Daily Archives: May 15, 2022

The lending needs for consumers and businesses are rapidly evolving. Lenders are increasingly aware of the need to provide a superior customer experience throughout lead generation to seamless digital applications, instant decisioning, and account management capabilities. GDS Link's Modellica platform provides lenders of all types with an agile, adaptable decisioning platform powered by TransUnion's world-class data.

Through this partnership, GDS Link and TransUnion are delivering real world results by providing clients a platform with self-service capabilitiesboth of which empower business users to change custom rules, add new data sources, and update custom risk models to adapt to the market in real-time

"GDS Link and TransUnion have already acquired several joint clients. We expect this trend to continue as we work together to rapidly deliver solutions to meet the current needs of this market. The process to be appointed as a formal TransUnion partner in this program required a vigorous screening and evaluation, ultimately proving that GDS Link is a leader in the space," said CEO of GDS Link Paul Greenwood.

TransUnion based their Partner Program assessment on both current and future needs of customers, performing an extensive analysis to select industry-leading decisioning platforms that are best suited to meet those needs. "Now our customers can leverage TransUnion data in more ways with a flexible platform and a consultative GDS Link professional services team," said Aaron Smith, TransUnion's Vice President of Global Platform Partnerships.

SkyCap Financial, a leading lender in Canada and 2022 Consumer Lender of the Year finalist, is one of several clients realizing the benefits of this partnership for data and decisioning. SkyCap Financial chose GDS Link's Modellica platform because of the flexibility that allows platform users to access third party data bureaus they currently leverage, rapidly add new data sources, manage decision strategies, expand current offerings, and provide support for their long-term roadmap.

"GDS Link's Modellica solution empowers SkyCap Financial with a flexible platform and ultimately improves the borrower experience with instant decisions. This partnership allows us to quickly automate and modify decisioning strategies in a self-managed solution, all while leveraging the power of TransUnion data. We expect to not only improve our customer experience, but also grow our customer base in a way that aligns to our strategy and meets the needs of borrowers," states joint client Jeremy Wilson, President of SkyCap Financial.

Learn how GDS Link can help your business manage risk while driving growth.

About GDS Link

Founded in 2006, GDS Link is a global leader in credit risk management, providing tailored software solutions and analytical and consulting services. Our customer-centric risk management and process-automation platforms are designed for the modern lender in their pursuit to capitalize on the entire credit lifecycle. By providing a personal, consultative approach and leveraging our own industry-leading knowledge and expertise, GDS Link's solutions and services deliver exceptional value and proven results to clients around the world.

https://gdslink.com

About TransUnion

TransUnion is a global information and insights company that makes trust possible in the modern economy. We do this by providing an actionable picture of each person so they can be reliably represented in the marketplace. As a result, businesses and consumers can transact with confidence and achieve great things. We call this Information for Good. A leading presence in more than 30 countries across five continents, TransUnion provides solutions that help create economic opportunity, great experiences and personal empowerment for hundreds of millions of people.

Learn more at http://www.transunion.com/business.

About SkyCap Financial

SkyCap Financial is a personal loan provider offering alternative financing to Canadians since 2013. Based in Kingston, Ontario, SkyCap endeavors to offer a better lending experience to its customers through a quick and easy online loan application process, that in most cases can be completed in just five minutes. Recognizing that people sometimes fall into difficult financial situations, SkyCap Financial specializes in helping people with low credit or poor credit get the financial assistance they need, offering short-term loans ranging from $500 to $10,000.

https://skycapfinancial.com

For more information:[emailprotected]

SOURCE GDS Link

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GDS Link and TransUnion Partner to Deliver Superior Decisioning Solutions to Clients - PR Newswire

Melissa Ben-Ishay started scrolling through TikTok two years ago. It seemed like a virtual scrapbook you can piece together little clips of what you create, said Ben-Ishay, 38, the founder, president and CEO of Baked by Melissa.

I love to cook. I spend all day in my kitchen if Im not working.

Ben-Ishay knew she needed to leverage TikTok for her business, but didnt know how. Then one night, she posted a video of overnight oats that shed made into cupcakes. That morphed into content of her making salad or savory dishes, and they started going viral. So she began including corresponding recipes on her companys Web site.

You learn by doing, said Ben-Ishay. Try! Failure on social media is great because failure means that nobody saw it. Win-win, right? So you learned, you failed, nobody saw it and you dont even have to feel silly about it. Great, do it again.

Going all in like Ben-Ishay did, and learning by doing, is key.

You have to jump in, you have to figure it out. Theres such a difference between a place of yes and a place of no, said Bethenny Frankel, TV star, founder and CEO of global lifestyle brand Skinnygirl, and author of a newly released book, Business Is Personal: The Truth About What it Takes To Be Successful While Staying True to Yourself (Hachette Go).

Who you are outside of business is who you are inside of business, said Frankel, 51. Its a crazy time now everybody sees and hears everything. Business really is personal, the lines are blurred.

With more than 620,000 followers, Frankel posts regularly on TikTok, including candid reviews of beauty products. She also hosts the podcast Just B With Bethenny Frankel, and puts on a philanthropist hat to head up BStrong, a worldwide disaster-relief initiativethat partners withGlobal Empowerment Mission.Most things are more or less challenging than they seem, Frankel said.

Years ago, I realized if you have something interesting to say, you can crystallize it and package it into a small parcel and let someone know why you have something interesting that they might not want to miss out on. Or, be so endearing that they want to help you or connect, or be the type of person that follows through, which most people dont. Its just important to reconnect and just say what you mean and mean what you say.

That rings true especially for making things happen and creating your own opportunities, as Frankel explained her book. Although you may think other people arent accessible, Frankel said they are actually accessible if you are a little bit strategic and creative in your way of accessing someone.

Two years ago, Jane Pennoyer, 29, did just that when she discovered a firm called Finch, a digital sustainability tool.

The problem was, there was no gig, said Pennoyer of the startup, which had zero funding. Her mothers friend knew the CEO and provided her with the e-mail address, so Pennoyer sought an informational conversation. After e-mailing the CEO with the subject line Connecting, she landed a call.

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Pennoyer offered to work for free, but the CEO started paying her to work 10 hours a week as a freelance consultant. Six weeks later, Pennoyer was hired full-time; one year later, she became chief of staff.

I knew that if I got my foot in the door, I could make myself valuable enough to stick around, said Pennoyer.

But bear in mind there are no shortcuts. You need to build a solid foundation with hard work, and making your own opportunities wont always happen in a New York minute but thats OK.

You can create an impact in New York, but most good things take a while and have to be built upon, said Frankel. They have layers. Its like a house. It feels better when you build something properly with layers and really just do it in a methodical, high-quality manner versus a rush job. It feels better, its more trusted. It takes a long time to be successful.

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Dont be afraid to jump into a new career feet first it often has rewarding results - New York Post

Farida Khelfa will be hosting Cartiers new podcast, yet another commitment to female power by the luxury French maison. The Franco-Algerian documentary filmmaker, actress and model will be having personal conversations around womens empowerment with her notable guests while presenting the Womens Perspectives series.

" Through these conversations, I wanted to share the stories of amazing women and their destinies. Their success needs to be known because these women are carving out their own path. the multi-faceted Khelfa said about the series, which is available on Spotify.

A variety of exceptional women, as well as supportive men, have been invited to be part of the podcast that reflects Cartiers belief that we are always stronger together. Womens Perspectives also underscores the importance of tackling the issue of equality hand in hand. Discussions range from defining childhood experiences to career journeys and how guests see the future, while focusing on the importance of womens influence and work in society.

The series launches with a duo of episodes that epitomise this approach, with friends of the maison Khatia Buniatishvili and Rami Malek. Buniatishvili describes her journey as a young female pianist, challenging stereotypes and nailing it in the traditional world of classical music. Meanwhile, Oscar-winning actor Malek talks about the influence his mother and sister have had on his worldview and the role men have to play in building a more equal world.

Womens empowerment has been an important area of commitment for Cartier for a long time. The Cartier Womens Initiative and Cartier Awards nurture and support female entrepreneurship and Cartier Philanthropy has defined womens social and economic development as a key pillar of change. And now the podcast has arrived to continue the dynamic spirit cultivated at their Womens Pavilion during Expo 2020 Dubai.

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Farida Khelfa Is The Host Of A New Podcast Highlighting Women's Empowerment - About Her

CHARLESTON, S.C., May 12, 2022 /PRNewswire/ -- SOFX is excited to announce partnership with Gatorz Eyewear, Radical Firearms and Recoil Magazine in a Special Operations Themed giveaway featuring premium products and merchandise.

The giveaway will feature two grand prize drawings, one for a Special Operations Forces Conference in-person winner, and one winner located anywhere not prohibited by law. Both winner drawings will be held at the 2022 Special Operations Industry Conference (SOFIC) trade show floor in Tampa, Florida and will be celebrating recent approval of Gatorz Eyewear Products on the United States Special Operations Command, Special Operations Eyewear Approved Eyewear (SOEP) List. Currently, the Magnum MILSPEC Ballistic glasses are approved for use in Special Operations.

The drawings will be held at Booths (#2139 & #2137) where Gatorz and SOFX are co-located on the afternoon of Wednesday, May 18th, 2022 at SOFIC, Tampa Convention Center.

Sam Havelock, former Navy SEAL, CEO of SOFX, and Gatorz Advisory Board Member stated, "We can't wait to get down to Tampa and see our friends from the Special Operations community who have been so instrumental growing the Gatorz brand over 30 years across SOF. Our friends at Recoil Magazine and Radical Firearms have generously added gifts to ensure that whoever wins our American made, super durable eyewear will win additional professional tools to bring to the range."

HOW TO ENTERTwo winners receive prize packages worth over $1,500:

There is no cost to enter. Anyone wishing to enter the drawing may do so by entering at

2022 SOFIC MULTI-BRAND GIVEAWAY | SOFX

Persons attending SOFIC are invited to stop by SOFX and Gatorz booths to enter via QR code or enter additional daily drawings for eyewear, and complimentary copies of Recoil Magazine.

This offer void where prohibited by law. Winners may select a cash award for the value of the firearm if they are prohibited or wish not to accept the firearm component of the prize package.

About SOFX:SOFX Inc., is the publisher and operator of http://www.sofx.com and the SOFX Newsletter. The SOFX newsletter is world's largest free newsletter covering global Special Operations and personal empowerment. People from all walks of life are invited to subscribe and learn about the people of special operations. SOFX Inc. pledges to never rent, sell or share subscriber data. SOFX generates revenue by helping companies find and hire the world's best talent not by selling data

SOURCE SOFX

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SOFX INC Announces Special Operations Themed Product Giveaway with Radical Firearms, Gatorz Eyewear and RECOIL Magazine - PR Newswire

I am no stranger to a tattoo thats centered around my favorite character or franchise. All of mine are nerdy in some way or another and, at this point, I have 11 of them. But theres a beauty in having a tattoo on you that means something more than just representing a fictional character. From the first tattoo I got on to my most recent, theyve all been rooted in my love of pop culture and also significant moments in my life. My first tattoo ever was a Spring Awakening tattoo because I wanted to star in a production of the show, which I went on to do.

I just kept getting tattoos for characters who helped to inspire me or in honor of something I love coming to an end. I have a Deathly Hallows tattoo, and while I no longer support the Harry Potter series thanks to J.K. Rowlings continued attacks on the trans community, I dont regret the tattoo because it is representative of me and my best friends and something that we did together. So, even though my love for the series has waned, my love for that tattoo wont because it has a meaning outside of just me liking something. And I think theres an empowerment there for all of us to have, especially when we find peace in whatever thing were getting tattooed on us.

My most recent tattoo is one that brings two of my favorite Marvel characters together: Wanda Maximoff and Yelena Belova. You can see in the post below that I also have a Spider-Man tattoo with a red star for Wonder Woman next to it and its representative of my favorite heroes.

But the tattoos are more than just characters I love. For me, its about what they represent specifically to my journey. Wonder Woman is someone who I looked up to growing up, Peter Parker was always my comfort character, Wanda Maximoff helped me understand how my grief can be different and my own journey, and Yelena Belova is someone I can find strength in. They all remind me that I have the ability to be my own hero. My Wanda and Yelena tattoo was done by the incredible Kreg Franco at East Side Ink!

Another tattoo that I have that serves as a constant reminder to keep moving on is my Leia Organa/Carrie Fisher tattoo. Ive loved Carrie Fisher my entire life, and while I have another Star Wars tattoo (a quote from Rogue One), I wanted one specific to Fisher/Leia for how they have helped make me into the woman I am today. So I thought the perfect way to share that love is by doing a Leia picture with a Carrie Fisher quote, and it ended up being a beautiful nod to two of my favorite women.

Leia/Carrie was done by the amazing Jes Valentine!

Tattoos arent for everyone, but if you find comfort in them, they can be some of the greatest ways to cope and I love all mine very much.

(featured image: Marvel Entertainment/Lucasfilm)

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The Empowerment of Getting a Fandom Tattoo - The Mary Sue

Narikuravar activist Karai R. Subramanian runs a free school for the community

Narikuravar activist Karai R. Subramanian runs a free school for the community

A narrow winding road from the Perambalur-Tiruchi highway leads to Netaji Subhash Chandra Bose Undu Uraividapalli (residential school), in Malaiyappa Nagar, Karai village. This is an institution that has been educating children of the Narikurvar community since 1996. An English exam is in progress, and children are seated on the ground, heads bent in concentration.

We have 52 boys and 48 girls drawn from the 120 Narikuravar families in this area, who study from Class 1 to 8 here. At least 45 of our alumni have become graduates; if the parents had been more enthusiastic, perhaps we could have had over a thousand of them by now, Karai R. Subramanian, the community activist and entrepreneur who runs the free school, told The Hindu.

Getting children to attend school has been an uphill journey. Parents do not want to pay fees. They also dont see the need for modern education, and it is hard to convince the children when they get no encouragement from their parents. You send them for a four-day holiday break, and they will come back after a month, said Mr. Subramanian.All the students are first-generation learners, not just in class, but also in other matters, such as toilet training and personal hygiene. We had to teach them how to use the toilet and take care of their personal grooming because they had no exposure to these concepts before, said an educator.The Narikuravars speak to each other in their native Vaagri Booli, an unclassified Indo-Aryan language. As we get more modernised, our children are forgetting Vaagri Booli, and require Tamil translation to understand their mother tongue. I always advise our community folks to keep in touch with Vaagri Booli, said Mr. Subramanian.

Mr. Subramanian, 50, was among the many Narikuravars who were settled in Karai by the government in 1954. Like most men in our community, my father was a hunter, and we led a peripatetic life, moving from spot to spot. When hunting was banned after Independence, we had to look for new ways to make a living, he said.

Mr. Subramanian took the advice of his friends and became a travelling salesman of religious artefacts in Singapore in the 1990s. I would buy bead chains for 20,000 and earn over a lakh of rupees by selling them in Singapore. I took up export orders with my friends and made good money, he said.

But it took a stint in jail to set him in an entirely new direction. I participated in a march from Kanyakumari to Chennai in 1993 to demand the Scheduled Tribe (ST) status for our community, when a bunch of us were arrested and sent to jail. After being abused by friend and foe alike, I realised that education alone could help us to improve our lot, said Mr. Subramanian, who decided to invest his savings in his school projects.

Before he shifted to Karai, he ran a small boarding facility for Narikuravar children in Siruvachur village. The school building in the Karai campus was built at a cost of 9 lakh with the aid of the Tiruchi district chapter of Sri Sathya Sai Seva Organisations Tamil Nadu from 2017 to 2019. It has four classrooms on the ground floor that also double up as the boys dormitories, and a girls hostel on the first floor.

All of Mr. Subramanians five children are college graduates. But there is a new challenge that he faces as an activist: getting educated Narikuravars jobs. There have been numerous efforts to get our community the status of a scheduled tribe; each time, the political process is set in motion, there is very little progress on the ground. And now, when our children cannot find jobs, it seems we are back where we started, he said.

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Using education for empowerment - The Hindu

When Calgarian Maddison Tory was 13, she had to undergo heart surgery.

The hospital was a scary place for her, and when she looked around, she noticed a lot of other kids struggling on their own health care journeys too.

The experience prompted Tory to create HUGS, a program committed to improving kids' mental health and quality of life during their hospital stays.

"For kids in hospital, activities like your normal sleepovers or snowball fights, they're all being replaced with needles and IVs, and I wanted to be able to find a way to change that narrative," she said in an interview on The Homestretch.

Tory, now in Grade 12, is one of two Calgary recipients of the Terry Fox Humanitarian Award. The scholarship is awarded to inspiring young peoplewho emulate Fox's courage and determination through volunteer work.

Ye-Jean Park, a third-year health sciences student at the University of Calgary, is the second recipient from the city. She'sthe co-founder of the Home Food Community Kitchen, the university's first youth-led food education club.

Through the initiative, they provide students with free meal kits and lessons on how to cook healthy, affordable and culturally diverse meals.

"I've just really felt empowered throughout my entire educational and personal journey to have had amazing support from mentors and to be able to really stand on the shoulders of giants and grow as a person," she said.

"I really wanted to give back and take what I've learned to empower others."

Believe it or not, the above projects are just a small portion of the volunteer work done by these two humanitarians.

Tory hasmade several visits to the hospital over her lifetime so far. She has lupus, and said she knows what it feels like to miss out on childhood experiences.

Through her fundraising for HUGS, she's been able to create several "distraction" events for kids, including superhero nights, princess tea parties and Build-A-Bear workshops. Recently, the programalso helped to turnpatients' drawings into real-life stuffed animals.

"I've had times where moms would come up to me as they watched their little daughters dance with the princesses," she said.

"One of the moms came up and told me that since her daughter was diagnosed with leukemia, she hasn't seen her dance or smileand this brought her the ability to smile and have a normal break."

As part of the initiative, Tory wrote a children's empowerment book called, Your Secret Superpower: Ignite your SPARK.

"The book aims to challenge children to discover their own passions and make the world a better place," she said, adding all of the proceeds go to HUGS events.

Tory is also a coach with the Special Olympics for rhythmic gymnastics, a volunteer with Ronald McDonald House and an advisory board member with the Alberta Children's Hospital.

"That's also why this scholarship means so much to me, because it makes it so that I don't have to hold a part-time job and can instead focus all my energies on my academics and also on my leadership and volunteer initiatives."

Tory plans to attend the University of Calgary, and she hopes to have a career in medicine.

For Ye-Jean Park, winning the Terry Fox Humanitarian award is a dream come true.

Throughout the pandemic, she's used the food club to spread awareness about the importance of eating nutritious meals.

"I think being able to witness firsthand and experience the challenges of when my parents were having a family restaurant and then subsequently experiencing some financial struggles with that and cultural struggles I think that's really been what first motivated me to try and really do my best in helping others," she said.

Park also works with CanShine Tutoring a nonprofit aimed at bringing free or subsidized tutoring lessons to underprivileged youth and mentors other young students, including helping them with public speaking.

"I do love to helpstudents to gain more confidence in becoming more active advocates in their own communities," she said.

Music also plays a large role in Park's life. She's a cello player, performing regularly at local seniors homes.

It's a passion inspired by her grandfather, who had Parkinson's disease, but loved music.

"I was able to communicate beyond really what words can express," she said.

"I wanted to continue conveying my empathy and my connection to seniors and our community, particularly during the pandemic."

Ye-Jean is pursuing a medical degree and is currently researching treatments for dogs with cancer.

She hopes to become a clinician-scientist, while continuing to follow her passions in music, writing and public speaking.

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Meet the 2 Calgary women who earned Terry Fox Humanitarian Awards this year - CBC.ca

By Dr. Dyotona Sen

Enriching womens healthcare delivery is a vital step to gender equality in India. Its important to consider the facts currently, India ranks 140th of 156 countries on gender inequality, based on World Economic Forums 2021 Global Gender Gap Report. This reflects the countrys performance on numerous dimensions health and survival, economic participation and opportunity, educational attainment, and political empowerment. To pave the way for gender equality, it is imperative to scale efforts to support girls and women across growth indicators. One such way is to advance womens healthcare, such as by supporting women to take charge of their health through initiatives that ensure equitable access to quality care.

The latest National Family Health Survey (NFHS-5) showcased a picture of progress on gender equality and healthcare in India. More women nationwide have their own phones (although there remain disparities in rural India) now more than ever before. Additionally, married womens household decision-making relating to healthcare increased from 73.8% in 2015-16 to 92% in 2020-21. Even as growth is visible across womens healthcare, there are still gaps to bridge.

For example, by 2025, there will be 1.1 billion menopausal women in the world. These are women in the prime of their life, possibly at the height of their careers, on whom society depends. Yet many women experience this life stage as a negative one. Half of menopausal women are unlikely to seek medical help for their symptoms even if some can be debilitating, owing to factors like social stigma and low awareness. As menopause is a natural stage of life, it should be recognized by society as such, with more openness to talk about it, its symptoms, and ways to alleviate them.

Also, to ensure women feel confident in opening up about their health, holistic support is key. It is important for women to have access to safe spaces so that they feel comfortable to have conversations where they can be empowered with relevant information and tools to manage their health concerns. By increasing opportunities for trusted interaction between health care professionals and patients, support, and psychological counselling options, we can foster high-quality patient centric care. Women, couples, or families taking the time to understand both the physical and emotional aspects of health complications have a greater chance of coping with situations better.

Moreover, womens health education is important not just for patients, but also for healthcare practitioners. This especially holds true for misdiagnosed and unrecognized conditions like endometriosis and anemia. By skilling healthcare practitioners, such as through training modules, we can expand the base of their knowledge regarding latest developments and effective practices. Pregnancy, for instance, can be a time filled with joy but also worries. To avoid health complications and support maternal health and safer childbirths, Abbott introduced Gynecology Anemia checklists across India with the Federation of Obstetric and Gynaecological Societies of India (FOGSI) to help doctors better manage iron deficiency anemia in pregnancy. Such measures streamline service delivery across the board with latest evidence-based recommendations.

As such healthcare solutions become available to support physicians and patients, another part of the larger picture must be to scale access. To reach women with healthcare solutions in underserved areas, including rural and peri-urban regions, collective action by multiple stakeholders is key. National and state governments, industry bodies, private players and public-private partnerships are all integral to a sustainable approach. Abbott supports work to overcome urban-rural disparity in accessing healthcare services, hospitals, and treatment through the Abbott Strengthening Healthcare Access (ASHA) initiative. Working with the Indian Medical Association (IMA) on educational programs, we also aim to empower healthcare professionals and rural health care workers to improve treatment options in rural areas. Leveraging collective strengths to set up and support primary health centre capacities are ways to reach women with health information and get a step closer to equitable health coverage.

By having access to trusted information, women can address health issues they may have previously neglected and thrive in their personal, social, and work life. In fact, Abbott is working to foster science-based learning amongst 1,500 young children 45% of whom are girls from socially disadvantaged communities. In addition to helping improve their problem-solving skills through access to digital tools for science-based learning, we are working to improve their knowledge of health challenges such as non-communicable diseases, nutrition and menstrual hygiene, while also providing them with access to indoor and outdoor sports. By empowering them with skills to be future-ready, such as by promoting healthy choices and preventive behaviours, we intend to ensure they maintain good health to reach their full potential.

Womens health needs to be a nationwide priority, upheld through the synergies between collaborative efforts and advanced health solutions. At Abbott, we believe that health and dignity are vital to every human beings ability to live a full life. We aim to continue to invest in expanding the scope of healthcare for women and girls so we can advance the future of equity and empowerment in Indian healthcare.

By Dr. Dyotona Sen, Head Medical Affairs, Abbott India

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Championing Womens Healthcare Needs: Towards Equity & Empowerment - ETHealthWorld

Executive summary

1. It is clear from ONS quantitative studies that all minority ethnic groups in the UK have been at higher risk of mortality throughout the COVID-19 pandemic (high confidence). Data on wave 2 (1 September 2020 to 31 January 2021) shows a particular intensity in this pattern of differential mortality among Bangladeshi and Pakistani groups (high confidence).

2. This paper draws on qualitative and sociological evidence to understand trends highlighted by the ONS data and suggests that the mortality rates in Bangladeshi and Pakistani groups are due to the amplifying interaction of: I) health inequities; II) disadvantages associated with occupation and household circumstances; III) barriers to accessing health care; and IV) potential influence of policy and practice on COVID-19 health-seeking behaviour (high confidence).

3. Pakistani and Bangladeshi groups suffer severe, debilitating underlying conditions at a younger age and more often than other minority ethnic groups due to health inequalities. They are more likely to have 2 or more health conditions that interact to produce greater risk of death from COVID-19 (high confidence).

4. Long-standing health inequities across the life course explain, in part, the persistently high levels of mortality among these groups in wave 2 (high confidence).

5. Occupation: Pakistani and Bangladeshi communities are more likely to be involved in: work that carries risks of exposure (such as retail, hospitality, taxi driving); precarious work where it is more difficult to negotiate safe working conditions or absence for sickness; and small-scale self-employment with a restricted safety net and high risk of business collapse (high confidence). By comparison, Black African and Black Caribbean groups who work more widely in health and social care roles were likely not fully protected in wave one, but consistent access to workplace PPE and new safe practices and regulations in wave 2 in health and social care settings may have produced comparatively less transmission in this group (low confidence).

6. Household circumstances among Bangladeshi and Pakistani families amplify disadvantage due to higher numbers of multigenerational households, family members with chronic, disabling illness (at a younger age) and women involved in care work for family or others (medium confidence). [See SAGE Ethnicity Subgroup, 2020b.]

7. Stigma: All minority groups face stigma. Bangladeshi and Pakistani groups face intersecting forms of stigma and racism relating to their ethnic and their religious identity, and triggering events intensify experiences of stigma, including media coverage and central government COVID-19 interventions, for instance introducing restrictions during celebrations such as Eid and Ramadan. Stigma can cause health inequalities, drive morbidity and mortality, and undermine access to health services (medium confidence).

8. Over-burdened health services: The regions in which Bangladeshi and Pakistani communities live such as in London and the Northwest have faced high COVID-19 hospitalisations over a longer period of time, with greater strains on GP services (high confidence).

9. Practical difficulties of access: it is more difficult for minority ethnic groups to access NHS Track and Trace services due to testing site locations, difficulties taking time off from work for testing, and concerns about loss of livelihood if required to self-isolate (medium confidence).

10. Financial support: Furlough, self-employment and business support schemes have helped thriving businesses and better-off self-employed people the most, rather than those in the most hard-pressed situations (high confidence).

11. Communications and community support: The Black Lives Matter movement increased solidarity within and between Black African and Black Caribbean groups. Additionally, culturally appropriate approaches to delivering health education may have increased knowledge of COVID-19 in Black communities in the UK (medium confidence). By contrast, British Pakistani and Bangladeshi communities have been stigmatised by media narratives around multigenerational households and religious festivals, which can result in barriers to seeking help and contribute to more severe health problems (medium confidence).

A range of steps have the potential to deliver greater health equity and aid recovery from COVID-19 impacts:

a. MHCLG funded Community champion schemes are an effective means to reach minority ethnic communities, including Bangladeshi and Pakistani groups. There is scope to use these schemes in the future to target communications and support. In doing so, it would be important to include non-stigmatizing advice in relevant languages on multi-morbidities and COVID-19 risks, vaccination access, the importance of lateral flow testing in schools, and workplace risks and mitigations.

b. Evidence shows that vaccine access has been improved through provision in faith institutions. Inclusion of workplaces that are at risk for COVID-19 transmission, including factories, hospitality and retail may help increase uptake further among disadvantaged groups. [See SAGE Ethnicity Subgroup, 2020c.]

c. Unaffordability of taking unpaid time off, or concerns about the effect of absences on job security are likely to be significant contributory factors to low vaccination rates among low paid individuals, including ethnic minorities. UK employment law does not currently require employers to allow paid time off for vaccination (Hanif et al, 2020; CDC, 2021).

d. Uptake of testing and adherence to self-isolation among groups who feel less able to do so given possible financial implications for themselves and their families should be incentivised. Evidence suggests that greater support for those who are socio-economically disadvantaged, including Bangladeshi and Pakistani groups (who predominantly work in precarious occupations), will enable them to adhere to the test, trace and isolate system (Bodas and Peleg, 2020 ,SPI-B, 2020b).

e. Other forms of practical help for those self-isolating, including accommodation outside the household and assistance from subsidised carers and with supplies of food and other provisions, would also likely increase adherence.

f. To improve testing uptake in disadvantaged and minority community areas, a focused health promotion campaign is needed to explain the importance of lateral flow testing in schools for the prevention of transmission to multigenerational households as is providing easier access to lateral flow testing, for example by increasing the number of testing sites.

g. Given evidence that Pakistani and Bangladeshi groups in particular have felt that communications in the context of COVID-19 have reinforced stigma, it is important to avoid stigmatising communications about vaccine uptake or in relation to local interventions, such as surge testing for variants in particular neighbourhoods or local restrictions. This might involve, for example, training and advice in the NHS and in Public Health Teams on the impact of stigma on health outcomes and on how to de-stigmatise interactions and communications.

h. If it is necessary to restrict minority celebrations, explanations could emphasise that affected communities are hardworking and have faced exposure through occupations that serve and benefit the whole country.

i. Messaging should focus on testing equity and vaccine equity rather than testing or vaccine hesitancy.

j. Mass media communications can reduce stigma by promoting collective identity and social cohesion.

k. Effective community engagement is more likely to have an impact if it recognises within-group, inter-generational and gender differences. This requires working with diverse authority figures perceived to be locally legitimate. [See also SAGE Ethnicity Subgroup 2020a.]

l. Targeted investment in improving housing stock in overcrowded areas could help to alleviate increased transmission and risk in Bangladeshi and Pakistani communities based on evidence [showing that these groups have higher rates of living in crowded housing, which a driver of increased mortality and morbidity].

m. Improvements in the provision of COVID-safe formal elder care and childcare in socio-economically deprived and minority settings may help in reducing COVID-19 risks in these settings.

n. On impacts of COVID-19 on all religious minorities and precarious migrant groups, such as those with no recourse to public funds.

o. On the impact of social cooperation (like that associated with the Black Lives Matter movement) on response to government COVID-19 public health initiatives.

p. On the amplifying intersections between employment, household and family structure that cause chronic COVID-19 transmission and higher mortality rates among minority groups.

q. On the long-term COVID-19 health effects (Long-Covid) for and socio-economic recovery among ethnic and religious minority groups.

r. On improving data quality throughout government on ethnicity and health inequality, including for subgroups of religion, gender and age.

It is clear from quantitative studies that all minority ethnic groups in the UK have been at higher risk of mortality throughout the COVID-19 pandemic (high confidence). If we look at the existing data on wave 2 (1 September 2020 to 31 January 2021) we see a particular intensity in this pattern of differential mortality among Bangladeshi and Pakistani groups (high confidence). In this paper we concentrate on qualitative explanations for this pattern. However, further disaggregation of differential mortality among all minority ethnic groups is required, along with concerted policy attention to preventing unequal outcomes. Research-led policy is essential to prevent endemic COVID-19 related health disparities continuing during and after the vaccine roll-out.

In wave one (24 January to 31 August 2020) people from all minority ethnic groups were at greater risk of death from COVID-19 compared to White British groups (high confidence; OpenSAFELY, QResearch, Nafilyan 2021). Highest risk of mortality was evidenced among people from Black African ethnic backgrounds. In wave 2, risks among Black African and Black Caribbean groups compared with people of White British ethnicity still remained high but attenuated somewhat (medium confidence). However, this emerging data should be treated with caution, as it does not chart the full course of the pandemic in the UK. In addition, during wave 2, men and women from Bangladeshi and Pakistani ethnic groups were at a considerably higher risk of death involving COVID-19 compared with those of White British ethnicity (high confidence; ONS 2021). Rates were by far the highest among men and women from Bangladeshi backgrounds. They were closely followed by those from Pakistani backgrounds. Indian ethnic groups showed slightly less elevated levels above Black African and Caribbean groups. These patterns raise 3 important questions:

This paper draws on existing qualitative evidence to address these questions. However, further quantitative and qualitative research is required to prevent persistent, or even, rising health inequalities.

Differential health outcomes are the result of intersecting forms of disadvantage experienced by members of social groups over their life-course. Political, economic and social factors contribute to differing COVID-19 mortality rates, including structural inequalities faced by specific communities. As these factors combine, they can produce exponential impacts on social groups, increasing the transmission and severity of COVID-19, which are captured in statistics under an ethnicity identifier. The elevated mortality risk for Bangladeshi and Pakistani men and women in wave 2 data so far likely results from multiple socio-economic factors amplifying each other, rather than being due to a single aspect of their social or cultural circumstances (high confidence).

To explain such group effects, we need to look at the matrix of social relationships that produce mortality impacts. Therefore, in this paper we focus on:

I. health equity issues faced by minority ethnic groups II. disadvantages produced by occupation and household circumstances III. barriers to accessing health care IV. potential influence of policy and practice on COVID-19 health-seeking behaviour

The interaction of I to IV generates elevated risk of illness and mortality from COVID-19. In distinct groups and their subgroups (of religion, age, gender, place and time of migration), different social inequalities may have greater or lesser impacts. It is particularly important to consider these intersections as we move into the next phase of the pandemic in the UK, including vaccination rollouts and Long-Covid support, or disparities will likely persist, and the pandemic may become a source of permanent health inequality.

Ethnic minorities did not enter the pandemic on an equal footing in relation to their underlying health. It is well known that socio-economic inequality produces effects on physical health and the process of ageing (Nazroo, 2015). Underlying conditions can contribute to disease severity, thereby contributing to the persistently high levels of mortality among Pakistani and Bangladeshi groups (medium confidence).

Pakistani and Bangladeshi groups experience severe, debilitating conditions earlier and more often than other minority ethnic groups. This contributes to a process of weathering, or biological ageing, whereby disadvantages accumulate over the life course, producing increased risk of age-related conditions (Nazroo, 2015). In wave one, individuals from South Asian groups with COVID-19 infection experienced more severe health outcomes than those from other groups (Public Health England, 2020).

Additionally, according to the Health Survey for England, the level of reporting fair or bad health for White English people aged 61 to 70 years is equivalent to that of Black Caribbean and Indian people aged 46 to 50 years, Pakistani people aged 36 to 40 years and Bangladeshi people aged 26 to 30 years (Chouhan and Nazroo, 2020). British Pakistani and Bangladeshi men and women have the highest levels of self-reported poor health of all ethnic groups. This divergence appears at age 30 years, becoming steadily more marked among older age groups (Nazroo, 2015; Nazroo and Williams, 2006). The high levels of pre-existing chronic health conditions among Pakistani and Bangladeshi minorities (Platt and Warwick, 2020) create increased risk of severe complications from COVID-19 if infected (medium confidence).

Many of the co-morbidities associated with severe COVID-19 are more prevalent among British Pakistani and Bangladeshi groups than others (for example diabetes, ischaemic heart disease: Prats-Uribe et al. 2020). Additionally, they are more likely to have multimorbidity, that is, 2 or more long-term health conditions (Salway et al. 2007 cf. Zimedikun et al. 2018; Watkinson et al. 2021). Multimorbidity creates additional health needs beyond those from each individual condition. British Pakistani and Bangladeshi people with long-term health conditions are disproportionately likely to report activity limitations as a result (Salway et al. 2007, p.20-1). Self-reporting as disabled is a high risk factor for COVID-19, above risks associated with each individual health condition (ONS 2020).

Long-standing health inequalities across the life-course, and chronic health inequalities likely contribute to persistently high levels of mortality among Bangladeshi and Pakistani groups (medium confidence). These effects are likely to have been amplified by household members being disproportionately exposed to COVID-19, due to disadvantages associated with occupational and household settings (Section II).

Exposure to and transmission of COVID-19 can be intensified through interconnections between risky working environments and household circumstances (high confidence). Here we define risky working environments in 3 ways:

a. they involve work that carries risks of exposure (the ONS definition) b. they are precarious work in which it is difficult to negotiate safe working conditions or leaves of absence for sickness; orc. they are small-scale self-employment with a restricted safety net and risk of business collapse

Occupations that have greater exposure to virus (for example; health workers, social care, close contact workers, construction and warehouse workers) are associated with greater risk of infection (Hiironen et al. 2020) and death (ONS 2020a) (high confidence). Jobs associated with higher death risks are also those in which ethnic minorities are clustered (high confidence). For example, Black African men and women are particularly heavily concentrated in social care roles (ONS, 2014; Platt and Warwick, 2020) and ethnic minorities (including migrant workers) are heavily concentrated among security guards and cleaners. Men from Asian and Asian British groups are highly concentrated in jobs in the hospitality and in the wholesale and retail trade with over a third (36 per cent) of Bangladeshi men working in this sector. Pakistani and Bangladeshi women are over-represented among sales workers (Platt, forthcoming 2021). Additionally, in the Midlands, South Asian men and women are often employed in small-scale textile and other industrial or food production units. Alongside this they predominate in taxi driving (for example around 21 per cent of foreign-born Pakistani men are taxi drivers, as are 8 per cent of UK born Pakistani men) (Platt, forthcoming 2021).

These differences in occupation are likely to have contributed to differential exposure in wave 2 for distinct ethnic groups. During wave one, the workplaces of some Black African and Black Caribbean groups, for example those working in health and social care, were not yet fully protected (Community Cares 2021), but in wave 2 PPE and new safe practices and regulations may have produced less transmission in this group (low confidence). By contrast, Pakistani and Bangladeshi groups are likely to have continued to be at the same level of risk in their workplaces as it is unlikely that new COVID-19 secure practices were introduced (medium confidence).

The occupational risks for Bangladeshi and Pakistani groups may even have increased in the lead up to wave 2. In late September into October 2020, when case numbers were rising rapidly across most UK regions, hospitality and non-essential retail was kept open, exposing workers to risk of infection. When the UK entered a national lockdown on 5 November, essential retail remained open along with takeaway services even as numbers of cases rose steeply. At this point the relatively more transmissible variant emerged (B.1.1.7), creating a potentially greater risk of exposure for Pakistani and Bangladeshi groups who remained unable to work from home.

Pakistani and Bangladeshi groups are also more likely to work in precarious work (short-term, contractual work, usually without union protection (high confidence). In this situation it is difficult to negotiate sick-leave, and if sick-leave is taken employees may be dismissed or penalised with shorter hours. Figures from the 2011 census that report that over half (54 per cent) of Bangladeshi men and women (56 per cent) worked part-time along with over half of Pakistani women (52 per cent) (ONS 2011). Part-time work is more likely to be precarious and associated with zero-hours contracts. The extent of zero-hours contracts across minority groups, and especially Pakistani workers, was also an issue addressed in the Women and Equalities Committee report on unequal impacts of the pandemic (House of Commons Women and Equalities Committee, 2020; Bowyer and Henderson, 2020).

Self-employment where incomes may be especially uncertain is also more prevalent amongst Pakistani and Bangladeshi men (high confidence). Pakistani men are over 70 per cent more likely to be self-employed than White British men (Platt and Warwick 2020); this presents distinct difficulties in reducing the risk of exposure or self-isolating in the event of symptoms, as most self-employed work among Pakistani men involves contact with the public. Non-attendance at work would risk business viability, in part because government measures only offered one-off loans to small businesses and initially did not support the self-employed (see below).

Some deaths are direct consequences of exposure through employment, but it is likely that occupational exposure and severity of infection are amplified by household transmission. Recent work has illustrated how larger or multigenerational households are associated with risks of infection and death (high confidence; SAGE Ethnicity Subgroup, 2020b). This is due to several factors:

a. poor quality and dense housing stock, which creates high risk for transmission (SPI-B, EMG, 2020; SPI-B 2020c) b. age structure of multigenerational households, which place older family members at risk of exposure from younger family members c. caring for family members, social support and care networks that link households, particularly involving middle aged and older women; or d. concentration of time within the home due to national restrictions, school closures and job losses, allowing prolonged exposure to viral loads within the home

While Black African and Black Caribbean households also have a multigenerational structure and will have been affected by job losses and school closures and face poor housing stock, these factors are amplified among Pakistani and especially Bangladeshi communities. Multigenerational households in Bangladeshi and Pakistani families contain family members with chronic, disabling illness at a younger age. Rates of age-adjusted disability are known to differ across ethnic groups, with those for Bangladeshi men historically being particularly high. Reported rates among Black Africans are, by contrast, markedly lower and there may be different responses to disability across ethnic groups (Salway et al. 2007). For example, long-term sick Pakistani and Bangladeshi people especially in contexts of low labour demand were likely to retreat from active participation in labour markets (Salway et al. 2007, p. 32; Gardner 2002), which suggests that long-term sick adults in these groups may be disproportionately exposed to household transmission (medium confidence).

This risk of household transmission may be exacerbated through an interaction between economic disadvantage and the multigenerational household (medium confidence). The economic downturn is likely to have affected Bangladeshi and Pakistani communities disproportionately especially because of their profile of precarious work and self-employment. The disproportionate impact could mean potential exposure to COVID-19 at home from younger family members spending more time with older, chronically ill members. Impacts could be expected to be exacerbated by increased stress which generates suppressed immune responses (Segerstrom and Miller, 2004; Algren et al., 2018).

The risk to family members with long-term health issues may also be increased through transmission from schoolchildren attending education in areas with high levels of community transmission (medium confidence). Family size differs substantially by ethnic group, and it is likely that multiple-child families would face greater risks than single-child households. In addition, recent research from Born in Bradford (Bingham et al., 2021) suggests that during school closures, there were substantial ethnic differences in the extent to which children spent time outside the home by ethnic group, with Pakistani children much less likely than White UK children to leave the home. Children previously exposed to transmission in schools or the community could then potentially be more likely to transmit to older family members within the home. This could occur despite the careful protective practices reported in recent research on British Pakistani families (Atiya Kamal, unpublished research), given the poor quality, dense housing stock that Bangladeshi and Pakistani families live in.

Multigenerational households are also highly networked to the wider community through ties of social support and care-work which are especially important to maintain when formal services are closed, inaccessible or too expensive (Bear et al 2020, SPI-B Wellbeing and Household Connection). For many ethnic minority groups, these ties are often held together through the work of women, especially middle age and older women. The ONS reported from the 2011 census that the highest proportion of women who reported carrying out unpaid care work were Bangladeshi (54 per cent) and Pakistani (52 per cent) of all communities in the UK. Preliminary qualitative research indicates British Pakistani families in large and multigenerational households have implemented several control measures to reduce the risk of COVID-19 including limiting contact with wider networks, particularly where family members are identified as having increased risk due to age or co-morbidities (Atiya Kamal, unpublished research). However, it is likely that women carrying out paid and unpaid care labour may be at higher risk than the family members being cared for (medium confidence). There is some suggestion that this is the case from a recent paper and we should carry out further qualitative and quantitative research to address this (SAGE Ethnicity Subgroup, 2020b).

Overall, it is important to note that the multigenerational household in itself is not a single risk factor producing differential mortality effects. Instead, it is because of the amplifying effects of household stock, high density of family members, underlying health and disability, age structure, social support networks and occupational and school risks that we see persistently high mortality rates in Bangladeshi and Pakistani groups (high confidence).

It is notable that little quantitative or qualitative analysis to date has been able to examine how far household level factors interact with ethnicity and occupation for different minority groups. We need further research on this across all minority groups as mortality rates are inequitably high for all of them. We also need to immediately address the acute issues for all such groups.

Stigmatisation is the process of stereotyping, labelling, separation, status loss and discrimination, which can arise through media representations and in institutional and community settings. Evidence suggests that stigma including racism is a fundamental cause of health inequalities, and a driver of morbidity and mortality (Hatzenbuehler et al, 2013) which undermines access to housing, employment and health treatment (high confidence).

Stigma disrupts social relationships and creates behavioural or psychological responses among individuals and groups, generating physiological stress. All minority ethnic communities face stigma, affecting medical treatment, and responses to central government public health measures (Link and Phelan, 2001; Metzl and Roberts, 2014). Bangladeshi and Pakistani groups face intersecting forms of stigma and racism that relate to their ethnic and their religious identity (Samari et al., 2018).

A history of experiencing stigma can directly impact on individuals health, creating physiological effects including long-term health conditions, and preventing people from accessing health care and other public institutions (Karlsen and Nazroo, 2002; Karlsen and Nazroo, 2004; Wallace et al., 2016). Imbalances of power, inappropriate cultural idioms and lack of sympathy are longer-term experiences within health and social settings for minority groups in the UK (Memon et al, 2016). These experiences are increased by hostile environments and policies such as Prevent, which can lead to ethnic and religious minorities experiencing more difficulty trusting in, and seeking help from, healthcare and other institutions (Fazil et al., 2002; Laird et al., 2007).

Policy environments and events can intensify or decrease the experience of stigma and racism in institutions and workplaces, leading to changes in community norms, interpersonal relations and individual capacities (Stangl et al, 2019). The COVID-19 pandemic in the UK has intensified uncertainty and social distrust, and at times, stigmatisation of minority groups (Bear et al., 2020; Major and OBrien, 2005). Recent research suggests that some central government COVID-19 interventions have unintentionally increased stigma against Muslim groups (medium confidence). In particular, the introduction of restrictions before Ramadan and Eid celebrations fuelled disproportionate public emphasis on transmission within this religious group, leading to direct effects on social cohesion (Abrams et al, 2020; Bliuc et al, 2019). Additionally, press and political coverage has often singled out multigenerational households in ethnically diverse neighbourhoods as a particular source of transmission. This has fuelled social division, hostility and stress for groups such as Pakistani and Bangladeshi communities. This is particularly problematic as levels of adherence to government regulations are high across all social groups, and research shows that South Asian families follow social restriction rules more than other groups overall (Bingham et al., 2021; Nandi and Platt, 2020). Such flashpoints of singling out communities can threaten individuals identities, widely reported in the stigma research literature, which intensifies historical experiences of exclusion, leads to greater psychological stress and more difficulty engaging with health initiatives (Major and OBrien, 2004; Holzemer et al, 2007). Pakistani and Bangladeshi groups have therefore likely been adversely affected due to their public visibility during the local interventions in 2020, with potential physiological effects and undermining health seeking and engagement with institutional settings relating to COVID-19 (medium confidence).

It is essential that the public environment changes, particularly during the vaccination roll out and with the implementation of local interventions to prevent local transmission or surge-testing in areas where new variants emerge. If COVID-19 becomes endemic in a local area, public communications and media should clearly state this is due to the structural driver of socio-economic disadvantage, and supportive messages should be given to avoid compounding stigma and exclusion, and thereby worsening health outcomes from COVID-19. Unfortunately, the media emphasis on BAME communities having low vaccine uptake may also unintentionally contribute to the process of stigmatisation, if not handled correctly. Similarly, if surge testing is carried out in a particular area, local public health teams and the national government must be considered in their communications about this to prevent singling out particular minority or religious groups.

Regions in London and the Midlands where many Bangladeshi and Pakistani communities live have had high COVID-19 hospitalisation rates over a longer period of time, along with greater strains on GP services, than other areas. There are also disparities in access to testing sites, with free taxi rides provided in some areas by charities, but not others, and difficulty accessing testing locations by public transport.

It is likely that there are barriers to testing among Black African, Black Caribbean, Pakistani and Bangladeshi groups (SPI-B, 2020d; Kamal et al., in prep). This likely reflects physical barriers (distance, lack of transport), occupational barriers (not being able to take time off work) and concerns about loss of livelihood for individuals, their family and community networks through a positive test (which would force self-isolation), and experiences of stigma. However, qualitative research to understand the reasons for delayed test-seeking is warranted.

Overall, this section suggests that stigma and racism affects health outcomes for all minority ethnic and religious groups, including during the COVID-19 pandemic, and its current effects require further research, However, due to public media attention to Muslims during Eid and Ramadan this has intensified between wave one and wave 2 for people of this faith including for Muslims in Bangladeshi and Pakistani groups. This may have contributed to more barriers to accessing health services. It is important that politicians, media, civil servants and local public health teams seek actively to reduce stigmatising practices and representations inside and outside of institutions, including in public communications around targeted variant surge testing, vaccines uptake and local interventions to prevent transmission.

Rather than defining specific groups as hard to reach communities, it is more effective to address why certain social groups might find it difficult to protect themselves from COVID-19 exposure and how they might be supported to do this. Policies should therefore address questions of inequality alongside issues of trust and communication. In the sections that follow we will examine how insufficient financial and practical support, community engagement and communications may have produced persistently high levels of mortality in Bangladeshi and Pakistani groups in wave one and wave 2 (medium confidence).

Since Bangladeshi and Pakistani communities are disproportionately employed in precarious work or businesses, measures addressing their economic situation and workplace rights will help decrease COVID-19 exposure and transmission. The pressures to attend work even during local and national social restrictions were particularly intense for these communities (TUC, 2020; Matilla-Santander; 2021; Discover Society, 2020). In addition, precarious workers in textile factories, food production or retail and hospitality have little scope to not attend work if they are unwell (TUC, 2019). It may be that further regulations for COVID-safe workplaces would help with these situation of exposure along with regular inspections in environments that are known to be risky. Furlough, self-employment and business support schemes rolled out by the government have been shown to have benefited already thriving businesses and better-off self-employed people the most (Bear et al., 2020). Since Bangladeshi and Pakistani groups rely centrally on lower-rated businesses or lower income self-employed work they may have felt greater pressure to continue working during the second national lockdown. This was the crucial period in October to November when transmission through exposure would have been most risky and which contributed to the second peak in December 2020 to January 2021.

In addition, evidence shows that increased self-isolation payments would assist all low paid workers and therefore minority ethnic groups as well (SPI-B 2020b, Smith et al 2020, Bodas and Peleg 2020). Furthermore, while some localised support has been offered by local authorities to assist families to self-isolate should multiple members become unwell, which is particularly important for multigenerational household (SAGE Ethnicity Subgroup, 2020b), further support through food delivery, paid care workers and paid for accommodation outside the home may be required.

Looking to the present situation of vaccination roll-out, there is currently no legal or financial support for time off work to attend appointments. For precarious workers it is very difficult to ask for leaves of absence. Introducing workplace vaccination schemes in high risk workplaces including retail and hospitality, along with factories, and incentivising, or legally requiring, employers to give time-off for vaccination, along with a payment of a usual days wages to the employees, could enable more people in precarious and low-income work to get vaccinated (medium confidence; CDC, 2021).

ONS analysis for wave 2 mortality figures should also include mortality rates for non-residents for all ethnic minority communities, as it is likely that recent migrants and people with no recourse to public funds are omitted from our public health measures and policy support (Bear et al., 2020).

As many of the factors that relate to increased risk in minority ethnic groups are structural, such as occupation, the impact of health messages can be limited (SAGE ethnicity sub-group, 2020). However, health communication can support dissemination of public health information but must use culturally accessible language, be shared via trusted sources and tailored to reflect personal circumstances (SPI-B, 2020a).

Ongoing primary research has shown that during wave one, health messages were not reaching all Black, Bangladeshi and Pakistani groups due to inaccessible language, modes of delivery and mistrust towards formal organisations that were sharing the messages (Kamal, unpublished research; TSIP, 2020; medium confidence). This resulted in adopting a more strategic, co-designed approach to health messaging with a strong focus on community engagement (GOV.UK Press Release, 2021). In addition national communications in wave 2 occurred against the backdrop of a national anti-racist movement, Black Lives Matters (BLM), which began in June and continued through August 2020 and may have created greater empowerment. During the same period stigmatising communications towards some Bangladeshi and Pakistani groups increased (as outlined above). This hypothesis has not been tested and requires further research (hence low confidence). However, understanding the process of community engagement at the local level, and how it has been different for diverse ethnic and religious minority groups, may offer insights into different health disparity outcomes in wave one and wave 2.

The BLM movement has fostered greater empowerment within the Black African and Black Caribbean community and enabled these groups to express their frustrations of many years (medium confidence). This new empowerment may have created a sense of optimism and facilitated open dialogue which increased knowledge and contributed to greater use of cultural, religious and collaborative approaches to reducing risk and transmission of COVID-19 in Black communities in the UK (medium confidence) (Kamal and Bear, ongoing research). Strategies include sharing videos of elders having the vaccine and hosting a COVID-19 vaccine event to address misinformation stemming from historic issues of unethical scientific research and religious beliefs (Caribbean and African Health Network, 2021).

In contrast, recent and ongoing research shows that Bangladeshi and Pakistani groups have not reported similar feelings of empowerment (Kamal and Bear, ongoing research; Bear et al, 2020). While there is increased use of cultural, religious and collaborative approaches for these communities, access to evaluation data is limited. Stigmatising communications are known to disempower communities (Public Health Wales, 2019) and stigma can result in mistrust towards formal organisations and contribute to more severe health problems (Gronholm et al, 2021). Although community engagement efforts are now underway with MHCLG funded Community Champions schemes running in several parts of the UK, establishing and/or rebuilding trust may take longer, particularly for Bangladeshi and Pakistani groups in the absence of a national movement such as BLM. Some groups may feel more wary or sceptical of community engagement activities based on their experiences of wave 1 communications (Kamal et al 2020) (medium confidence). Effective community engagement will also involve recognising within-group, inter-generational and gender differences to ensure health messages do not treat minority ethnic groups as homogenous. Health messages should also be tailored to the lived experiences of these groups. Communications should avoid attaching locations and ethnicity to COVID-19 to minimise stigmatising attitudes towards specific groups and mass media strategies should be used as a platform for anti-stigma communications to promote social cohesion and collective identity (Gronholm et al, 2021) at a national and local level.

Laura Bear, Lucinda Platt and Nikita Simpson.

Here we illustrate how occupational, household disadvantage and stigma intersect through a case study of Leicester to produce a chronic situation of COVID-19 transmission. While Pakistani and Bangladeshi communities are not the largest minority group in this city, which is highly diverse, this example illustrates how socio-economic factors intersect to produce ethnic health disparities. We first set out the context and patterns of infections and deaths before drawing on ethnographic work to explain COVID-19 health outcomes.

With a population of a little over 0.5 million people, Leicester has a large Indian population, but also has substantial shares of Black African and Pakistani ethnic groups, compared to their representation in the population as a whole. Importantly, it has faced relatively high death rates in the aftermath of the first period of national restrictions from March to May 2020. It has also experienced specific local interventions since the end of June 2020 as well as substantial media attention, leading to stigmatisation. It has never had restrictions lifted and yet has experienced a chronic situation of COVID-19 transmission and mortality. Therefore from the patterns here we can pick up directly on underlying socio-economic interactions that generate disproportionate impact on minority ethnic groups.

Occupational distributions are distinctive in Leicester with large numbers of people working in risky and lower-paid occupations. Looking at the three-digit occupational level for the years 2015 to 2017 (ONS, no date), Leicester has markedly higher shares of Process Operatives, Transport Drivers, Assemblers and Routine Operators, Elementary Process Plant Occupations and Elementary Storage Occupations than for Great Britain as a whole. On the other hand, it has lower shares of various professional occupations including teaching and business professionals. While any occupational group has just a small percentage of all workers (a few per cent), the somewhat distinctive occupational profile nevertheless is of interest for the extent to which it may lead to greater risks especially if the distribution among such occupations is uneven across the population. It is worth noting that in the ONS analysis of occupations, process plant operatives and elementary process operatives were among the occupations with higher risks of death (ONS, 2020). In fact all elementary occupations were associated with higher risks for men compared to the average, comparable to caring and service occupations. Working conditions have been flagged as more at the root of the greater risks for these occupations, compared to the greater chances of coming in contact with someone infected in health and social care occupations (POST, 2020). In addition, as argued in the main paper, these forms of work have greater precarity than others, making it hard for people to self-isolate because they are pressured by employers or cannot risk their livelihoods. It is important to note for example that deprivation among Indians is rather greater in Leicester than it is in other cities (Zuccotti and Platt 2017).

The greatest housing and occupation disadvantage in Leicester (according to the 2011 census) is in the North-East and East, followed by the West and North-West districts. This ranking also captures ethnic differences, with minority groups living in the greatest numbers in the North-East, East and West of Leicester (Leicester City Council, 2011).

The central district of Leicester is relatively affluent and occupied by 2 university campuses and business and retail premises, with residential areas for students and skilled or professional occupations. It is predominantly of white ethnicity (49.7 per cent) with 4.3 per cent reporting as long-term sick or disabled. In the North-west (Beaumant Leys, Mowmacre Hill, Stocking Farm, Abbey Rise and New Parks) older housing estates are occupied by 65.3 per cent White Ethnicity, with an equal mix of retail, service, care, education, manufacturing and professional occupations. Overcrowding is at 12.1 per cent. 10 per cent are long-term sick or disabled.

In the North-East (Northfields and Tailby estates and the Golden Mile Shopping District) 52.8 per cent of the residents are Asian British: Indian with 24.9 per cent White British. Overcrowding is at a higher level of 14.7 per cent and the area is less affluent with 40.5 per cent working in retail or manufacturing with only 10 per cent in professional occupations. 9.5 per cent are long-term sick or disabled.

The East area of the city (St Matthews and St Peters Thurnby Lodge) includes the oldest housing stock in Leicester in the district known as Highfields. 46.9 per cent of the residents here are Asian British Indian with 20.8 per cent White British. Overcrowding is at an even higher level of 17.8 per cent. Job profiles are more deprived as well with 40 percent working in retail or manufacturing with 17.1 per cent in Elementary occupations and 11.9 per cent in Sales and Service sector. 9.9 per cent are long-term sick and disabled.

The South district is more suburban, white ethnicity and professional (Aylestone and Knighton, the Eyres Monsell estate, Aylestone Park, Saffron Lane, Knighton Fields, West Knighton and the Stoneygate Conservation Area). White ethnicity residents are 72 per cent with overcrowding at a low rate of 9 per cent. 60 per cent of people in this area are in professional, skilled, administrative and caring occupations. There are 7.4 per cent reporting as long term sick or disabled.

The West part of Leicester presents a more mixed picture with close packed terracing, council estates and a garden city estate (Braunstone, West End, Newfoundpool, Danes Hill and Fosse). 63.4 per cent are White ethnicity, with 10.8 per cent other white groups and 5.7 per cent Black African and Black Caribbean, and 9.9 per cent Indian. Overcrowding is high at 13.4 per cent and long term disability at 7.5 per cent. Professional profiles are similarly split with thirty percent in elementary or manufacturing process jobs, while 34 per cent are in skilled, service and professional trades.

Overall we see most of Leicesters minority ethnic populations distributed in the following way within the most crowded, most socio-economically disadvantaged wards (Leicester City Council, 2011) Indian groups in -Spinney Hills, St Matthews, Highfields, Belgrave, North Evington, Leicester City, Rushey Mead, Latimer, Coleman; Black African groups in St Matthews (Somali especially), Beaumont and Braunstone; Bangladeshi groups in Highfields, Spinney Hills and North Evington; and Pakistani groups in Spinney Hills, Highfields and Washbrook (Leicester City Council, 2011).

By 1 March, Leicester had experienced 34064 COVID-19 cases, a rate of 9616 per 100,000.

Figure 1 shows hose those infection rates evolved over time since 13 March 2020, though of course part of this is to do with the increase in testing.

Figure 1: Cases: Weekly rates since 13 March 2020, Leicester. Source: derived from data downloaded from UK Coronavirus Dashboard on 2 March 2021.

Hospital admissions (Figure 1a) tend to follow the pattern for cases in the more recent period. In the earlier period cases only tended to be identified in hospital, hence the peak for hospitalisations is not reflected in the case rate for wave one.

Figure 1a: Hospital Admissions for COVID-19 since 13 March 2020, Leicester. Source: derived from data downloaded from: UK Coronavirus Dashboard on 2 March 2021.

There had been 731 COVID-19 deaths by 1 March 2021. Figure 2 shows how the cumulative total evolved over time. And for comparison, Figure 3 shows the cumulative rate (per 100,000 population) compared to Hackney, which makes it clear that the cumulative rate for Leicester overtook that for Hackney in May 2020. We have chosen to compare with Hackney because it is an area that has a diverse inner-city population too, but with a different occupational make-up, strong connections between the local authority and third sector and mutual aid groups and a greater amount of black African and Caribbean residents than Leicester. This comparison merits much further investigation than it is possible to complete here, including data from the end of the second wave in Hackney.

Figure 2: Deaths (cumulative), Leicester. Source: derived from data downloaded from: UK Coronavirus Dashboard on 2 March 2021.

Figure 3: Cumulative Death Rate Leicester and Hackney compared. Source: derived from data downloaded from: UK Coronavirus Dashboard on 2 March 2021.

Figure 4, rather than looking at the cumulative total, looks at the rolling death rate (namely the rolling 7-day average). This shows how the rate in the more recent period exceeded that for the earlier period. Again, a comparison with Hackney shows how the patterns across the 2 areas differ. The England rolling rate is also included for reference. The rate in Leicester is clearly to the right of that for Hackney with a lower initial peak but slower decline, including some upticks. Note that Leicester was put into lockdown on 26 June, by which time its rolling rate had been above that for England for a few weeks. Leicester experienced a higher second peak than Hackney and then a later third peak.

Figure 4: Rolling Death Rates by Date. Source: derived from data downloaded from: UK Coronavirus Dashboard on 2 March 2021.

Finally, Figure 5 digs a bit deeper to look at variation in case rates by ward within Leicester. For this information there is just the week ending 26 February.

Figure 5: Cases and rates of cases by ward, Leicester, week ending 26 February. Source: derived from data downloaded from: Open Leicester on 2 March 2021.

In addition we have plotted local public health case date per week per 1000 according wards in Leicester from 20 April to 21 January.

These graphs indicate that mortality and case loads across Leicester have been chronic, and COVID-19 is endemic in some areas in spite of restrictions. In addition there has been a particularly high case load clustered in the area East and adjacent to the city centre that includes Spinney Hills, Evington, Mowmacre, Rushey Fields, Charnwood, St Matthews and St Peters, Northfields and Stoneygate. This is mainly South Asian, and densely populated. It is the area where many textile factories are (especially Evington and Spinney Hills) and where those who work there live. This has had chronically high transmission rates through the whole year with especially high transmission rates in the Summer and Autumn. It seems likely that these spikes represent the interactions of disadvantages of occupation and household circumstances. Or in other words high case loads due to people working in precarious work in which they cannot negotiate sick-leave and living in multigenerational households containing members with reduced health in densely packed neighbourhoods. It is clear too that the people engaged in these occupations would have still had to go to work during local interventions. The disproportionate ethnicity effect of this is visible in the following graphs.

Continued here:

COVID-19 Ethnicity subgroup: Interpreting differential health outcomes among minority ethnic groups in wave 1 and 2, 24 March 2021 - GOV.UK

Photos: Sheikh Mohamed bin Zayed wears many hats all of which make him an icon respected by Emiratis and expats alike

Published: Sun 15 May 2022, 5:31 PM

Last updated: Sun 15 May 2022, 9:42 PM

The third UAE President, His Highness Sheikh Mohamed bin Zayed Al Nahyan, had proven himself to be a versatile leader during his 18-year tenure as the Crown Prince of Abu Dhabi.

Proving his mettle as a visionary representing the country on the world stage and as an icon respected by Emiratis and expats alike on the domestic front, the new Ruler of Abu Dhabi wears many hats. Here are just a few different facets of Sheikh Mohamed.

Sheikh Zayed was a mentor, father, and teacher to young Sheikh Mohamed, who accompanied him on several tours around the country and abroad. The future President was hands-on and delved into the various facets of governance during this time.

Sheikh Zayed believed that his son Sheikh Mohamed should get the right education from an early age. School shaped the Presidents worldview and made him resilient, and hard work and discipline made him a favourite among his teachers.

National commitments did not stop Sheikh Mohamed from spending time with his family, his core support system.

The Presidents influence has grown on the world stage. He has forged relationships with global leaders at a personal level.

UAE forces have taken part in peacetime and combat operations worldwide to ensure global security. They have a strong backer in Sheikh Mohamed.

The UAE is laying a new model of governance for the Arab world, and Sheikh Mohamed believes that Gulf nations have a major role to play in this transformation.

While Saudi Arabia and the UAE are diversifying their economies, Oman and Kuwait are embarking on economic reforms. The GCC has remained a force for good and has brought stability to the Middle East. The UAEs ties with Jordan, Turkey and Egypt also remain strong.

The President enjoys a great rapport with His Highness Sheikh Mohammed bin Rashid Al Maktoum, Vice President and Prime Minister of UAE and Ruler of Dubai. They often visit each other to discuss matters of state and the welfare of the people.

Sheikh Mohamed is a President with the common touch. He always stops and listens to what people have to say while inspiring them. A mass leader, he is equally comfortable speaking about space as he is about womens empowerment.

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Expat workers have contributed a great deal to the growth of the UAE, and Sheikh Mohamed values their contributions. He even takes time off from his busy schedule to make surprise visits to the sick and injured in hospitals.

The charismatic leader is also a hit with children who adore him. He even visited a young girl who expressed a desire to meet him.

See more here:

Family man, student, soldier: UAEs new President is all these and more - Khaleej Times