Originally published here.

This paper examines the evidence on health inequalities experienced by Black, Asian and minority ethnic (BAME) people with a learning disability. While this issue has long been of concern, such as the higher risk of avoidable deaths in NHS care, the experience of the Covid-19 pandemic has shown in stark terms just how extreme these inequalities are. People with learning disabilities were six times more likely to die from Covid and 40 percent of these deaths were people from Black and Pakistani communities.

Despite decades of evidence and campaigning for the health outcomes of both the Black, Asian and Minority Ethnic community, and people with learning disabilities, it remains evident that the inequalities in treatment and therefore outcomes are appalling. There is a disproportionate burden of poor health on people with learning disabilities and particularly those with a learning disability from BAME communities.

The societal response to their needs has been found wanting from the moment of their birth be it because of their disability and also the colour of their skin. The figures have shown that even when socio-economic deprivation is taken into account, Black and South Asian people living in the UK are more likely to die from Covid-1930 These individuals are more likely to live with extended family in multi-generational households, increasing the risk of cross-infection, with some cultural practices making social distancing challenging.

Implicit bias presents a further disadvantage to people with a learning disability, more so to those from BAME communities. Equal opportunity is not apparent in the lives of people with a learning disability, rather segregation, stigma, separation and discrimination are apparent in much if not all of their lives from birth. The overall picture shows that little progress has been made in the past twenty years and that institutional discrimination and racism is still endemic in the lives of people with learning disabilities from BAME communities.

Building a system that is based on equality is crucial if we are to eradicate institutional disablism and racism. Strategic and financial investment is required in building a fair society that ensures equality. Many questions remain unanswered in our attempt to understand the extent of institutional disablism and racism in the lives of People with learning disabilities. More important question being how can Government and Transforming Care not mention Black, Asian and Minority Ethnic communities, in terms of recording generally but more specific what are their intersectional needs.

This may imply out of sight and out of mind policy leading to ʻif it is not counted it is not importantʼ. What is needed is individual and collective actions to reduce inequalities. Tackling racism and disablism has to become a priority which requires true leadership. The following questions give rise to an urgent need for us to ensure that social justice becomes part of the narrative in the lives of people with learning disabilities.

1. How can we better understand the needs of the local community, particularly those with learning disabilities from BAME communities? What can be done to make links to ensure that referral rates reflect the population and reasonable adjustment are made?

2. How can we commit, train, and plan to talk about inequalities, implicitly bias, systemic institutional disablism and racism? Should this training be mandatory, regular, and underpinned by human rights?

3. How do we talk to people with learning disabilities about racism and provide a therapeutic space to manage these experiences?

4. What can be done to better understand the impact of implicit institutional racism/disablism and its impact on all our practices from strategic development, policy and practice at all levels?

5. What should be put in place to develop a commissioning process that listens, knows its population, plans and measures impact and is guided by community, equality and inclusion? What is needed so that prevention and early intervention is at the heart of the commissioning process as well as antiracist, disablism and institutional discrimination?

6. How can research create understanding about this population and their experiences across health and social care settings, to further inform policy, training and practice?

You can read the complete briefing here.