How to develop and implement effective policy interventions that tackle systemic racism

Harriet Lloyd is a research associate with the International Public Policy Observatory based at Cardiff University

The pandemic shone a light on the entrenched racial inequalities across the world, with the harms inflicted by the spread of COVID-19 falling disproportionately on people of colour.

Early in 2021, the Welsh government signalled a new approach to tackling race inequality and racism, which lead to the Anti-racist Wales Action Plan published in June 2022.

In Wales, IPPO’s team worked closely with three of the creators of the plan to help establish what work could help policymakers make effective decisions to address systemic racism.

However, it became clear that an academic exercise, such as a systematic review of evidence, would not be helpful. Instead, there needed to be a fuller consideration of how to further the plan’s ambitions and its implementation.

In this post, I reflect on some of the key issues surrounding this topic for policymakers, as well some potential lines of inquiry for researchers or reviewers.

Background

Across the UK, rates of both serious illness and mortality from Covid-19 were significantly higher in members of ethnic minorities than in their white counterparts.

Some of the differences found can be attributed to known factors, including:

  • Comorbidities, including mental illnesses and diabetes
  • Vulnerable status (for example, of asylum seekers) impacting on access to healthcare
  • Late presentation more generally (not accessing services early enough for interventions to work effectively), including avoiding healthcare interactions because of fear
  • Housing (especially overcrowding and lack of access to outside spaces)
  • Increased exposure because of higher rates of employment in frontline roles
  • Language barriers causing delays in appropriate treatment

Yet none of these, even in the aggregate, has yet adequately explained the disparity.

It is also worth noting that knowing about, but not being able to fully explain, disparities carries further risks.

It could further undermine ethnic minorities’ faith in health services, which in itself is linked to poor health outcomes. A lack of engagement with promoted health behaviours can lead to poor uptake of healthcare programmes, such as the vaccination rollout.

These problems persist at every demographic level. There are racial disparities in health outcomes, irrespective of an individual’s educational attainment, for example.

How to tackle our knowledge gap

There are three broad approaches policymakers can take when faced with evidence gap:

  • Addressing the contributory factors that are known about. In the context of Covid, this could include giving frontline workers access to PPE, or encouraging early presentation via trusted community leaders. In the context of employment, it could include positive action in recruitment or promotion processes.
  • Calling for improved data collection to identify the missing variables and therefore make interventions to address them more successful.
  • Judging that this gap must be related to experiences of racism, which have not shown (and perhaps will not show) up in official statistics. These causes may include: less confidence in challenging unsafe practices (such of lack of adequate PPE) at work; PTSD and other mental health impacts of racism, which have not been diagnosed or measured; not being taken seriously or treated in the same way when presenting at healthcare settings. From this standpoint, it becomes clear that taking action to address racism in any form should ultimately lead to different outcomes.

These responses can, of course, happen alongside each other, but there are debates around the most productive of these standpoints and where each type of action should sit.

The UK Government’s Commission on Race and Ethnic Disparities Report and its response to the report (‘Inclusive Britain’) primarily focussed on known contributory factors.

The Welsh government’s ‘Anti Racist Wales’ plan aims to tackle racism more generally, and the Scottish Government’s Expert Reference Group on Covid-19 and Ethnicity, which fed into its existing race equality framework and action plan, also pushed for recognition of the systemic causes of inequalities. Sheffield city council’s own Race Equality Commission took a similar approach.

All have called for more extensive, more systematic and more fine-grained data collection to varying extents.

Issues surrounding data

Data is often seen as a prerequisite for accountable action because it facilitates understanding of the problem and allows for a baseline to be compared with what happens subsequently.

As things stand, these preconceptions are undermined by a lack of systematic, disambiguated data collection.

In many instances, racial data is not collected (for example, on death certificates), which makes comparisons between groups difficult. Where it is collected, races and ethnicities are often lumped together (e.g. under the ‘black, Asian or minority ethnic’ category), which masks the distinct challenges faced by each group.

The causes of this data deficit are linked to the problem itself. The OECD notes that in some of its member countries, such as France and Germany, collecting this sort of data is actively prohibited because of how information on ethnic minorities has been used against them in the past. Even where it is requested, there is likely to be some hesitancy from some groups in sharing it for this reason.

However, the call for evidence is not universal, and is a point of contention in discussions around racism. For some, the call for more evidence of racism is seen as a delaying tactic, or as a sign that all those people who have shared their experiences so far have not been believed. Similarly, to question how to address it may seem dismissive when racialised people have been calling for certain interventions for decades.

The implementation gap

While good-quality data on the state of racial equality has been lacking, the legal requirement to address discrimination has been clear, most notably, with the Equality Act in 2010.

Policymakers have focused on why problems persist despite legal requirements to treat people fairly, and how to close this gap between what’s written in policy and what actually happens: the ‘implementation gap’.

It is hoped that this will be addressed partially by establishing clear lines of accountability for different actions in the plans. But as workers, particularly in frontline education, health and social care roles, face increasing strain after the pandemic and related economic shocks, there is clearly a need to ensure that it stays on the agenda. This may depend on the extent to which people see it as a problem and are personally committed to addressing it.

Further areas of debate

Literature on racism and how to address it is vast. Some of the key debates and ongoing questions can be summarised as follows:

Catalysts for action.

While advocates will have been working on these issues for a number of years, there has been increased buy-in (or at least the display of it) from policymakers, businesses and others at this point. There are debates around what has caused this (for example, differential Covid outcomes, or increased acceptance of racism as a problem in the wake of George Floyd’s highly mediatised murder, and whether and how it is likely to be sustained.

Terminology.

The terms used in this debate reflect ideological positions. For example, ‘anti-racism’ has been adopted by Welsh and Scottish governments. This term is associated with the idea that actions need to be taken to tackle racism, regardless of whether or not society largely consists of non-racists. Decisions on what actions to take and how to measure them are therefore attached to how plans are framed.

The role of data vs. lived experience

Different parties involved see the role of these in different ways (as indicated above). How can these different standpoints be understood and reconciled?

Levers for action

What opportunities for change have been, or can be made use of? Do existing structures of power and responsibility have the capacity to make meaningful change?

Barriers to change

What are the most significant obstacles in creating policies to address structural racism? What resistance are these actions likely to be met with externally? These might include time pressures, resistance to accept the realities of racism and processes that do not lend themselves to doing things differently. How might these be understood and addressed?

Intersectionality

While the impacts of racism themselves are felt unequally depending on identities such as gender or sexuality, different parties in this field have addressed this in different ways. Accountability becomes complicated if there are too many categories. How do we decide which concerns should be prioritised? Will the focus on race might be watered down if addressed from too many individual standpoints?

Ideological underpinnings

While the business case for taking anti racist action is fairly easy to make (for example, if you’re selecting talent from a limited pool, you’re unlikely to be truly selecting ‘the best’) many make the case for moving to a rights-based approach. (How) does this affect which actions are taken or prioritised? Are other inequalities also implicated in this approach?

IPPO’s role

The anti-racist or race equality plans produced by each administration have been framed in vastly different ways by their authors and those responding to them. Whether these differences reflect a difference in the types of actions proposed in them is a topic for consideration.

The plans were informed by an extensive series of evidence reviews. While there are gaps in data and primary research, evidence synthesis for policymaking in this area seems to be a saturated market. On the other hand, a broad overview of policy options could help others in a similar situation to assess their own options. Our conversations with policymakers have also revealed lots of tacit knowledge about what works in different ways that would be useful to capture and share in a form they were comfortable with.