It is increasingly clear that inequalities in socio-economic status (SES) contribute to, but do not fully explain, ethnic inequalities in health1. Emphasis on cultural and genetic explanations has shifted to a focus on systemic causes, drawing upon systemic racism2 – policies and processes embedded in society which disadvantage ethnic minorities – to better understand persistent ethnic inequalities in health. Two mechanisms have been proposed. First, racism is a fundamental cause of differences in SES which itself drives inequalities in health outcomes1. Second, racial discrimination is directly associated with health, independent of SES, through inequalities in power, freedom, neighbourhood context, and health care provision and access3.
Previous studies in the UK have identified racial discrimination in the workplace and higher poverty among minority ethnic groups as potential instigators of the observed levels of financial discrimination4. US evidence indicates a role for racial discrimination in persistent inequalities in food insecurity5, a rapidly escalating UK public health crisis and one with clear racial disparities6. In 2022 to 2023, 10% of households in the UK were food insecure, with either low (5%) or very low household food security (5%) and 7% experienced marginal food insecurity. Food insecurity was highest in households where the head of the household was Arab (23%), Black, African, Caribbean and Black British (21%), Mixed and Multiple Ethnic Groups (16%) and Pakistani (15%), and lowest where the head of the household was White (7%), Indian (5%) or Chinese (3%)6. Nevertheless, the relationship between food insecurity and racial discrimination has not been explored in the UK. In this exploratory study, we examined the relationship between sociodemographic and SES factors, including financial and food insecurity, with reports of discrimination.
