We would never ignore decades of scientific evidence on the cause of a disease – why is racism any different?

When it comes to health in Britain, racism has a lot to answer for. Whether it be historical, institutional, or overt, any and all “types” of racism have recognised and quantifiable effects on the health of people from minority ethnic backgrounds. That the Commission on Race and Ethnic Disparities, whose report was published this week, has found otherwise is yet another example of how Britain continues to ignore the many ways in which the social world impacts on health.

Ignoring is precisely how this government, and the ones that have come before, are dealing with the unpalatable truths about racism in our country. The commission concluded that “geography, family influence, socio-economic background, culture and religion have more significant impact on life chances than the existence of racism”.

Well, this is awkward, because years of research show that all of these things are negatively impacted by racism. The commission has ignored the decades of evidence showing that this situation has arisen because of the many real ways that historical and current racism restricts where people from ethnic minority backgrounds live, learn and work. Several studies have shown that this trend persists through the unconscious bias and overt racism of employers and landlords across many European and North American countries.

Since the race report was published, major academic groups have swiftly and strongly condemned its findings, including the BMJ and, most importantly, the British Sociological Association.

The race report isn’t just choosing to take a page right out of The Thick of It, cherry-picking research whose findings are, to use their language, “in contrast to the narrative of other reports”. The commission is wilfully blacklisting the one discipline which has spent decades researching the relationship between race, racism and the everyday: sociology. It is notable that only one member of the panel appears to have any grounding in the social sciences (their experience is in policy rather than sociology). Even the research favoured in the report leaves sociology out in the cold, citing mostly rapid-evidence reviews of a select few topics.

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Which leads me to an important question, one I am asking openly and genuinely: how many studies does it take to make a truth?

It is a question I have asked myself continuously since I read the race report, because its findings are, to most social scientists, utterly baffling. It ignores not just decades of work, but even recent, well-respected reports such as Build Back Fairer and Health Equity in England: The Marmot Review 10 Years On. It ignores how the pandemic has starkly revealed the already underlying racial inequalities in our society and intensified their effect on the health and wellbeing of the minority ethnic population.

Yet as a country we have largely ignored these findings again and again. It would be inconceivable to ignore 40 years of scientific evidence about the cause of a disease, for example, but somehow we have been doing just that with racial health inequalities. That several decades’ worth of research has come to the same conclusion, but sparked little change, is arcane. In science, reproducibility and precision are considered important tenets of the scientific method. That different researchers, over time, are able to come up with the same results again and again is the bedrock on which science itself is built. So why the reticence when it comes to the social determinants of health and illness?

To draw a ludicrous but useful parallel, if a commission to determine whether Covid-19 is a virus had ignored all the scientific evidence to find that it was not a virus but in fact an innocuous butterfly, we would rightly be questioning the sanity of the commissioners (and of the government who appointed them). Racism has reproducible, quantifiable and demonstrable effects on the health of people from ethnic minority backgrounds. It is a very real, very dangerous virus.

I have a hunch that all this is about how we as a society value the knowledge that the social sciences produce. Which is to say not at all. Science is often seen as immutable because it offers objective facts that are reproducible by following an experimental protocol that leads scientists to the same conclusion time and time again. That’s not strictly true, but it is mostly true. Even I teach my students that epidemiological precision (meaning the ability to obtain similar results every time we sample a population) is a key component of a good and strong study. This is exactly what is happening with research on racism and health: time and time again the conclusions are the same – that racism impacts negatively on health, even today – and yet these findings are often disregarded as “subjective” and “unscientific”.

But we cannot ignore what racism has done to the health of valued members of our society, and so perhaps how we value the social sciences is about to change. This year has highlighted how much can be learned from the social sciences, and there have been calls from far and wide to better include and incorporate the social sciences into policy, practice and governance, from such esteemed publications as the BMJ, The Lancet and Nature.

To better account for the social sciences in these fields, we could do worse than consider the findings of the Build Back Fairer report, and implement its major recommendation: to commit to social justice by putting equity of health and wellbeing at the very heart of national and regional policy-making.

To do this we need scientists of the social kind, sociologists in particular, working with societal, cultural, and behavioural truths to help inform how we build back (a fairer and inclusive) Britain.

Dr Alexis Paton is a lecturer in social epidemiology and the sociology of health at Aston University, chair of the Committee on Ethical Issues in Medicine at the Royal College of Physicians, and a trustee of the Institute of Medical Ethics