Are health outcomes fair across ethnic groups?

Black women are 3.7 times more likely to die in childbirth than white women — a disparity documented in MBRRACE-UK reports for over two decades that has not narrowed.^[1] The gap is not explained by socioeconomic factors alone: Black women at all income levels face elevated risk, and the evidence increasingly points to differential treatment within healthcare settings. Black people are detained under the Mental Health Act at approximately four times the rate of white people per million of population, a gap that has been growing;^[2] they are more likely to be detained via police or courts rather than clinical pathways and less likely to receive talking therapies. Pakistani-heritage people are 3.5 times, and Bangladeshi-heritage people 3.8 times, more likely to develop Type 2 diabetes than white British people.^[3] COVID-19 mortality in the first wave fell disproportionately on Black, Asian, and minority ethnic people even after adjusting for age, reflecting higher occupational exposure, worse housing, higher rates of underlying conditions, and worse outcomes when hospitalised.

These disparities are not explained by genetics or individual behaviour; they reflect structural differences in housing quality, employment, income, and access to care. The NHS Race and Health Observatory, established in 2020, has recommended mandatory ethnicity data collection at all healthcare touchpoints and culturally competent service redesign, but implementation has been slow and patchy.^[4] The populations most affected — Black, South Asian, and mixed-heritage communities — are also more likely to live in deprived areas with fewer GP surgeries per head, longer waits for specialist referrals, and less access to preventive services.