Ethnic minorities, income inequalities and the COVID-19 pandemic: evidence from English local councils

Figures & data

Figure 1. Causal path diagram for excess mortality in terms of ethnic minorities, income inequality and other variables.

Table 1. Descriptive statistics for the 310 local councils analysed and for subgroups of high- and low-income unequal council.

	All local councils			Low-income inequality local councils			High-income inequality local councils
	Mean	Median	SD	Mean	Median	SD	Mean	Median	SD
	(N = 310)			(N = 155)			(N = 155)
EXCESS_MORT (ratio of the population)	1.28	1.27	0.12	1.24	1.24	0.10	1.31	1.28	0.13
COVID19_RATE (% of the population)	0.86	0.81	0.33	0.95	0.95	0.37	0.78	0.74	0.25
%BAME (% of the population)	12.76	6.56	14.05	8.45	4.76	9.23	17.08	10.88	16.53
INC_INEQ (normalized Gini index)	0.33	0.29	0.18	0.19	0.21	0.07	0.46	0.43	0.13
%LEAST_DEP (% of the population)	15.73	10.59	15.57	21.36	18.12	15.96	10.10	4.91	12.96
%MOST_DEP (% of the population)	21.94	18.74	15.85	15.16	13.76	10.61	28.71	27.96	17.29
%AGED65+ (% of population)	19.67	19.65	4.75	20.84	20.40	4.06	18.51	18.79	5.11
LIFE_EXP (years)	20.25	20.31	0.96	19.75	19.74	0.82	20.76	20.79	0.80
HOSP_BUSYNESS (% of critical care beds)	79.37	81.24	12.22	78.36	80.07	12.79	80.39	82.01	11.59
HOSP_MORT (ratio of the population)	1.00	1.01	0.08	1.03	1.03	0.06	0.98	0.99	0.09
HOSP_CANCEL (no. of cancellations)	2.42	0.00	6.28	2.01	0.00	5.91	2.84	0.00	6.62
DENSITY (population/km^2)	1847.60	743.49	2675.27	1250.65	796.13	1233.87	2444.54	632.95	3481.49
REG_COVID19_RATE (% of the population)	0.90	0.80	0.22	0.97	0.99	0.25	0.83	0.77	0.17
JOB_INEQ (% of the population)	17.66	16.25	11.27	11.07	9.80	7.13	24.25	23.50	10.80
%WHITE_BRIT (% of the population)	81.69	88.45	17.52	87.93	91.53	10.24	75.45	83.43	20.80

Note: See Appendix A in the supplemental data online for variables definitions.

Figures in bold indicate statistically significant differences in means and medians at least at the 5% level between councils with high- or low-income inequality.

Figure 2. Excess mortality and percentage of BAME in English local councils.

Table 2. Pearson’s correlation coefficients.

		1	2	3	4	5	6	7	8	9	10	11	12	13	14	15
1	EXCESS_MORT	1
2	COVID19_RATE	0.279*	1
3	%BAME	0.602*	0.140*	1
4	INC_INEQ	0.429*	−0.312*	0.423*	1
5	%LEAST_DEP	0.065	−0.193*	−0.282*	0.389*	1
6	%MOST_DEP	0.098	0.455*	0.309*	−0.341*	−0.628*	1
7	%AGED65+	−0.516*	−0.199*	−0.771*	−0.332*	0.166*	−0.389*	1
8	LIFE_EXP	0.151*	−0.509*	0.007	0.637*	0.594*	−0.730*	0.218*	1
9	HOSP_BUSYNESS	0.185*	−0.085	0.166*	0.147*	0.026	0.033	−0.214*	−0.011	1
10	HOSP_MORT	−0.407*	0.188*	−0.422*	−0.521*	−0.163*	0.150*	0.346*	−0.432*	−0.016	1
11	HOSP_CANCEL	0.003	−0.064	−0.019	0.035	0.088	−0.071	0.040	0.139*	−0.309*	−0.121*	1
12	DENSITY	0.475*	−0.032	0.743*	0.488*	−0.322*	0.373*	−0.706*	0.012	0.218*	−0.495*	0.025	1
13	REG_COVID19_RATE	0.042	0.583*	−0.133*	−0.350*	−0.071	0.392*	0.030	−0.491*	−0.097	0.252*	−0.129*	−0.160*	1
14	JOB_INEQ	0.222*	−0.285*	0.118*	0.711*	0.515*	−0.450*	−0.102	0.628*	0.086	−0.452*	0.126*	0.201*	−0.309*	1
15	%WHITE_BRIT	−0.606*	−0.070	−0.973*	−0.519*	0.245*	−0.259*	0.792*	−0.097	−0.163*	0.510*	−0.001	−0.815*	0.197*	−0.219*	1

Note: See Appendix A in the supplemental data online for variables definitions.

*Significant correlation at least at the 5% level.

Table 3. Main results.

	Effect of %BAME	Effect of INC_INEQ	Effects of %BAME and INC_INEQ	Interaction effect of %BAME and INC_INEQ
	Model 1	Model 2	Model 3	Model 4
Direct effects
COVID19_RATE	0.170***	0.274***	0.202***	0.188***
%BAME	0.003***		0.003***	0.000
INC_INEQ		0.170***	0.118**	0.005
%BAME × INC_INEQ				0.007***
%LEAST_DEP	0.001	−0.001**	0.000	0.001
%MOST_DEP	0.000	0.000	0.000	0.000
%AGED65+	−0.004**	−0.008***	−0.003	−0.002
LIFE_EXP	0.041***	0.050***	0.033***	0.022*
HOSP_BUSYNESS	0.001***	0.002***	0.001***	0.001***
HOSP_MORT	−0.203***	−0.210***	−0.193***	−0.134*
HOSP_CANCEL	0.000	0.001	0.001	0.000
Constant	0.415	0.240	0.522*	0.678**
Indirect effects
%BAME	0.009***	0.010***	0.009***	0.010***
INC_INEQ	−0.292**	−0.375***	−0.320***	−0.310**
%LEAST_DEP	0.002	0.002*	0.002	0.002
%MOST_DEP	0.005***	0.005***	0.005***	0.005***
DENSITY	−0.001***	−0.001***	−0.001***	−0.001***
REG_COVID19_RATE	0.666***	0.639***	0.663***	0.656***
Constant	0.173**	0.201***	0.180**	0.184**
Observations	310	310	310	310
R^2 direct effect	0.540	0.470	0.536	0.560
R^2 indirect effect	0.473	0.473	0.473	0.474
Overall R^2	0.737	0.734	0.742	0.751

Note: See Appendix A in the supplemental data online for variables definitions.

***, ** and *Statistical significance at the 1%, 5% and 10% levels, respectively.

Table 4. Additional analysis. Income deprivation and the relationship between COVID-19 excess mortality and ethnic minorities.

	Effect of %BAME	Effects of %LEAST_DEP and %MOST_DEP	Effects of %BAME, %LEAST_DEP and %MOST_DEP	Interaction effect of %BAME and %LEAST_DEP	Interaction effect of %BAME and %MOST_DEP
	Model 1	Model 2	Model 3	Model 4	Model 5
Direct effects
COVID19_RATE	0.205***	0.274***	0.202***	0.199***	0.198***
%BAME	0.002***		0.003***	0.003***	0.003***
INC_INEQ	0.121***	0.170***	0.118**	0.120**	0.120**
%LEAST_DEP		−0.001**	0.000	0.001*	0.000
%MOST_DEP		0.000	0.000	0.000	0.000
%BAME × %LEAST_DEP				−0.000***
%BAME × %MOST_DEP					0.000
%AGED65+	−0.004**	−0.008***	−0.003	−0.005**	−0.003
LIFE_EXP	0.036***	0.050***	0.033***	0.035***	0.032***
HOSP_BUSYNESS	0.001***	0.002***	0.001***	0.001***	0.001***
HOSP_MORT	−0.191***	−0.210***	−0.193***	−0.204***	−0.191**
HOSP_CANCEL	0.001	0.001	0.001	0.001	0.001
Constant	0.460**	0.240	0.522*	0.517**	0.519*
Indirect effects
%BAME	0.009***	0.010***	0.009***	0.009***	0.009***
INC_INEQ	−0.324***	−0.375***	−0.320***	−0.317***	−0.320***
%LEAST_DEP	0.002	0.002*	0.002	0.002	0.002
%MOST_DEP	0.005***	0.005***	0.005***	0.005***	0.005***
DENSITY	−0.001***	−0.001***	−0.001***	−0.001***	−0.001***
REG_COVID19_RATE	0.664***	0.639***	0.663***	0.661***	0.663***
Constant	0.180**	0.201***	0.180**	0.182**	0.181**
Observation	310	310	310	310	310
R^2 direct effect	0.535	0.484	0.536	0.568	0.537
R^2 indirect effect	0.473	0.472	0.473	0.474	0.473
Overall R^2	0.742	0.730	0.742	0.755	0.742

Note: See Appendix A in the supplemental data online for variables definitions.

***, ** and *Statistical significance at the 1%, 5% and 10% levels, respectively.

Table 5. Additional analysis: job inequality and the relationship between COVID-19 excess mortality and ethnic minorities.

	Effect of %BAME	Effect of JOB_INEQ	Effects of %BAME and JOB_INEQ	Interaction effect of %BAME and JOB_INEQ
	Model 1	Model 2	Model 3	Model 4
Direct effects
COVID19_RATE	0.185***	0.254***	0.183***	0.178***
%BAME	0.003***		0.003***	0.002**
JOB_INEQ		0.000	0.000	−0.002**
%BAME × JOB_INEQ				0.000***
%LEAST_DEP	0.000	−0.001	0.001	0.001*
%MOST_DEP	0.000	0.000	0.000	0.000
%AGED65+	−0.005**	−0.011***	−0.005**	−0.003
LIFE_EXP	0.043***	0.070***	0.044***	0.033***
HOSP_BUSYNESS	0.001***	0.002***	0.001***	0.001***
HOSP_MORT	−0.205***	−0.238***	−0.210***	−0.163**
HOSP_CANCEL	0.001	0.001	0.001	0.001
Constant	0.388	−0.008	0.376	0.524**
Indirect effects
%BAME	0.008***	0.009***	0.008***	0.008***
JOB_INEQ	0.000	0.000	0.000	0.000
%LEAST_DEP	0.000	0.001	0.000	0.000
%MOST_DEP	0.006***	0.006***	0.006***	0.006***
DENSITY	−0.001***	−0.001***	−0.001***	−0.001***
REG_COVID19_RATE	0.690***	0.682***	0.691***	0.684***
Constant	0.103	0.105	0.102	0.105
Observations	310	310	310	310
R^2 direct effect	0.537	0.479	0.538	0.549
R^2 indirect effect	0.463	0.462	0.463	0.463
Overall R^2	0.732	0.720	0.732	0.739

Note: See Appendix A in the supplemental data online for variables definitions.

***, ** and *Statistical significance at the 1%, 5% and 10% levels, respectively.

Table 6. Additional analysis: ethnic minorities are estimated as the proportion of the population that has White British ethnicity.

	Effect of %WHITE_BRIT	Effect of INC_INEQ	Effects of %WHITE_BRIT and INC_INEQ	Interaction effect of %WHITE_BRIT and INC_INEQ
	Model 1	Model 2	Model 3	Model 4
Direct effects
COVID19_RATE	0.173***	0.255***	0.203***	0.203***
%WHITE_BRIT	−0.003***		−0.002***	−0.001
INC_INEQ		0.166***	0.109**	0.390***
%WHITE_BRIT × INC_INEQ				−0.004**
%LEAST_DEP	0.001	−0.001**	0.000	0.001
%MOST_DEP	0.000	0.000	0.000	0.000
%AGED65+	−0.003	−0.008***	−0.003	−0.003
LIFE_EXP	0.035***	0.049***	0.030**	0.023*
HOSP_BUSYNESS	0.001***	0.002***	0.001***	0.001***
HOSP_MORT	−0.172**	−0.205***	−0.171**	−0.120
HOSP_CANCEL	0.000	0.001	0.001	0.001
Constant	0.754**	0.277	0.754**	0.724**
Indirect effects
%WHITE_BRIT	−0.009***	−0.010***	−0.009***	−0.010***
INC_INEQ	−0.374***	−0.441***	−0.399***	−0.394***
%LEAST_DEP	0.002	0.002*	0.002*	0.002*
%MOST_DEP	0.006***	0.005***	0.005***	0.006***
DENSITY	−0.001***	−0.001***	−0.001***	−0.001***
REG_COVID19_RATE	0.680***	0.666***	0.677***	0.670***
Constant	1.093***	1.154***	1.102***	1.120***
Observations	310	310	310	310
R^2 direct effect	0.534	0.489	0.529	0.537
R^2 indirect effect	0.481	0.480	0.481	0.481
Overall R^2	0.737	0.735	0.741	0.745

Note: See Appendix A in the supplemental data online for variables definitions.

***, ** and *Statistical significance at the 1%, 5% and 10%S levels, respectively.