A Kingston University, London study has revealed that people from Black and Asian backgrounds were reluctant to test for Covid due to feelings of alienation and stigmatisation.
A lack of trust in agencies, such as the UK Government and the National Health Service (NHS), contributed to the reluctance to test for Covid. Socio-economic deprivation and lack of financial support to self-isolate influenced whether ethically diverse communities were to test for Covid.
The study was funded by the National Institute for Health Research (NIHR) and UK Research and Innovation (UKRI). The study was led by professors at Kingston University, the Royal Surrey NHS Foundation Trust and Brunel University, London.
Hesitancy to test for Covid
The professors identified and interviewed people from Black and Asian communities to find out how they engaged with the testing process and their reluctance to test for Covid, with hopes that the results can be used to influence policymakers in health care messaging.
The participants explained during the interview process that the media narrative in the early part of the pandemic that people from a Black and Asian background were more likely to catch and die from COVID-19, leaving them feeling stigmatised and alienated from their communities.
“Our participants told us that this narrative adopted by the media made them feel blamed and responsible for the spread of the virus. The prevailing narrative was that no one was getting COVID-19 except them, and this left them feeling isolated from society and in a sense they had to fight for and look after themselves,” Professor Tushna Vandrevala from Kingston University said.
She added it was dangerous that race and ethnicity were being highlighted as a risk factor when the broader issue was more related to poverty and socio-economic deprivation. “It’s really important to try and unpick the broader socio-economic determents of health. This study highlights the damage that can be done by consistently highlighting race as a risk factor, rather than consider issues of socio-economic deprivation,” she said.
How has the UK Government messaging impacted the testing process?
Furthermore, the participant’s reluctance to engage with the testing process was the COVID-19 UK government messaging, which they felt did not relate to them. “They didn’t feel protected and told us the guidance didn’t identify with their struggles as a migrant or someone from an ethnic community. COVID-19 was one of many struggles they have had to endure, alongside the economic pressures and having to previously flee from civil war – they felt that in comparison to their migrant history, the virus was small and inconsequential and this had huge implications on whether they engage with the testing process,” Professor Vandrevala said.
The pandemic also brought focus towards the sense of a historical mistrust in systems that should protect those from ethnic minority communities but failed to do so, according to Professor Vandrevala. “COVID-19 testing and the track and trace system wasn’t considered a mechanism to protect them, their families or communities but to monitor them. People from minoritised communities were frightened to seek help via the NHS, as they did not feel they would be treated fairly or equally to others,” she said.
The lack of financial support available
The participants interviewed between August and December 2020 also revealed the lack of financial support created a reluctance to test for Covid. “Their biggest concern was around financial viability and being able to feed their families. They were more concerned about the economic consequences of not providing for their families – losing their jobs rather than contracting Covid-19. The testing system, with its lack of financial support to self-isolate, did not take into account the economic struggles of being a migrant and from a marginalised community. All people who lacked the economic means to self-isolate irrespective of their ethnicity faced similar barriers to testing. People will not engage in testing if they do not have the economic means to isolate,” Professor Vandrevala said.
The few participants who revealed they did test for Covid said they did not do it for themselves but to protect their family members, and Professor Vandrevala said future healthcare messaging should highlight how testing is to protect others – particularly given the discovery of a new variant. “These issues remain salient as we grapple with the changing reality of the new Omicron variant and the continued need to engage in testing.
“Many people from ethnically diverse communities live in multi-generational homes and told us they didn’t want to infect their communities – they were more concerned about their neighbours and their families than themselves. Illness is stigmatised in ethnic communities and has cultural implications and therefore there needs to be better education around the symptoms people need to be concerned with, along with the material support for those having to self-isolate,” she said.