BAME Population Intelligence Pack
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West Yorkshire and Harrogate Intelligence and Insight Pack Addressing Inequalities for BAME staff and communities Version 1.0 15.07.20 Overview This pack provides a summary of intelligence published to date regarding inequalities related to ethnicity for the population of West Yorkshire and Harrogate and also the staff that work for the West Yorkshire and Harrogate Health and Care Partnership. This information will inform a review into health inequalities that Contents Page the West Yorkshire and Harrogate Health and Care Partnership is Population Intelligence 3 undertaking between July and September 2020 LINK Population Insight 13 This pack contains: Staff Intelligence and Insight 21 • Intelligence data on population demographics, coding of ethnicity and disproportionate impacts of COVID. • Insight from BAME population groups related to health and wellbeing. • Intelligence and insight for inequalities for BAME staff. This pack will be developed iteratively and will be added to during the review as new data and insight becomes available. Version Control Version 1.0 15.07.2020 Population Intelligence related to BAME Communities Intelligence • This sections covers available intelligence to date in the following areas: • Population Demographics for ethnicity • Recording of ethnicity data in healthcare settings • Intelligence related to impact of COVID-19 for BAME communities • We will couple this intelligence with emerging insight to focus our efforts to reduce Health Inequalities. • This section highlights the need for additional intelligence and improved coding of ethnicity in order for us to better understand health inequalities faced by BAME communities in West Yorkshire and Harrogate. Demographics – Population for local West Yorkshire and Harrogate (WY&H) by ethnic group: 2016 This data shows based on estimates from the 2011 Black / Mixed / census for WY&H All Asian / African / Other White Multiple Other Asian Caribbean ethnic Residents. British ethnic White British / Black group groups British Between the places in West Yorkshire WY&H there is variation in 80.4 4.1 1.6 11 1.8 1.1 and Harrogate proportions of Black, Asian Craven 96.4 3.6 0 0 0 N/A and Minority Ethnic (BAME) population groups. Harrogate 90.1 5.6 0.6 1.9 0.6 1.2 Bradford 68.8 5.6 1.1 22.6 1.1 0.8 Overall in WY&H 19.6% of residents are from a BAME Calderdale 89 2.9 1 6.2 0.5 0.5 background. Leeds 81.5 3.8 2.7 6.8 3.1 2.1 Kirklees 75.9 2.8 1.6 17 2.1 0.6 Bradford has the highest proportion of BAME Wakefield 89 4.2 1.2 4.2 0.9 0.5 groups (31.2%) and Craven has the lowest (3.6%). Annual Population Survey (which is the Labour Force Survey plus various sample boosts), the mid-year population estimates and 2011 Census. ONS LINK TO DATA Population Distribution by ethnicity for West Yorkshire and Harrogate Harrogate Bradford Leeds Halifax UK Census Data one dot per person Huddersfield Wakefield Ethnicity for School Pupils in West Yorkshire and Harrogate Pupil Characteristics - Ethnicity for West Yorkshire Schools 2019/20 (percentage) Bradford Calderdale Kirklees Leeds Wakefield Any other ethnic group 1.5 0.5 1.2 1.9 0.8 The annual census of children in schools is another source for Asian - Any other Asian background 1.2 1.1 1.8 2.2 0.4 understanding the ethnicity of Asian - Bangladeshi 3.3 0.4 0.3 1.2 0.0 residents across the system. Asian - Indian 2.0 1.4 6.0 2.4 0.4 Asian - Pakistani 36.5 14.6 19.8 6.5 3.3 In 2019/20 the percentage of Black - Any other Black background 0.2 0.2 0.3 1.1 0.3 BAME children in school across West Yorkshire ranges from 57.9% 1.3 0.6 1.2 5.8 1.3 Black - Black African in Bradford to 15.6% in Wakefield. Black - Black Caribbean 0.2 0.2 0.5 0.7 0.0 Chinese 0.1 0.2 0.3 0.6 0.3 After White British, the next Mixed - Any other Mixed background 2.0 1.2 1.5 2.3 1.2 highest ethnic group in West Mixed - White and Asian 2.4 1.5 2.1 1.6 1.0 Yorkshire schools is Asian – Pakistani ,followed by Other Mixed - White and Black African 0.4 0.4 0.6 1.0 0.6 White. Mixed - White and Black Caribbean 1.2 1.2 2.8 1.9 0.6 Unclassified 1.2 0.6 1.2 1.4 1.0 When looking at previous years’ White - Any other White background 4.2 2.3 2.8 5.2 5.2 data the proportion of BAME pupils in West Yorkshire Schools White - Gypsy/Roma 1.1 0.4 0.1 1.0 0.1 has increased from 36% in White - Irish 0.1 0.1 0.1 0.2 0.1 2015/16 to 39% in 2019/20. White - Traveller of Irish heritage 0.0 0.0 0.0 0.1 0.1 White - White British 40.9 73.1 57.6 63.2 83.4 LINK TO DATA Recording of Ethnicity Primary Care • This chart shows improvements in • Coding of ethnicity is extremely important. ethnicity coding in For us to understand health inequalities for general practice for BAME communities we require good coding Leeds GPs. of ethnicity across all health and care • Gaps in “Unknown or settings. If ethnicity is not coded we are not Not Recorded” data able to adequately understand differences in has reduced from risk factors for ill health, disease prevalence 22% in January 2013 or mortality. Understanding these differences to 6% in January in wellbeing and access to care helps us to 2020. take the first steps in understanding health • This reduced gap inequalities at a population level. allows for • A recent inequality report into elective hip opportunities for surgery in West Yorkshire and Harrogate much improved found that ethnicity was only reported in understanding of 80% of these procedures. This is also inequalities with reflected in recent figures for cardiac and ethnicity and pulmonary rehabilitation figures in Leeds disease prevalence Teaching Hospitals. We would like to do or long term more to fully understand gaps in recording condition ethnicity across West Yorkshire and management to Harrogate and how we can work with care LINK to DATA target improvements providers to improve this. in preventative care. COVID-19: Diagnosis Rates and Outcomes by Ethnicity In England the highest age standardised diagnosis rates of COVID-19 per 100,000 population were in people of Black ethnic groups (486 in females and 649 in males) and the lowest were in people of White ethnic Age standardised diagnosis rates by ethnicity and sex, as of 13 May 2020, England, Source groups (220 in females and 224 in males). Public Health England Second Generation Surveillance System. After accounting for the effect of sex, age, deprivation and region, people of Bangladeshi ethnicity had around twice the risk of death when compared to people of White British ethnicity. People of Chinese, Indian, Pakistani, Other Asian, Caribbean and Other Black ethnicity had between 10 and 50% higher risk of death when compared to White British LINK TO REPORT Age standardised mortality rates in laboratory confirmed COVID-19 cases by ethnicity and sex, as of 13 May, England. Source: Public Health England: COVID-19 Specific Mortality Surveillance System COVID-19 Comorbidities and Ethnicity in England High Blood Pressure The proportion of COVID-19 deaths where hypertensive disease is mentioned ranged from 17% in the White ethnic group to 40% in the Black group but is also high in the Asian and Mixed groups Diabetes Diabetes was mentioned on 21% of death certificates where COVID-19 was also mentioned. The percentage was higher in all BAME groups. The proportion of COVID-19 deaths where diabetes is mentioned ranged from 18% Percentage of COVID-19 deaths where hypertensive disease was also mentioned in the White ethnic group, 43% in the on the death certificate, by broad ethnic group, 21 March to 1 May 2020, England. Asian group to 45% in the Black group. Source: Public Health England analysis of ONS death registration data LINK TO REPORT All Cause Mortality in England by Ethnicity When considering the impact at a population level it is important to consider all cause mortality as this can take into account the wider impacts of COVID-19 on health outcomes. Comparing to previous years, all cause mortality was almost 4 times higher than expected among Black males for this period, almost 3 times higher in Asian males and almost 2 times higher in White males. Among females, deaths were almost 3 times higher in this period in Black, Mixed and Other females, and 2.4 times higher in Asian females compared with 1.6 times in White females. These analyses did not include the effect of occupation, comorbidities or obesity which are important factors because they may by associated with the risk of death and may disproportionately impact some BAME groups. LINK TO REPORT Age-standardised mortality rates for all cause deaths and deaths mentioning COVID-19, 21 March to 1 May 2020, compared with baseline mortality rates (2014 to 2018), by ethnicity and sex, England. Source: Public Health England analysis of ONS death registration data Ethnicity and COVID-19 cases and deaths in Bradford district In April 2020 Bradford Institute for Health Research analysed data on positive COVID-19 tests by ethnicity and subsequent outcomes. Data showed that South Asians were overrepresented among those testing positive proportionate to their representation in Bradford District's population.