Using the term ‘BAME’

Abstract

I do not recall when I first heard the term BAME, nor do I recall when its use became so widespread, but in the first wave of the pandemic the term BAME was impossible to ignore. It is defined as an ‘abbreviation for Black, Asian, and minority ethnic: used to refer to people in the UK who are not white.’ As a medical student who would fall under the all-encompassing term ‘BAME’, I watched with alarm as my news feed was inundated with articles highlighting that BAME individuals were dying at a disproportionate rate. My alarm was not unwarranted as although the headlines referred to BAME people, a rather broad group, the research was not so kind as it singled out Black African males as the group with the highest rate of death from COVID. I, as you may now have gathered, am a Black African male. Although we have been drawn together under the umbrella of ‘BAME’, our experiences of healthcare are not the same. This is exemplified by the fact that while Black African males are 2.7 times as likely to die of COVID as white males, there is very little difference in mortality between Chinese and White males. ‘Don’t add to the statistic’: an expression told to many young black men by wise elders aiming to deter their impressionable youth from a desolate life of crime and uncertainty, I had managed to avoid adding to this statistic. Yet as I lay in a hospital bed on oxygen a week after testing positive for COVID, I questioned whether perhaps I would be adding to a statistic after all—the number of black people dying of COVID. Numerous well-meaning doctors offered unsolicited explanations as to why I, an ordinarily fit 21-year-old male would be afflicted so heavily with the disease; without fail they would point out my ‘BAME’ background and that would be enough. BAME was both my background and my cause of illness. Using the term BAME readily to explain a patient’s deteriorating condition can be dangerous. The impression given is that across nonWhite groups there is an innate predisposition for poorer healthcare outcomes, whereas in reality research has shown that in COVID the factors involved are more institutional than constitutional. Statistical models show that a large proportion of the differences in mortality between ethnic groups can be attributed to socioeconomic, demographic and geographical factors. Poverty and social disparities drive these figures, but it can be far less confronting to use ‘BAME’ as an explanation. Social determinants of health such as housing, education and income as well as their interplay with racism and discrimination is a more fitting explanation. Unfortunately, those suffering with these adverse social determinants will struggle the most with the interventions introduced such as social distancing and school closures. These individuals often have precarious jobs with a greater risk of catching COVID and will be unable to educate their children, further perpetuating these inequalities.