Intended for healthcare professionals


Playing hide and seek with structural racism

BMJ 2021; 373 doi: (Published 21 April 2021) Cite this as: BMJ 2021;373:n988
  1. Dipesh P Gopal, NIHR in-practice fellow in primary care1,
  2. Mala Rao, director2
  1. 1Institute of Population Health Sciences, Queen Mary University of London, London, UK
  2. 2Ethnicity and Health Unit, Department of Primary Care and Public Health, Imperial College London, London, UK
  3. Correspondence to: D P Gopal

A key contributor to ethnic disparities in health

The much anticipated report from the Commission on Race and Ethnic Disparities1 has generated controversy. The commission was established by the UK government after the Black Lives Matter protests in 2020 to explore the “state of race relations today” and “why so many disparities persist.” In particular, the commission was to investigate ethnic differences in education, employment, crime and policing, and health.

Despite confirming that racism “is a real force in the UK,” the report’s overall findings were widely condemned, with leaders and experts united in their concern that the report minimises and sometimes even rejects the key role of structural racism in theinequalities endured by ethnic minority people in the UK.

The 34 page chapter on health compares ethnic minority and white people on a wide range of outcomes. It examines differences in life expectancy, behavioural risk factors, genetics, and access to health. It rightly identifies that risk factors for health outcomes may include behaviours that in theory are modifiable by individuals but are also influenced by “socio-economic factors which can …

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