justice requires that we take the action necessary to deal with it. It is a profound injustice if the conditions for good health are unequally distributed, depending on ethnicity,” Marmot said. “Especially so, where that unequal distribution results from the evils of racism. Inequalities in the social determinants of health are storing up health problems for the future.”

He added: “Focusing on disease and healthcare services fails to address three impacts of racism on health. First, how racism directly damages health and wellbeing. Second, the reasons why some ethnic groups are more likely to be in poverty, experience poor housing, suffer in the educational and criminal justice system, be low paid and experience racism and poor employment prospects – all of which harm health. Third, it does not deal with racism that leads to worse experiences of healthcare and other services and worse outcomes as a result.”

Prof Kevin Fenton, a public health director for London and president of the Faculty of Public Health, said: “This new report shows clearly the devastating impact that structural racism continues to have on the health and wellbeing of Londoners in 2024.

“It adds to the growing body of work providing evidence on the persistent, pervasive and harmful impacts of structural racism, and why tackling these issues must be taken forward as a key public health issue.”

Fenton added: “It is time for us to learn the lessons of the Covid-19 pandemic, the murder of George Floyd and the recent race riots across the UK – that ingrained, structural racism continues to be a scourge on our society, directly impacting the lives of Britons even in a global city like London.

“The data on these racial inequalities in London – a multicultural urban centre – are stark, and we must learn lessons for other parts of the UK and carry forward recommendations to protect and improve the health of minority ethnic communities and ensure that everyone in our society is able to realise their full potential.”

Prof Habib Naqvi, the chief executive of the NHS Race and Health Observatory, said: “We know that racism is a challenge that transcends boundaries and borders, and whilst this report is for London, we hope it will have wider impact across the UK.

“Racism has deep historical roots. It is pervasive and it is embedded in the structure of our society. We find ourselves at a pertinent time in history; now is the time to wake up to the scale of inequality and remove the scourge of racism from our society and improve health for all.”