Covid-19 race disparities: Multigenerational households may partly explain why Bangladeshi and Pakistani communities were disproportionately affected in the UK’s second wave

People in the UK of Bangladeshi or Pakistani heritage are more likely to live in households that include schoolchildren and people aged 70 or older – a factor that may explain why people from these backgrounds were more likely to die from covid-19 during the country’s second wave


3 December 2021

Vaccinations taking place at Derby's Pakistani Community Centre in April, 2021

Vaccinations taking place at Derby’s Pakistani Community Centre in April, 2021

Nathan Stirk/Getty Images

People of Bangladeshi and Pakistani heritage in the UK were more likely to become infected with the coronavirus and die from covid-19 during the country’s second wave, in part because they are more likely to live in multigenerational households. The findings suggest that infections caught in schools may have a disproportionate impact on some ethnic minority groups.

The new data, published today in a UK government report on ethnic health inequalities during the pandemic, suggests that people of Bangladeshi heritage in England and Wales over the age of 65 were three times more likely to have caught the coronavirus between 12 September 2020 and 31 March 2021 than white people in the same age group. People of Pakistani heritage over the age of 65 were 2.5 times more likely to be infected than white over-65s in this period.

People of Bangladeshi and Pakistani heritage in England and Wales, of all ages, died from covid-19 at a 5 times and 4.1 times higher rate, respectively, than white people during the second wave.

“When looking at the second wave, there’s a clear gradient in which ethnic groups were worst affected with what percentage of those groups live in multigenerational households,” says the report’s lead author Raghib Ali. “With Bangladeshis the worst off, then Pakistanis, then Indians and then Black Africans.”

A multigenerational household is defined as one that contains at least one person aged 19 or under, at least one between the ages of 20 and 69, and at least one who is 70 or older. About 56 per cent of households of Bangladeshi heritage in the UK are multigenerational, whereas only about 1.5 per cent of white households are. Around 35 per cent of households of Pakistani heritage are multigenerational.

Living in a multigenerational household appears to have had only a relatively small impact during the UK’s first pandemic wave. “But now we know that this was probably due to schools being closed,” says Ali. In the first wave of the pandemic, schools in England switched to mostly remote learning in March 2020 and didn’t fully reopen until September. In-person school attendance then went down again in England in December 2020, with most children doing remote learning until March 2021. This meant that most children attended schools for several months of the second wave, but not the first.

Yize Wan at Queen Mary University of London says there are many reasons why living in a multigenerational household increases the impact of covid-19. “For example, there is an increased transmission in enclosed spaces, difficulty in being able to self-isolate, as well as increased transmission to individuals who may carry greater risk due to age and other chronic health conditions,” she says.

Until recently, there has been a lack of data on multigenerational living, says Ali. “We now have data that shows that multigenerational households suffer the worst from influenza too,” he says. “But this data only came out in the last year.”

Another issue is that early pandemic decisions were based on census data from 2011, says Ali. “This meant families who had children afterwards and also lived with an older relative were not considered multigenerational.”

Ali says it is difficult to know what could have been done differently during the second wave to protect multigenerational households. “I don’t think a targeted approach to sending children back to school would have worked,” says Azeem Majeed at Imperial College London. “This would have excluded children from minority groups from education, which has its own adverse consequences. More could have been done by the government to reduce infection risk in schools.”

Renee Luthra at Essex University in the UK says in hindsight perhaps a more targeted vaccine approach would have been more effective. “Accelerating vaccine access for school age children who live with vulnerable household members would be one such possibility,” she says.

“Particularly with the new omicron variant, decision makers must urgently act to mitigate the risks facing Black and ethnic minority communities by committing to a fully funded cross departmental strategy to reduce health inequalities,” says a spokesperson for race equality charity Runnymede Trust.

“Our priority throughout the pandemic, in line with scientific and expert advice, has been for children to be in face-to-face education as much as possible, as it is the best place for their development and wellbeing,” a Department for Education spokesperson told New Scientist. “We have made sure that a balance of protective measures has been in place throughout to reduce the risks from the virus, including to different ethnic and racial groups, while also reducing the harm caused by children missing out on face-to-face education.”

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