Racial injustice: missing link in the chain of poverty and mental ill-health

Our new report Anxiety Nation highlights many extraordinarily clear links between material insecurity and mental distress in Britain today. We were jolted into our analysis by the numbers of English adults on antidepressants – over 7 million in 2017/18 and growing fast – and used the Understanding Society survey to demonstrate that a range of mental health warning lights flash more often for those of us who lack security in the material basics of life: those with no savings buffer, those in insecure work and those stuck in rental properties, in which there is frequently little security of tenure.

But because we were already looking at the intersection of mental and material problems, to keep things manageable in the main report, we didn’t look at the further interaction of all this data with demographic categories, such as race, gender and disability. Our conclusion flagged these as further avenues for JRF to explore, potentially including the technically challenging angle of establishing whether material insecurity could translate into mental distress at a higher ‘exchange rate’ for marginalised ethnic minorities.

In this short blog, we will not attempt anything so ambitious, but do wish to briefly highlight how the shadow of mental distress falls across one social divide – namely, race. This is important both in principle, because JRF has recently committed itself to being an anti-racist organisation, having concluded that it is no longer plausible to make sense of injustice and inequality in the UK today without keeping the lens of race close at hand. But also because it’s an obvious practical research priority, given evidence from elsewhere in the world about large ‘ethnic penalties’ on well-being.

For the sake of starting somewhere and getting a quick feel for whether there is anything worth exploring here, we broke down the population using the crude binary ‘Black, Asian and minority ethnic’ (BAME) and compared that with ‘white’. ‘BAME’ is increasingly judged to be an over-simplistic grouping, but it is nonetheless interesting to start by asking ourselves whether being in a ‘minority’ is in itself associated with higher rates of distress – as measured by our 12 markers of mental health problems, from losing sleep to feeling worthless.

Many media articles bemoan the supposedly singular woes of the ‘white working class’ – without acknowledging the extraordinary diversity of the UK’s contemporary working class. If you’ve read too many of them, you might expect that being in a minority is no longer associated with any detriment to welfare. But in fact, as Figure 1 shows, BAME people as a whole suffer from higher rates of 10 of our 12 mental health markers, with visibly higher risks including sleep loss, inability to make decisions and feeling ‘under strain’. Indeed, the only risk which looks to be higher for the white majority is ‘lacking energy’, an exception which is almost certainly explained by the higher average age of the white group: as you might expect, lack of energy is one risk that is higher in older than younger age groups.

Source: JRF analysis of Understanding Society, 2019/20.

Notes: Indicators without an asterisk are derived from the General Health Questionnaire (GHQ) and those with an asterisk are from the Short Form Survey (SF-12). See Annex A of Anxiety Nation for the precise wording and use made of each question.

But, as we have acknowledged, the BAME grouping probably conceals more interesting variation than it reveals. The relative material prosperity of, say, many British Indians does not diminish the reality of intense poverty among British Bangladeshis, nor indeed the specific difficulties that some Black Britons complain of in relation to policing and other public services, which could give rise to specific anxieties.

JRF’s UK Poverty 2022 report has highlighted people in Pakistani*, Bangladeshi and black families all have high poverty rates, of double or more that for the white majority. So let’s now look at how three particular ethnic communities, each with certain distinct social or economic disadvantages, fare in relation to British white people on our 12 mental health markers.

The first thing to note is that the relative mental health disadvantage when compared to the white majority is now revealed as much larger. While the differences between white people and the broader BAME group were often relatively modest, if we compare ‘UK white’ on the chart with, say, Bangladeshis, we can see that for the first three markers (losing sleep, indecision, under strain) the flag is raised at least twice as often for the latter. We can see, moreover, that Bangladeshis fare worse than white Britons on all 12 counts, and that both Pakistanis and black people fare worse than white people on the great majority of counts.

Source: JRF analysis of Understanding Society, 2019/20.

Notes: Indicators without an asterisk are derived from the General Health Questionnaire (GHQ) and those with an asterisk are from the Short Form Survey (SF-12). See Annex A of Anxiety Nation for the precise wording and use made of each question.

But with this chart, we also get a glimpse of some potentially revealing differences between these three minorities. On the majority of counts, people of Bangladeshi origin fare worst, but the black group reports being most likely to lose sleep, while people of Pakistani origin are most likely to have emotional difficulties that leave them feeling they are achieving less than they would like. Some of this could be explained by quirks of the data, but in future work it might be interesting to look at whether such inter-minority variations persist in repeated survey years, which might reveal something about particular pressures on particular groups.

The exciting thing about the Understanding Society data is sheer size. It means that we can, potentially, explore how members of even relatively smaller minorities that are often ignored in society research, such as people of Arabian heritage, are faring on mental health. It also, potentially, allows us to examine the fortunes of various ‘mixed’ heritage groups, which our initial explorations have suggested can sometimes have very high rates of mental distress. A final advantage of this large data set, is that we can explore how economically insecure groups within the minorities are faring, for example, black people in private rental, or Pakistanis with low levels of savings.

There is obviously an area where much more analysis is needed. But we hope this short blog has been enough to persuade you that mental health is one more dimension of British society where you can’t meaningfully struggle for progress without grappling with racial injustice.

*Here, we have used the adjectives Pakistani, Indian, and Bangladeshi to refer to individuals of those ethnicities, even though they will often have British nationality.