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The Guardian - AU
The Guardian - AU
National
Melissa Davey and Josh Nicholas

Covid death rate three times higher among migrants than those born in Australia

A woman waits for her Covid jab in front of a Lakemba mosque's pop-up vaccination clinic last year organised by the Lebanese Muslim Association with health authorities in Sydney. Vaccine hesitancy can be an issue among migrant populations.
A woman waits for her Covid jab in front of a Lakemba mosque's pop-up vaccination clinic last year organised by the Lebanese Muslim Association with health authorities in Sydney. Vaccine hesitancy can be an issue among migrant populations. Photograph: Saeed Khan/AFP/Getty Images

Most Covid deaths in Australia have affected migrants, with people born in the Middle East suffering the highest death rate, data from the Australian Bureau of Statistics show.

Despite just 26% of Australians being born overseas, new ABS data shows there were 2.3 Covid-19 deaths per 100,000 people born in Australia, compared with 6.8 for those born overseas.

Experts say Australia’s reliance on migrants to undertake essential, insecure work and a failure to engage migrant communities early in pandemic planning is a key reason for this.

The ABS data also supports previous data gathered throughout the pandemic that found deaths are higher in older populations and those with pre-existing conditions. Almost 70% of death certificates in Australia reported pre-existing chronic conditions such as dementia and diabetes, according to the data which analysed 2,639 deaths where people died with or from Covid-19 from the start of the pandemic to 31 January 2022.

The ABS expects to receive further data for this period once it receives information from the jurisdictional registries of deaths.

The data shows many of the hardest areas hit by the pandemic, such as in Sydney’s south-west, were also areas with high migrant populations.

People born in the Middle East had the highest death rate at 29.3 deaths per 100,000 people.

Dr Margaret Heffernan, a behavioural researcher with expertise in cross-cultural communication and vaccination, said numerous factors led to the high deaths among those born overseas that had little to do with their country or origin, but a lot to do with failures in the way they were treated in Australia throughout the pandemic.

A failure of the federal and state governments to engage people from migrant backgrounds early during pandemic planning, or to communicate health information through appropriate avenues and in the correct language, led to a slow pandemic response in many areas with high migrant populations, she said.

“The mediums of communication used did not sufficiently support their needs,” Heffernan, who is with RMIT University in Melbourne, said.

“Then we get down to socioeconomic factors, and we know that many migrants are in the casual workforce, and therefore risk of exposure through their work is high because they often have multiple jobs in essential industries.

“We then look at housing for many of our migrants. Many live in high-rise towers without adequate ventilation, so no balconies or windows they can open, and often very large numbers of people live together in some of the suburbs most affected by outbreaks.

“Finally, the vaccine rollout was slow to get organised and to bring the vaccine to some of our most vulnerable people including migrants in aged care, and we also know from research that vaccine hesitancy can be an issue among migrant populations because of their cultural values towards health and wellbeing and the fear of what components are in the vaccine.”

Cultural and linguistic diverse health promotion expert Daniel Reeders said migrants were doing the jobs other Australians often did not want to do, “where it’s very hard to protect yourself”.

“We were slow to recognise the role of workplaces as the major driver of new transmissions,” Reeders, a PhD researcher with the Australian National University, said.

“When I look at those data based on country of birth, what I’m seeing is people who have exposure to the so-called ‘dirty jobs’ that middle-class, Anglo-Saxon Australians usually don’t want to do, things like the meat processing, age and disability care, and hospital cleaners and porters. They are jobs where it’s very hard to protect yourself from close contact with your staff on high-density work floors and that combined with slow proactive health outreach programs drastically increased migrant exposure to infection.”

Covid was the underlying cause of death for 2,556 Australians in the pandemic up to 31 January. This is more than 96% of deaths related to Covid, leaving just 83 people who died with – but not due to – Covid.

The distinction between dying with or due to Covid has been controversial, with some vaccine and lockdown sceptics claiming that deaths were being overreported.

Throughout the pandemic the statistical definition of a Covid death was a death of a confirmed case unless there is a clear alternative cause that cannot be related to Covid, such as trauma or a car accident.

This caused confusion as more than 90% of deaths due to Covid had other conditions also listed on the death certificate. Of the 83 people who died with Covid up to 31 January, cancer was the most common underlying cause of death at almost 40%.

Almost 40% of all Covid-related deaths up to 31 January were in more disadvantaged areas of Australia. The least disadvantaged areas saw less than 10% of the total deaths in the pandemic to this point.

The ABS “indexes of socioeconomic disadvantage includes measures of income, education, employment and housing. Guardian Australia has previously reported that Covid outbreaks have repeatedly and disproportionately hit more disadvantaged groups. This was true during the 2020 Melbourne outbreak and the 2021 outbreak in New South Wales.

These areas often also have lower access to social infrastructure such as health, education, early childhood, culture and emergency services. They also have disproportionately large households, overcrowding and low access to public open space.

The shadow minister for multicultural affairs, Andrew Giles, said: “Where you were born shouldn’t determine your health outcomes.”

“The disparity in Covid mortality rates between those born in Australia and migrants is shocking and getting worse,” he wrote on Twitter in response to the ABS data. “This has to be unacceptable. The Morrison government must start listening.”

Heffernan said she agreed the deaths are unacceptable, but that her response to Giles and other politicians is: “If you’re also speaking for those constituents, what did you do about it?

“What were you doing during 2021 to make sure their voice was heard, that they weren’t getting incorrect information, and that they were getting access to prevention?

“I would ask any politician who is representing these communities, what did you personally do?”


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