Bradford is the fifth largest Metropolitan Local Authority District in England and the youngest district in the UK with nearly a third of the population aged under 20. And we are diverse.
At the very start of the pandemic it was clear that COVID would impact heavily on the poorest in our communities. It also became clear that higher numbers of black, Asian and minority ethnic (BAME) people were dying and becoming very sick.
The district has high levels of diabetes, obesity and heart disease and a high prevalence of multi-generational and overcrowded housing with many people suffering multiple inequalities. Tackling this inequality and working with communities was an essential part of our response to addressing diversity and inclusion and to keeping communities safe.
It became clear that one of our key assets was data and by working with partners, we created our own Bradford SAGE, the dedicated COVID Scientific Advisory Group (CSAG) with the intention of using data to inform local decision-making and communications with citizens. The real strength of this partnership was how involved our communities were from the very start and how they continued to work with us throughout.
The council along with the Centre for Applied Education Research, Bradford Teaching Hospitals and Bradford Institute for Health Research brought together our data, expertise and links to local families to support an evidence-based response to the pandemic that helped to address the challenges faced by vulnerable individuals and families across the district. Bradford’s CSAG worked across a range of partners, including community champions, health care practitioners, faith leaders, academics, youth workers and council ward officers.
Working together as a partnership we were able to get ahead of the national debate in gathering evidence to help support local people including enabling socially distanced worship and burials, providing support for Roma communities with appropriate language and messaging, helping people with mental health support through the crisis and ensuring resilience in recovery.
We have great assets in our research and intelligence infrastructure, supported by enthusiastic teams across the local authority alongside an enviable network of epidemiologists and health researchers at the Bradford Institute for Health Research and across our university partners who are all passionate about the health and wellbeing of our people and communities. We have rich, linked data that allows us to model and analyse the local impact of the pandemic. And, we have an incredible resource in the families participating in our research who provide us with a unique window into their daily lives.
We undertook short and longer-term work in order to drive action in the short term whilst also understanding the longer-term impact of the pandemic. In March, April and May of 2020 we worked to understand the impact of the pandemic on our communities by:
- Looking at local population groups and characteristics who might be more vulnerable to both the virus itself and its socio-economic impact due to a range of factors including health conditions, race, gender, employment status and deprivation.
- Examining the emerging data on the impact of COVID on BAME communities in terms of infection rates, hospitalisation and deaths.
In the summer of 2020, we carried out a survey of more than 1,000 households and families to understand COVID’s impact on factors including resilience and mental health. The work continued throughout the pandemic.
Health beliefs and health experiences during COVID and attitudes towards vaccination were identified as a priority for qualitative research to help us understand the social impacts of the virus and assist our response.
Interviews were conducted with 20 people from different backgrounds and areas of Bradford between September and October 2020. CSAG wanted to understand why some people feared vaccines and the complexity of people’s relationships with health services and health information during COVID. We needed to continue to talk directly to our communities to develop trust, understand vaccine hesitancy, improve access to healthcare and support a positive experience for residents.
We used this evidence to recruit from the district’s diverse communities for vaccine trials (including halal and vegan vaccines) ensuring that the district was in the lead for engagement rates in the trials. We also led a campaign to redress ‘fake news’ and established hubs to boost vaccine take-up in all of the district’s diverse communities.
The work of CSAG meant we were looking at excess deaths before this became common, tracking the disproportionate impact of COVID on poorer and BAME communities before it became part of the national conversation, and that we had a care home resilience plan in mid-April 2020.
This Building Diversity and Inclusion Award, sponsored by Gatenby Sanderson, has highlighted the strength of local partnerships and of using research and intelligence during the early stages of the pandemic to deliver effective data-led public health interventions that saved many lives. It is now being used to tackle other longstanding health inequalities in Bradford district.
Kersten England is chief executive of Bradford City Council