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People of Black or Asian background in the U.K. are far more likely to fall ill and die from COVID-19, the government said Tuesday, reinforcing months of reports from media, think tanks, and health care officials that the impact on non-white Britons has been disproportionate.

The release of the report on Tuesday afternoon, followed by a pledge that Health Secretary Matt Hancock will face questions in Parliament on Tuesday, came amid some confusion and public outcry over when the report, which was commissioned for release by the end of May, would ever see the light of the day.

Recent accounts in the British press suggested the government was trying to delay the report’s release to avoid stoking racial tensions. The killing in America of George Floyd has triggered street protests in cities the world over, including the U.K. The government denied this was the case.

The report comes at a tense time for the U.K. Protests have also highlighted racism against Black Britons, including the death of ticket officer Belly Mujinga from COVID-19 in April after she was spat on by a man who said he had the virus, alongside the well-documented toll COVID-19 was taking on Black, Asian and other people of an ethnic minority background. In the U.K., the signifier Asian typically refers to people of South Asian background.

Reversed death rates

The report, which also covered age, gender, and geographic location, affirmed previous studies, saying that the pandemic had effectively reversed death rates for Black and Asian patients versus white ones. In the years before the pandemic, white patients had a higher death rate than non-white patients. The opposite is now the case, Public Health England said, characterizing the impact as “disproportionate.”

The overall data “confirms that the impact of COVID-19 has replicated existing health inequalities and, in some cases, has increased them,” the report concludes.

Taking only age into account—the non-white population is on average younger than the U.K. population as a whole—Black men were 4.2 times as likely to die from the virus as white men, for example.

The disparity was largely explained by a range of social and economic factors, the report said, including the fact that a higher proportion of Black and Asian people live in cities, in overcrowded housing and deprived areas; holding jobs that put them at greater risk of being exposed to the virus; and with lower access to regular health care.

However, even with these additional factors considered, there were still disparities: For instance, those from a Bangladeshi background were more than twice as likely to die from COVID-19 than white people, and those of other non-white ethnicities were between 10% and 50% more likely to die as a result of the virus.

The report’s delay highlights a growing source of frustration in the U.K., as evidence has emerged time and again—including from other government reports—of the disproportionate risk to Black and Asian people from COVID-19, a deep disparity that is also evident in the U.S. The report also affirmed that more than a third of coronavirus patients in critical care had an ethnic minority background, despite that same group making up only 15% of the total population, a figure first reported in early April by the Intensive Care National Audit and Research Centre.

Further analysis from the U.K.’s Office for National Statistics, the Institute for Fiscal Studies think tank, and Oxford University’s Centre for Evidence-Based Medicine has also found that people with an ethnic minority background are more likely to become critically ill from COVID-19.

The impact has been dramatic in fields where Black, Asian, and other workers with an ethnic minority background are overrepresented—including health care. While about 21% of the 1.2 million people employed by the U.K.’s National Health Service came from an ethnic minority background as of March 2019, more than 60% of health care workers who have died after contracting COVID-19 came from that same group, according to separate investigations conducted by the Guardian newspaper and Health Service Journal in April and May.