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‘COVID-19: review of disparities in risks and outcomes’ report

In March 2020, the World Health Organization (WHO) declared the outbreak of COVID-19, an infectious disease caused by a novel coronavirus, a pandemic. Early evidence on the disease suggested that some people were at greater risk of worse clinical outcomes, including older and disabled people. 

There had been longstanding health inequalities in the UK before the COVID-19 pandemic. In May 2020, government announced that Public Health England (PHE), the government agency responsible for health protection and improving population health, would conduct a rapid review of how different factors impacted people’s COVID-19 risk and outcomes. It would also look at the impact of occupation on the outcome of COVID-19 infections, initially focusing on doctors and nurses. 

Disparities in risks and outcomes from COVID-19

On 2 June 2020, PHE published its review. The report concluded that existing health inequalities had been replicated and exacerbated by the pandemic. PHE found disparities in outcomes after contracting COVID-19 according to age, gender, deprivation, ethnicity and occupation. Older people, men, people living in more deprived areas, people from minority ethnic backgrounds and workers in caring occupations were also at higher risk of dying due to COVID-19. The analysis took into account age, sex, deprivation, region and ethnicity but not comorbidities.

The review recommended that health inequalities be addressed to limit the spread of COVID-19 and that guidance and policies should be adapted to mitigate the impact of the virus on more vulnerable population groups.

The review was published soon after the murder of George Floyd in the United States, which led to protests against racism across the world, including in the UK. When asked to make a statement on PHE’s review, Minister for Equalities Kemi Badenoch responded that she was ‘profoundly disturbed by the brutal murder of George Floyd at the hands of the police’. She stated that ‘we must work together to improve the lives of people from black and minority ethnic communities. It is in that spirit that we approach the assessment of the impact of covid-19 on ethnic minorities.’

Later developments

On 16 June 2020, PHE published a second report on COVID-19 and black and minority ethnic groups, entitled ‘Beyond the data: Understanding the impact of COVID-19 on BAME groups’. This included a literature review and findings from stakeholder engagement. The report made several recommendations for policy and practice, including that ‘COVID-19 recovery strategies actively reduce inequalities caused by the wider determinants of health to create long-term sustainable change.’

Following the publication of the review, the Prime Minister Boris Johnson and the Secretary of State for Health and Social Care Matt Hancock requested that the Minister for Equalities Kemi Badenoch pursue cross-government work in this area.

Supported by the Race Disparity Unit within the Cabinet Office, the Government Equalities Office published four quarterly reports (between October 2020 and December 2021) on the government’s progress in addressing COVID-19 health inequalities. It reported on research into the causes of the disparities and measures to improve public health communications about COVID-19 vaccines, such as the Community Champions programme. They also described efforts to improve vaccination uptake among people from ethnic minority backgrounds.


Public Health England.
COVID-19: review of disparities in risks and outcomes.
gov.uk; 2020. 

House of Commons.
Public Health England Review; Covid-19 Disparities. Volume 676 debated on Thursday 4 June 2020.
Hansard; 2022.

Race Disparity Unit, Government Equalities Office, Equality Hub.
Quarterly reports on progress to address COVID-19 health inequalities [webpage].
gov.uk; 2021. 

Institute for Health Equity.
Health Equity in England: The Marmot review 10 years on.
Health Foundation; 2020. 

European Centre for Disease Prevention and Control.
Coronavirus disease 2019 (COVID-19) in the EU/EEA and the UK – eighth update.
European Centre for Disease Prevention and Control; 2020. 

Public Health England.
Review into factors impacting health outcomes from COVID-19 [webpage].
gov.uk; 2020.