IT WAS predicted that Bangladesh could be hit the hardest by the COVID-19 outbreak for being one of the most densely populated countries with an inadequate public health structure. COVID-19 mortality and morbidity rates in Bangladesh are lower in comparison with some high-income countries such as the United Kingdom until now.
Bangladeshis living in the United Kingdom were impacted more during the pandemic surge as highlighted by the Public Health England in terms COVID-19 transmission, mortality and morbidity in March–May. The pandemic surge in the United Kingdom exacerbated the long-standing inequalities associated with housing challenges and poorer socio-economic circumstances which left the Bangladeshi community in a more vulnerable state. The infection occurred faster and left a greater impact on the people living in deprived areas, such as Tower Hamlets and Newham, in London where Bangladeshis are concentrated the most. The Public Health England’s analysis suggests that health inequality is the root cause for disproportionate impact on the Bangladeshi community. However, we argue that there are other factors that contributed to heath inequality and subsequent COVID-19 vulnerability such as overcrowded and substandard housing, inadequate access to outdoor spaces, over-dependence on public transport and other socio-cultural factors such as intergenerational household.
THE Public Health England’s report also highlighted the fact that people living in more deprived areas were more likely to die of COVID-19 than those in less deprived areas. The majority of British-Bangladeshi are Commonwealth immigrants and their descendants who are concentrated in post-industrial conurbations, with about a half of them living in London. In London, Bangladeshis are mostly concentrated in Tower Hamlets which has remained one of the most deprived boroughs since 2007, according to the Index of Multiple Deprivation 2009. Recently, European people with a Bangladeshi ancestry — Bangladeshis who have a dual citizenship with Italy, France, Germany etc — immigrated to these Bengali-populated deprived areas who might also have been infected disproportionately as they are significantly employed as taxi drivers and chauffeurs, sales and retail assistants and other lower-skill jobs with direct contact with the public.
Government figures show that 30 per cent of Bangladeshis in the United Kingdom were more likely to be overcrowded in contrast to 2 per cent of White British households. Nearly a half, 48 per cent, of legally overcrowded households in Britain are headed by an individual from an ethnic minority including Bangladeshi-origin people. Living in overcrowded housing also increases the risk of contracting COVID-19 because of the challenges of self-isolation and maintaining social distancing. This is especially true when attempting to shield vulnerable people within multi-generational households. As a report estimated that more than two million people aged over 55 years are also thought to live in houses that endanger their health or well-being while households which include someone over 75 years are disproportionately likely to be living in a non-decent home. In the case of individuals showing COVID-19 symptoms, it is likely that the ailing people cannot isolate themselves from the rest of the family for lack of room in the household.
Moreover, 12 per cent of Bangladeshis were more likely to have damp problems. People who are living with poor indoor ventilation in a shared or overcrowded accommodation are more at risk for COVID-19 transmission with deadly consequences since damp may contribute to diseases like asthma. The crisis in affordable housing has already driven people into poor quality homes across Britain. It makes hard for the Bangladeshi-origin people to own decent homes at affordable prices. Therefore, non-white people are more likely to live in private rented or social housing than white households.
Living in low-quality housing with poor insulation increases the risk of developing health conditions such as high blood pressure, heart diseases and pneumonia, which increase vulnerability to COVID-19. The same is true for houses with poor quality ventilation which can lead to respiratory problems. The lockdown has also increased the risk of disease transmission as social distancing rules are difficult to adhere to in crowded neighbourhoods, narrow staircase and footpaths as a significant number of Bangladeshis are living in high-rise buildings with no access to private gardens.
Inequality in health and well-being
NEIGHBOURHOOD characteristics also impact the vulnerability and resilience to COVID-19, in terms of access to green and open space, local services and amenities, and critical infrastructure. With recreational trips to the countryside having been discouraged and many indoor places having been closed, accessible green and open spaces have provided a critical function in terms of supporting physical and mental health and well-being during the lockdown. This includes parks, doorstep green spaces within developments, pocket parks, community gardens and allotments. However, the pandemic has highlighted inequalities in terms of access to them. During the lockdown, 12 per cent of the households in Great Britain had no access to a private or shared garden, rising to 21 per cent in London. Across England, black and ethnic minority people were nearly four times less likely than white people to have outdoor space at home, according to a report by the Office for National Statistics 2020 while, according to the Green Space Index, London falls well below the minimum standards of provision for parks and green spaces with Yorkshire and Humber, North West, North East and East Midlands also falling below the minimum. Within these regions, ethnic minorities in more deprived areas have lower access to safe and high quality green spaces.
Social forces, institutions, ideologies and policies have interacted over many decades to generate and reinforce inequities among specific ethnic groups, resulting in concentrations of the black and ethnic minority communities in more deprived areas. In addition to the increased likelihood of living in overcrowded housing with poor basic infrastructure, deprived areas often have higher levels of air, noise and light pollution, lower levels of green space, and greater exposure to the urban heat island effect. These factors undermine physical and mental health and resilience to disease. For example, the London Borough of Newham, where 78 per cent residents are black and ethnic minorities, including Bangladeshis, has high levels of multiple deprivations and overcrowding and has been disproportionately impacted by COVID-19.
Restrictions on public transport capacity have made it even harder to access shops, amenities and essential jobs, especially for low-income households without a car. This is particularly difficult in low-density and homogeneous housing estates.
The 2019 Housing Design Audit examined 142 new housing developments, and rated the majority as ‘mediocre’ or ‘poor’ in terms of walkability, car-dependence, street connectivity and access to amenities. Research by the Transport for New Homes similarly examined more than 20 major new developments, and found that many lacked good accessibility to local services by walking and cycling.
With the black and ethnic minorities over-represented as key workers, and more likely to rely on public transport, lack of accessibility by walking and cycling has increased vulnerability to COVID-19.
Mohammad Taufiqul Islam is principal planning officer, planning and regeneration, Nottingham City Council, Nottingham, United Kingdom. Farjana Islam has a PhD in urban studies, Heriot Watt University, Scotland.