Structural exclusion and health inequalities among British Muslims: dual erosion of institutional trust and community capital

British Muslims experience marked health inequalities rooted in discrimination, racialised policing, housing density and financial hardship. This study examines whether two proposed protective mechanisms—trust in public institutions and community-level social capital—mediate the relationship between structural exclusion and health, and whether religious observance and local belonging and connectedness operate in equivalent ways. Using 1,977 Muslim respondents (analytic sample 1,940) from the 2021 Evidence for Equality National Survey (EVENS), the largest dedicated UK survey of ethnic and religious minorities conducted during COVID-19, we estimate indirect effects of discrimination and material hardship on self-rated physical health through institutional trust, religious observance and local belonging and connectedness. Models are tested using methods appropriate to binary and ordinal items, with multiple imputation, complete-case checks, 5,000-draw bootstrap confidence intervals and multigroup comparison of Pakistani and Bangladeshi respondents. Discrimination has no direct effect on health once mediators are included; its association operates through eroded institutional trust and weakened local belonging and connectedness. Financial difficulty has both direct and indirect effects through the same anchors. Local belonging and connectedness carries more of the indirect effect than either institutional trust or religious observance. Religious observance is not eroded by discrimination, suggesting a partial buffer against racialised mistreatment, although it is weakened by material hardship. The dual-erosion pattern replicates across Pakistani and Bangladeshi subgroups. These findings show that structural exclusion damages British Muslim health by eroding both institutional confidence and community capital, with neighbourhood attachment as the dominant protective anchor. Cohesion and health-equity policy must address upstream exclusion alongside investment in local social infrastructure; institutional confidence-building alone is insufficient.