In New York, blacks and Latinos appear to be twice as likely to die from Covid-19 as whites. In the UK, preliminary data show that non-white people have a 10 to 50% higher risk (pdf, p. 45) of dying from the disease.
In France, however, no one knows.
The country’s tense relationship with the collection of race or ethnicity statistics means that health officials are unsure whether Covid-19 kills communities of color or not. Some maintain that this prevents civil servants (link in French) from implementing specific policies for the protection of minorities. Advocates of France’s nominally color-blind system say that, since there is no cure or vaccine for Covid-19, having this knowledge would not help patients and would rather erode decades of policy that protects information personal information of those at risk populations.
There has long been a heated debate in France (French) on the rules governing the collection of this information, in particular in the context of police violence, inequality and discrimination. Now Covid-19 has brought this debate to the fore again, but it is not certain that it will move the needle.
France and race statistics
Popular understanding is that France prohibits the collection of all racial or ethnic statistics. The reality is more complicated.
Article 1 of the French constitution guarantees “the equality of all citizens before the law, without distinction of origin, race or religion”. And article 8-1 (link in French) of a law of 1978 on digital rights prohibits anyone from collecting or processing “personal data which reveal, directly or indirectly, racial or ethnic origins, political opinions , philosophical or religious or union membership of or which relate to their health or sex life. ”
There are two strong historical legacies behind these rules. The first is that the construction of the French republican identity seeks to erase individual differences in favor of a universal way of life, or live together. The American model, in which official documents regularly divide people into racial categories (and specific policies can be put in place to target one group or another) is contrary to this idea. Opponents say the government’s use of these statistics would undermine social cohesion.
A second factor is the Second World War and the murder of some 77,000 Jews living in France at the hands of the Nazi regime, with the active cooperation of the French state. Given the role that official and community registers played in gathering Jews to be sent to concentration camps, France is sensitive to the question of collecting statistics based on race or religion.
This does not mean that it is completely prohibited. It is possible to collect anonymized data (French) according to the country of origin of the people, their nationality prior to French nationality or their “feeling of belonging” to France. Other data may sometimes be collected, but the reason and the means of collection must be approved by the digital authority of the country. On the whole, the judicial authorities have found it unconstitutional to carry out “studies on the measurement of the diversity of origins, of discrimination and of integration”. And even where it is legal, there is a taboo in France around the process.
So where does that leave public health statistics regarding the racial makeup of Covid-19 patients and deaths?
Covid-19 and race
There are more questions than answers regarding the racial disparities of Covid-19.
In the United States and the United Kingdom, minorities collectively seem more likely to die from the disease. The scientific community is just beginning to understand why, and there are two main assumptions.
One concerns the exhibition. Ethnic minorities represent a disproportionate share of low-paid service workers, including health workers, which means that they are more exposed to the virus. Another concerns socio-economic inequality and its impact on health. These populations are more likely to be poor, to live in cramped housing where social distancing is not possible, and less likely to seek and receive quality medical care. Hypertension, diabetes and coronary heart disease are also more common among minority groups in the United States and the United Kingdom. Doctors believe these pre-existing conditions worsen the symptoms of Covid-19.
Although doctors may whisper among themselves (French) the prevalence of minorities among their patients, the official statistics on the deaths of Covid-19 do not include a breakdown by race and ethnic origin – or even by country of origin or nationality , which would be theoretically legal. “We have the right to do it, the information exists, but it is not published,” said Patrick Simon, director of research in the International Migration and Minorities Unit of the National Institute for Demographic Studies.
“Not giving figures is to condemn these people a second time,” said Ghyslain Védeux, president of the Representative Council of Black Associations in France (CRAN), “because you have to know which populations are affected to better treat them.”
The idea isn’t just to collect this data, it’s to do something with it. Examples from the United States and the United Kingdom show that carefully collected data, in the right hands, can sometimes lead to policy change. For example, armed with information that the disease disproportionately kills people of black and ethnic minority backgrounds (BAME), the United Kingdom’s National Health Service (NHS) has requested that NHS staff from these environments be “risk-based” and reassigned to jobs where they are less likely to contract the coronavirus.
Reasonable people may disagree as to whether this is the right thing to do, but what is certain, says Simon, is that such a policy could not happen in France. This would require, he said, “several strong intellectual and political leaps”.
As the pandemic begins to recede in France, the window of action on this issue may close. But with the best experts warning that the virus is likely to come back, the lessons learned here could inform future public health responses. If so, says Vedeux, France will have missed an opportunity to learn more about the impact of Covid-19 on communities of color and to do something about it.