The role of work in supporting health has moved into the policy spotlight. Yet far less attention is paid to how racial inequality in the workplace can reinforce and widen health inequalities.

Too poor to be sick: Race, work and ill-health, a new report published by the Race Equality Foundation, seeks to address this gap. Based on international and UK evidence alongside the lived experiences of minoritised ethnic individuals, the report identifies a consistent pattern where the health advantages observed in younger minoritised ethnic individuals are eroded by the realities of racism and disadvantage in the workplace and labour market.

Key findings include:

• Black and Asian workers, by the time they reach their forties and fifties, experience the general health of people decades older than them, yet major 2025 policy reviews such as the Employment Rights Act 2025 treats the workforce as racially uniform.
• There is a critical evidence gaps in national data, with the effect that racial disparities in sick pay access, sickness absence and return-to-work outcomes remain unmeasured.
• In many of the jobs in which minoritised ethnic individuals find themselves, workers are often denied sick pay, disciplined for illness or required to send hospital photos with same-day newspapers to prove they’re unwell.
• Unless these issues are addressed, we will continue to see the early economic exit of what is the fastest-growing segment of the UK workforce, threatening productivity and widening health inequalities.

The report concludes: “The intersection of racial inequality and workplace ill-health creates a cycle of disadvantage that cannot be addressed by race-neutral policies. The evidence demonstrates that for many minoritised ethnic workers, the current structure of the UK labour market accelerates physical decline while simultaneously impeding access to the financial and institutional support necessary for recovery.”

Jabeer Butt OBE, Chief Executive of Race Equality Foundation, said:

“This report exposes the undeniable fact that the employment system designed to protect workers who fall ill is failing those who need it most. While recent policy reviews treat the workforce as uniform, the reality is that Black, Asian and minoritised ethnic workers face a triple bind – jobs with the highest physical demands, the weakest sick pay provision, and the least access to occupational health.

“But here’s what should alarm policymakers most: we still cannot measure the full extent of the problem because national datasets do not routinely disaggregate by ethnicity. This evidence gap is not accidental – it reflects structural racism in how we monitor workplace health and outcomes.”

The report makes four urgent recommendations:

• Measurement: Improve integration of ethnicity variables into national data on employment and ill-health, including quantifying racial disparities in sick pay access, fit-note use and return-to-work rates.
• Design and evaluation: Assess future reforms to Statutory Sick Pay and occupational health for differential impact by ethnicity and employment type, developing co-production mechanisms with minoritised ethnic workers.
• Mechanisms and lived experience: Support mixed-methods research investigating how racism and discrimination operate through employment practices, benefit eligibility and healthcare navigation.
• Framing and accountability: Recognise racism as a determinant of health within work and welfare policy.