The COVID-19 coronavirus pandemic has affected some groups in society disproportionately, in so doing increasing socio-economic divides. In the Netherlands, the relative excess mortality among people with a migration background is already 10% higher than among Dutch natives, and mortality rates among COVID-19 patients with a migrant background are higher than among the native population. Intensive care physicians report that migrants are also overrepresented in COVID-intensive care (IC) facilities.

More deaths among individuals with a migrant background

In the first six weeks of the corona pandemic in the Netherlands, 996 people with a non-Western background died: 306 more than the average in a year without a worldwide virus outbreak. This signifies an excess mortality rate of 47% among people with a non-Western background, which is higher than the rate among Dutch natives (38%). These mortality figures, analysed by Statistics Netherlands and Amsterdam UMC, represent a statistical indication that in the Netherlands the pandemic affects people with a non-western background more severely than the native population.

Staying at home is not always possible, nor is it the solution

There are indications that the reason for these higher illness and mortality rates is related to individuals' socio-economic conditions. This could include the higher population density in certain neighbourhoods in which many people with a non-western background live, for example, and people visiting each other’s homes out of necessity in order to share the internet. Further, essential high-exposure jobs are more often filled by individuals with a migrant background, such as store clerks, cleaners, and bus drivers, and in general many migrants are employed temporarily and/or paid only for work carried out, so endure a more precarious labour situation.

Chronic diseases and language skills as complicating factors

At the same time, chronic diseases such as diabetes, cardiovascular and pulmonary diseases are more prevalent among people with a migrant background. These individuals more often suffer from chronic stress caused by migration, poor social living conditions and discrimination. Additionally, some ethnic groups seem to be more susceptible to developing diabetes or high blood pressure. It is now clear that COVID-19 can be more serious in these underlying conditions.

Finally, the command of the Dutch language, literacy, and digital and health skills affect a person's ability to understand and abide by measures concerning the coronavirus. Many new and difficult words are used, such as 'intelligent lockdown', 'social distancing' and 'infection rate', and the guidelines issued by the National Institute for Public Health and the Environment (RIVM) and the government are very linguistic. Sometimes measures in a person's country of origin differ from those in the Netherlands, which increases the lack of clarity and stress.

Minorities less severely affected than in other countries

On the other hand, COVID-19 seems to have affected people belonging to ethnic minority groups less severely (in comparison with Dutch natives) in the Netherlands than in other western countries. The comparative difference is smaller than in the US and England, for example. The analysis of the mortality figures by Statistics Netherlands (CBS) is the first time that figures have been published in the Netherlands showing that the coronavirus hits ethnic minorities harder.

In other countries, some population groups were found early on to be overrepresented when it comes to deaths caused by the virus. Researchers in Denmark, Sweden, Norway, Great Britain and the US, among others, have reported this. According to Tanja Traag of the CBS, the differences in the Netherlands are smaller.

This is due to the Dutch welfare state - where migrants do not run greater health risks than others - according to Godfried Engbersen, Professor of Sociology at the Erasmus University: 'Everyone has a right to care, which is different from the situation in the United States. However, they [migrants and minorities] will have to deal more with the socio-economic consequences, such as loss of work and income. Loss of work, too, has been pointed out recently'.

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