5 years later: insights from COVID-19 and the importance of intersectionality in addressing health inequalities

The health impacts of the COVID-19 pandemic disproportionately impacted minorities and other minoritised groups in the UK, underscoring historical trends of social injustices. These health effects were felt by members of minoritised ethnic groups regardless of social or economic status. In this context, the combined impacts of disenfranchisement and discrimination accentuate health risks for members of these groups. These risks are worsened by structural racism, which frames vulnerability as linked to race instead of the effects of racism. This narrative has resulted in inadequate treatment pathways and unreliable data monitoring. In this paper, we discuss the impacts of discriminatory and racist practices in the UK, focusing on their role in perpetuating health injustices. We also present a few international examples to illustrate the widespread nature and harms of these discriminatory and racist practices, with a particular focus on the impacts and implications of the COVID-19 pandemic. We argue that, from an intersectional perspective, addressing systemic injustices requires comprehensive restructuring of health and social institutions. Our goal in doing so is twofold: first, to draw attention to the ways that the COVID-19 pandemic has highlighted and exacerbated existing racist health injustices and second, to propose an intersectional educational framework for students, practitioners and policymakers as one component of a response to these injustices. We argue that such a framework is vital in enabling practitioners, healthcare leaders and policymakers to appreciate the multiple layers and interconnecting impacts of social, economic and structural inequalities within healthcare to enable reform to improve patient outcomes for ethnic minorities. Education on this intersectionality is thus necessary to reduce the harmful impacts of discriminatory practitioner, leaders and managers’ attitudes, and prompt the development of personalised treatment which responds to individual health needs, rather than erroneous assumptions based on prejudiced stereotypes and racist clichés. Such efforts must fully recognise and address the role of systemic racism and other forms of discrimination to mitigate health disparities effectively.