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LETTER | Ethnicity is not a determinant of health

LETTER | There has been an increased level of attention on our migrant workers and members of the migrant community during this Covid-19 pandemic. 

Regretfully, we have heard many Malaysian demanding that the authorities take action to remove these people from our communities and our borders. 

These unfortunate calls to action have been seen by many as appropriate and justified due to poor health conditions of the migrant community as well as their allegedly increased risk of developing and spreading the virus.

The health of a community and its members, as well as their susceptibility to diseases, depend on two main factors. The first is an individual’s physical characteristics including their age, sex, and pre-existing medical conditions. 

The second is a collection of socioeconomic circumstances popularly termed as the "social determinants of health". These include living conditions, access to clean water and sanitation, the amount and quality of food available, income, working conditions, and access to healthcare services. 

Take a pair of identical twins and place each one in environments where they are subject to vastly different social determinants of health, and they will have vastly different health conditions.

Ethnicity or race, however, is not a determinant of health. What this means is that if an ethnic community has poorer health or is more likely to get infected and develop Covid-19, it is a result of the conditions that they have been forced to live in. If we are concerned about their increased risk of spreading Covid-19, then it is their living conditions that we must address in the short term, and in the longer term, their socio-economic circumstances.

I have had the privilege of providing healthcare to some of the poorest Malaysians as well as some of our migrant and refugee communities. In my experience, there is very little that separates the Malaysian hardcore poor and the poorest of our migrants, in terms of their health and susceptibility to disease. Allow me to repeat myself: ethnicity is not a determinant of health.

Covid-19 does not discriminate based on ethnicity, neither should our efforts at combating it. At this very moment, when the health of every one of us is so tightly linked to one another, we need to ensure that everyone within our borders is cared for and can maintain a good level of health. 

That will require the engagement and willing cooperation of everyone, including the migrant community. We must not make the mistake of driving them away or into hiding. Instead, help them to protect themselves from Covid-19. 

The results can only benefit the rest of us.


DR MARK CHEONG WING LOONG is a lecturer at the School of Pharmacy, Monash University Malaysia. 

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.


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