People of colour have less opportunity to be healthy with housing, work and other barriers getting in the way of eating well and exercising more. Structural racism must be tackled to boost the health of the nation, Runnymede Trust’s Stephen Walcott writes.

A journey to better health starts long before any interaction we have with healthcare professionals. Whether it’s eating more nutritious food, exercising more, reducing stress, or spending more time in nature, the building blocks we all need to ensure good health go far beyond GPs and hospitals. But these building blocks are often only afforded to those privileged enough to access them.

Our new report with the Health Foundation shows that for people of colour, there are large, unacceptable variations in access to these core building blocks of good health. We show how racism is embedded in the everyday structures of society, from our labour market to our housing systems, and the clear impact of these inequalities on the health of people of colour in the UK.

Occasionally, a particularly harrowing story grabs the headlines and we recognise how structural racism operates – such as when two-year-old Awaab Ishak died from black mould in his home, or when nine-year-old Ella Adoo-Kissi-Debra became the first person to have air pollution stated as her cause of death.

But mostly we have stubborn conversations that view health inequalities as merely a social-class issue and racial disparities as a distraction – or, at the most extreme end, entertain racist arguments about genetic predispositions to poor health. None are helpful.

Of course, social class is a significant factor in determining access to the building blocks of good health and therefore their ability to be healthy. But a social class lens alone does not explain why it is people of colour who are more likely to be from a lower socioeconomic position in the first place.

Two thirds of Bangladeshi and Pakistani, and over half of Black children live in poverty, compared with a quarter of white children. Bangladeshi people in the UK have 26 times less wealth than White British people. Regressive social security policies and a stubbornness to redistribute wealth are cementing these inequalities and fuelling a health divide; this can only be explained when we look at structural racism as a factor alongside social class.

People of colour are more likely to be unemployed or have insecure, low paid jobs, which have a significant impact on a person’s health. It has long been documented that people of colour experience discriminatory hiring practices, biased policies, and hostility in the workplace – for instance, people with African or Asian sounding surnames have to submit twice as many CVs before being invited to an interview. There is also plenty of evidence showing how workplaces can discriminate either at interview stage or as part of a hostile culture.

When looking for a home, people of colour face up to five times more discrimination and a significantly increased risk of eviction. People of colour therefore fall into some of the worst housing conditions –many are more likely to be living with damp and mould, or overcrowded – or, worse still, made homeless. These conditions are also disproportionately situated in some of the least healthy external environments, where air pollution is high and access to green space is low.

It’s clear – people of colour have less opportunity to be healthy. Structural inequalities are a disease that cannot be treated with a plaster. We need to take seriously the factors that contribute to our health and wellbeing, long before it manifests as illness. Whether that’s via our housing or social security systems, only then can we claim to be taking people’s health seriously. Addressing the structural drivers of poor health would not only benefit people of colour, but be healthier for us all.

Posted on the Big Issue on 12 March 2025.