People from Bangladeshi and Pakistani backgrounds have continued to experience an “alarming” higher risk of dying with coronavirus throughout both waves of the pandemic, a study has shown.

All ethnic minority groups had a higher risk of dying with Covid-19 than white British people in the first wave, according to a study of 28.9 million people in private households in England.

In the second wave, people from black ethnic groups experienced a similar risk, which shows that ethnic inequalities in Covid-19 mortality can be addressed, the researchers said.

But the risk remained higher for people from Bangladeshi and Pakistani backgrounds, and was “substantially higher” in both waves after sociodemographic characteristics and health factors were taken into account.

The paper, which has not yet been peer reviewed, has been produced by researchers from the Office for National Statistics (ONS), University of Oxford, London School of Hygiene and Tropical Medicine, and University of Leicester.

They compared risk levels between different ethnic groups across the first wave (defined as the period from January 24 to August 31) and the second wave (September 1 to December 28).

In the first wave, people of black African background had the highest age standardised Covid-19 mortality rates – with the rate for black African men 4.49 times higher than the rate for men of white British ethnicity.

In the second wave, South Asian ethnic groups had a greater risk of death with coronavirus compared to white British people.

The death rate for men and women from a Pakistani background was 4.81 and 4.62 times higher respectively than that for white British men and women.

And the death rate for men and women from a Bangladeshi background was 4.11 and 3.98 times higher respectively than that for white British men and women.

The researchers said the continued higher rate of mortality in these groups is “alarming”.

The rate for Indian men and women was 1.80 and 1.63 times higher respectively, but there was no greater risk for black ethnic groups as observed during the first wave.

In both waves, adjusting for geographical factors, sociodemographic characteristics and pre-pandemic health substantially reduced the disparities between most ethnic groups and the white British population.

However, even after these adjustments, in the second wave people from Pakistani and Bangladeshi backgrounds remained substantially at greater risk of dying with coronavirus than white British people, while the adjustments had little impact on the risk for Indian people.

The authors said people from South Asian groups are more likely to live in deprived areas and in large, multigenerational households.

A higher proportion of Pakistani and Bangladeshi men work as taxi drivers, shopkeepers and proprietors than any other ethnic background – occupations with a higher risk of exposure to coronavirus.

The authors write: “An appreciable reduction in the difference in Covid-19 mortality in the second wave of the pandemic between people from black ethnic background and people from the white British group is reassuring, but the continued higher rate of mortality in people from Bangladeshi and Pakistani background is alarming and requires a focused public health campaign and policy response.

“Focusing on treating underlying conditions, although important, may not be enough in reducing the inequalities in Covid-19 mortality.

“Focused public health policy as well as community mobilisation and a participatory public health campaign involving community leaders may help reduce the existing and widening inequalities in Covid-19 mortality.”