In New York City, black and Latino people appear to be twice as likely to die from Covid-19 as white people. In the UK, preliminary data shows that nonwhite people have a 10-to-50% higher risk (pdf, p. 45) of death from the disease.
In France, though, nobody knows.
The country’s fraught relationship with the collection of statistics based on race or ethnicity means that health authorities are largely in the dark about whether Covid-19 is killing communities of color at higher rates or not. Some argue that it prevents officials (link in French) from putting in place specific policies to protect minorities. Defenders of France’s nominally “color-blind” system say that, since there is no cure or vaccine for Covid-19, having that knowledge would not help patients, and would instead erode decades of policy that protects the personal information of these at-risk populations.
There has long been a heated debate in France (French) about the rules around collecting such information, especially in the context of police brutality, inequality, and discrimination. Now, Covid-19 has brought this debate to the forefront once again—but it’s not clear that it will move the needle.
The popular understanding is that France bans 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 1978 law on digital rights prohibits anyone from collecting or processing “personal data which reveal, directly or indirectly, racial or ethnic origins, political, philosophical or religious opinions or the trade union membership of persons, or which relate to their health or sexual 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 vivre-ensemble. The American model, in which official documents routinely break up people into racial categories (and specific policies can be put in place targeting one group or another) is antithetical to that idea. Its opponents say the government-sanctioned use of these statistics would undermine social cohesion.
A second factor is World War II, 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 records played in rounding up Jewish people to send to concentration camps, France is sensitive to the issue of collecting statistics based on race or religion.
Still, that doesn’t mean it’s entirely banned. It’s possible to collect anonymized data (French) based on people’s country of origin, nationality prior to French nationality, or “feeling of belonging” to France. Further data can sometimes be collected, but both the motive and the means of collection must be approved by the country’s digital authority. Overall, legal authorities have ruled that conducting “studies on the measurement of people’s diversity of origins, discrimination, and integration” are unconstitutional. And even where it is legal to do so, there is a taboo in France around the process.
So, where does that leave public health statistics relating to the racial makeup of Covid-19 patients and deaths?
There are more questions than answers when it comes to the racial disparities of Covid-19.
In the US and UK, minorities collectively appear more likely to die from the disease. The scientific community is just beginning to understand why that is, and there are two major hypotheses.
One is about exposure. Ethnic minorities make up a disproportionate share of low-paying service workers, including healthcare staff, which means they are more exposed to the virus. Another is about socio-economic inequality and its impact on health. These populations are more likely to be poor, live in cramped housing where social distancing is not feasible, and less likely to seek and receive quality medical care. Hypertension, diabetes, and coronary heart disease are also more prevalent among minority groups in the US and UK. Doctors believe that these preexisting conditions exacerbate the symptoms of Covid-19.
Although doctors may whisper among themselves (French) about the prevalence of minorities among their patients, official statistics on Covid-19 deaths don’t include a breakdown by race and ethnicity—or even by country of origin or nationality, which would theoretically be legal. “We have the right to do it, the information exists, but they’re not published,” says Patrick Simon, research director in the International Migration and Minorities Unit of the French National Institute for Demographic Studies.
“Not giving the numbers means condemning these people a second time,” argues Ghyslain Vedeux, president of the Representative Council of France’s Black Associations (CRAN), “because we need to know which populations are affected so that we can treat them better.”
The idea isn’t just to collect this data, it’s to do something with it. Examples from the US and UK show that carefully-collected data, in the right hands, can sometimes lead to policy change. For instance, armed with the information that the disease disproportionately kills people from black and minority ethnic (BAME) backgrounds, the UK’s national health service (NHS) asked that NHS staff from these backgrounds be “risk-assessed” and reassigned to jobs where they have lower chances of contracting coronavirus.
Reasonable people can disagree about whether this is the right thing to do, but what’s certain, says Simon, is that a policy like that couldn’t happen in France. It would require, he argues, “several strong intellectual and political leaps.”
As the pandemic begins to recede in France, the window of action on this issue may be closing. But with top experts warning that the virus will likely return, the lessons learned here could inform future public health responses. If it does, says Vedeux, France will have missed an opportunity to learn more about Covid-19’s impact on communities of color, and do something about it.