The Cost of Racism: How ethnic health inequalities are standing in the way of growth
This briefing considers the benefits of taking an economic approach to assess the costs of racial discrimination to the NHS, individuals and to the economy. It explores a broad array of ethnic inequalities in healthcare which lead to excessive and avoidable costs and reduce efficiency in the economy.
The review proposes taking an economic approach to estimating the cost of racism, similar to ‘Cost of Illness’ and ‘Burden of Disease’ studies, to quantify the monetary value to individuals, the NHS, and society – of the impact of racism in health and healthcare. This could include measuring direct costs of treatment or the lack of treatment; indirect costs of reduced productivity in the economy; and costs to individuals and employers because of work-related mental health issues and absences due to discrimination.
Drawing insights from a rapid review of existing UK and international research, the review highlights several key reports which have sought to quantify inequalities in healthcare. These include the Black Report (1980), and a 2016 paper from the University of York’s Centre for Health Economics. Other studies are also cited, providing snapshots that illustrate significant economic losses, often amounting to billions of pounds due to disparities in healthcare.
The review highlights the current picture of institutional discrimination and racial health inequities across the NHS in England. These include poorer maternal and mental health outcomes, late diagnoses of cancer and other diseases, unequal access to healthcare including medical trials and personalised medicine, and wider disparities in the quality of healthcare treatment experienced by ethnic minority patients. However, there is a lack of analyses of the broad monetary value of the persistent racial and ethnic inequalities in society and its impact on people’s health.
The Labour government has made growth the centrepiece of its policy platform for this parliament, telling the nation that economic growth is route to prosperity, better public services, and ultimately a healthier and happier nation. Achieving this vision, however, will mean confronting a significant barrier to growth – the effect of racism on the health and wellbeing of the population.
The costs of racism also extend to the experience of NHS staff. A quarter of the NHS workforce are from Black, Asian, and other ethnic backgrounds, who are more likely to experience bullying, harassment and discrimination than White staff, and are less likely to be appointed, promoted or have routes for equal earning attainment. Apart from the millions of pounds spent annually on litigation with employment tribunals and settlements, discrimination has a negative impact on NHS productivity
