Perception of Hurricane and COVID-19 Risks for Household Evacuation and Shelter Intentions

The COVID-19 pandemic presented new challenges for scholars and government officials to predict people's evacuation decisions under a conflicting natural disaster. In this study, we examined households' evacuation and shelter intentions given the potential conflicts between the perceived risks from a hurricane and the coexisting public health crisis. We surveyed households living inside hurricane evacuation zones in Florida during the 2020 hurricane season. Data were first used to examine the evacuation and shelter intentions before and during the pandemic. We then measured respondents' hurricane and COVID-19 risk perception, respectively. The impacts of both risk perceptions on respondents' hurricane evacuation intentions were explored. We found that when people felt unsafe to stay home for a Category 2, 3, or 4 hurricane, their intended evacuation was about the same before and during the pandemic regardless of their COVID-19 risk perception. The COVID-19 risk perception, however, significantly lowered the evacuation intention for a Category 1 hurricane. It also significantly influenced evacuees' preference for nontraditional shelters such as government-contracted hotels. The results of our study have practical implications for emergency management and public health governance. Our study also provides insights into decision-making under the conflict between natural hazards and infectious diseases. (English) [ FROM AUTHOR] La pandemia del COVID-19 planteó nuevos retos a los eruditos y funcionarios gubernamentales para predecir las decisiones de evacuación de la gente sometida a un desastre natural conflictivo. En este estudio, examinamos la evacuación e intenciones de albergue de familias teniendo en cuenta potenciales conflictos entre los riesgos percibidos de un huracán y las crisis coexistentes en la salud pública. Encuestamos a las familias que residían en las zonas de evacuación por huracanes de la Florida durante la temporada de huracanes del 2020. Los datos se usaron primero para examinar las intenciones de evacuación y de refugio antes y durante la pandemia. Después, medimos la percepción del riesgo de afectaciones por huracanes y COVID-19 de los encuestados, respectivamente. Se exploraron los impactos de ambos tipos de percepciones de riesgo en las intenciones de evacuación, por encuestado. Hallamos que cuando la gente se siente insegura de permanecer en casa frente a huracanes de las categorías 2, 3 y 4, su evacuación intencionada era más o menos la misma de antes y durante la pandemia, sin importar la percepción del riesgo de COVID-19. No obstante, la percepción del riesgo de COVID-19 redujo de manera significativa la evaluación de la intención de evacuación para un huracán de categoría 1. Eso también influyó significativamente en la preferencia de los evacuados por refugios no tradicionales, como los hoteles contratados por el gobierno. Los resultados de nuestro estudio tienen implicaciones prácticas en el manejo de las emergencias y la gobernanza de la salud pública. También proporciona nuestro estudio nuevas visiones en lo que concierne a toma de decisiones bajo condiciones de conflicto entre las catástrofes naturales y la enfermedades contagiosas. (Spanish) [ FROM AUTHOR] 新冠肺炎流行病与其它自然灾害相互冲突, 给专家和政府预测人群的疏散决定提出了新的挑战。我们探讨了家庭疏散和避难的意愿, 考虑了飓风的感知风险与公共卫生危机之间的潜在冲突。我们调查了2020年飓风季节美国佛罗里达州飓风疏散区内的家庭。首先, 基于数据探讨了流行病之前和期间的疏散和避难意愿。然后, 我们分别度量了受访者对飓风和新冠肺炎的风险感知。探讨了这两种风险感知对受访者飓风疏散意愿的影响。我们发现, 在2、3或4级飓风中, 当人们认为居家危险时, 不管如何感知新冠肺炎风险, 人们在新冠肺炎流行之前和期间的疏散意愿大致相同。然而, 新冠肺炎风险感知显著降低了1级飓风的撤离意愿。它还显著影响了疏散者对非传统庇护所（如, 政府指定酒店）的偏好。我们的研究结果, 对应急管理和公共卫生治理具有实际意义。我们的研究, 还为自然灾害和传染病相互冲突情况下的决策提供了见解。 (Chinese) [ FROM AUTHOR] Copyright of Professional Geographer is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

A retrospective study of knowledge management for integrated resorts (IRs) crisis preparedness

PurposeThis study aims to propose a systematic knowledge management model to explore the causal links leading to the organizational crisis preparedness (OCP) level of integrated resorts (IRs) during the COVID-19 pandemic based on the intangible capital of organizational climate, dynamic capability, substantive capability and commitment.Design/methodology/approachThe authors use data obtained from IRs in Macau. The Wuli–Shili–Renli (WSR) approach underpins the study. Structural equation modeling following fuzzy-set qualitative comparative analysis (fsQCA) was used for data processing.FindingsThe results showed that organizational climate has an essential role in IRs preparedness for crises and affects their dynamic capacity, substantive capacity and commitment. The fsQCA results revealed that the relationships between conditions with a higher level of dynamic and substantive capability lead to higher OCP scores.Practical implicationsExecutives should develop systemic thinking regarding organization preparedness in IRs for crisis management. A comprehensive understanding of the IRs' business environment and crises is necessary, as they will require different factor constellations to allow the organization to perform well in a crisis. Financial support for employees could ensure their assistance when dealing with such situations. Rapid response teams should be set up for daily operations and marketing implementation of each level of the IRs management systems.Originality/valueThis study contributes to the extant literature on IRs crisis management in the OCP aspect. The authors constructed a systematic composite picture of organization executives' knowledge management through the three layers of intangible capitals in WSR. Moreover, the authors explored causal links of WSR from symmetric and asymmetric perspectives.

Establishment of medical service protocols in large public hospitals for the prevention and control of coronavirus disease 2019.

Coronavirus disease 2019(COVID-19) poses a challenge to hospitals for the prevention and control of public health emergencies. As the main battlefield of preventing and controlling COVID-19, large public hospitals should develop service protocols of diagnosis and treatment for outpatient, emergency, hospitalization, surgery, and discharge. The construction of medical protocols should be based on the risk factors of key points and focused on pre-inspection triage and screening, to establish a rapid response mechanism to deal with exogenous and endogenous risk factors. Implementation of all-staff training and assessment, strengthening the information system, and use of medical internet service are important. This study explores the construction of medical protocols in large public hospitals during the pandemic, and provides a reference for the orderly diagnosis and treatment in hospitals during the pandemic.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.

Death managers, public health, and COVID-19: An exploratory study

The ongoing COVID-19 pandemic has exacerbated cracks in the United States' healthcare systems-along with its deathcare systems. The pandemic as an ongoing mass fatality incident highlights the need to understand the public servants engaged in deathcare work, as they are a vital part of the emergency response equation. This exploratory, descriptive study focuses on the ways in which medical examiners and coroners (ME/Cs) in the United States provide core emergency management services to communities, relying on findings from interviews with 18 ME/Cs throughout the country. Findings indicate how COVID-19 cases are counted is difficult, the pandemic changed how ME/Cs operate in response, and burnout is eminent for these public servants.

Subsidy strategy for reserving flexible capacity of emergency supply production

This paper investigates a government's subsidy strategy for motivating a manufacturer to set up a flexible production line for emergency supplies. Four subsidy strategies are proposed to ensure a desired service level in case of an emergency: zero subsidy, a fixed subsidy, a marginal subsidy, and a hybrid subsidy. We develop a game theoretical model to examine how the government can induce a manufacturer to set up a flexible production line that can respond promptly to an emergency, based on the manufacturer's cost structure (fixed and marginal costs). We find that when the marginal profit of an emergency product is higher than that of the manufacturer's regular product, a fixed (marginal) subsidy is the dominant strategy if the manufacturer's fixed (marginal) cost is high, while a hybrid subsidy strategy is dominant if both costs are high. When the marginal profit of an emergency product is lower than that of the manufacturer's regular product, neither a fixed subsidy nor a zero subsidy will be the dominant strategy. We also find that a marginal subsidy can ensure the effectiveness of the strategy, while a fixed subsidy helps improve strategy efficiency. We use government subsidy strategies implemented for Chinese COVID-19 emergency supplies as examples to demonstrate the effectiveness and efficiency of the subsidy strategies under the proposed framework. We also extend the discussion by considering the manufacturer's social consciousness.

Chinese Normal Students' Satisfaction of Emergency Remote Learning in Higher Education during COVID-19 Pandemic

Despite the widespread use of emergency remote learning (ERL) during the COVID-19 pandemic in higher education, little is known about the determinants of Chinese normal student satisfaction with ERL. This study uses a questionnaire survey method to examine how Chinese normal students' satisfaction with ERL during the COVID-19 pandemic. The results show that Chinese normal students prefer face-to-face teaching to online teaching to some extent. According to the findings, it is important to emphasize students' pre-class preparation, adjust course assessment methods, change teachers' teaching strategies, create a positive teaching environment, boost students' learning confidence, and help them deal with their anxiety during ERL to improve the online course experience for Chinese students at normal universities. © 2023 ACM.

Impact of the COVID-19 pandemic on patients with osteogenesis imperfecta

OBJECTIVES: On March 11, 2020, the WHO classified COVID-19 as a global pandemic. Measures to quell the pandemic included limiting non-essential activities including clinic visits and procedures. It is unclear if individuals with OI had disruptions in their access to healthcare or medications, and if such disruptions affected patients' symptoms. METHOD(S): A REDCap survey was distributed through the OI Foundation on August 31. Surveys completed through September 11 by individuals with OI or their caregiver are included in this analysis. Participants were asked to compare their symptoms and access to healthcare during the first 4 months of the pandemic to the 4 months before the pandemic. RESULT(S): 85 surveys were completed, and 6 were partially completed. The median age of participants was 40 years;35% were children. 32% of participants self-identified as having severe OI. Although most reported no changes in bone pain or fractures, 46% reported they were less likely to seek emergency medical care to treat a fracture, while 33% reported they were more likely to treat fractures at home (Fig 1A). There were delays in accessing all services, with greatest delays accessing dentistry (74%) and aquatic therapy (84%) (Fig 1B). 36% of participants receiving bisphosphonate infusions had delayed infusions because of the pandemic (Fig 1C). Of note, 50% of planned surgeries were delayed. CONCLUSION(S): Although many individuals with OI and their caregivers reported delays in accessing bone-related services/clinics during this 4-month period, there was not a concomitant increase in reported symptoms. This may have related to shelter-in-place restrictions and decreased activity. Limitations of this study include small sample size and potential selection bias because responses were obtained only from OIF members. To address these limitations, we are distributing the survey through healthcare providers of individuals with OI across major regions of the US from a variety of practice types including endocrine, orthopedics and multidisciplinary clinics. Furthermore, as the COVID-19 pandemic continues, we hope that this survey will provide information to address what aspects of healthcare may be in greatest need, as well as the modality through which services may be met. (Figure Presented).

Impacts of COVID-19 on proton therapy - Shaping the future of patient selection

Objectives: This scoping review aimed to determine whether the COVID-19 pandemic influenced any modifications to patient selection methods or prioritisation and services provided by proton therapy centres. Method(s): This review was conducted based on the PRISMA methodology and Joanna Briggs Institute scoping review guidelines.1,2 A literature search was performed in Medline, Embase, Web Of Science and Scopus as well as grey literature. Keywords including "COVID-19" and "Proton Therapy" were used. Articles published from 1 January 2020 in English were included. In total, 138 studies were identified of which 14 articles met the inclusion criteria. A scoping review design was chosen to capture the full extent of information published relating to the aim. Result(s): Six of 14 articles included statements regarding treatment of COVID-19 patients. Three publications recommended deferred or alternative treatment, two indicated to treat urgent/emergency patients and one reported continuous treatment for infectious patients. Recurring impacts on PT provision included more frequent use of alternative therapies, reduced referrals, delayed treatment starts and CT simulation, change in treatment volume and staffing limitations due to pandemic restrictions. Consequently, telehealth consults, remote work, reduction in patient visitors, screening procedures and rigorous cleaning protocols were recommended. Discussion/Conclusion: Few publications detailed patient selection or workflow methods used during the pandemic. Further research is needed to obtain more detailed information regarding current global patient selection methods in proton therapy, collecting this data could aid in future planning for proton therapy in Australia.

Acute or chronic? Failing left ventricle in a 34 year old

Submission content Introduction: An unusual case of a very young patient without previously known cardiac disease presenting with severe left ventricular failure, detected by a point of care echocardiogram. Main Body: A 34 year old previously well man was brought to hospital after seeing his general practitioner with one month of progressive shortness of breath on exertion. This began around the time the patient received his second covid-19 vaccination. He was sleeping in a chair as he was unable to lie flat. Abnormal observations led the GP to call an ambulance. In the emergency department, the patient required oxygen 5L/min to maintain SpO2 >94%, but he was not in respiratory distress at rest. Blood pressure was 92/53mmHg, mean 67mmHg. Point of care testing for COVID-19 was negative. He was alert, with warm peripheries. Lactate was 1.0mmol/L and he was producing more than 0.5ml/kg/hr of urine. There was no ankle swelling. ECG showed sinus tachycardia. He underwent CT pulmonary angiography which demonstrated no pulmonary embolus, but there was bilateral pulmonary edema. Troponin was 17ng/l, BNP was 2700pg/ml. Furosemide 40mg was given intravenously by the general medical team. Critical care outreach asked for an urgent intensivist review given the highly unusual diagnosis of pulmonary edema in a man of this age. An immediate FUSIC Heart scan identified a dilated left ventricle with end diastolic diameter 7cm and severe global systolic impairment. The right ventricle was not severely impaired, with TAPSE 18mm. There was no significant pericardial effusion. Multiple B lines and trace pulmonary effusions were identified at the lung bases. The patient was urgently discussed with the regional cardiac unit in case of further deterioration, basic images were shared via a cloud system. A potential diagnosis of vaccination-associated myocarditis was considered,1 but in view of the low troponin, the presentation was felt most likely to represent decompensated chronic dilated cardiomyopathy. The patient disclosed a family history of early cardiac death in males. Aggressive diuresis was commenced. The patient was admitted to a monitored bed given the potential risk of arrhythmia or further haemodynamic deterioration. Advice was given that in the event of worsening hypotension, fluids should not be administered but the cardiac centre should be contacted immediately. Formal echocardiography confirmed the POCUS findings, with ejection fraction <35%. He was initiated on ACE inhibitors and beta adrenergic blockade. His symptoms improved and he was able to return home and to work, and is currently undergoing further investigations to establish the etiology of his condition. Conclusion(s): Early echocardiography provided early evidence of a cardiac cause for the patient's presentation and highlighted the severity of the underlying pathology. This directed early aggressive diuresis and safety-netting by virtue of discussion with a tertiary cardiac centre whilst it was established whether this was an acute or decompensated chronic pathology. Ultrasound findings: PLAX, PSAX and A4Ch views demonstrating a severely dilated (7cm end diastolic diameter) left ventricle with global severe systolic impairment.

PANDEMIC ALTERS POLICIES FOR DRUG DEVELOPMENT

The desperate need for new vaccines and therapies to tame the deadly COVID-19 virus required new policies and procedures for how biopharma companies select, test, and manufacture medical products-and revised regulatory practices for evaluating clinical data, manufacturing operations, and procedures for submitting and analyzing information. Vaccine experts at the Center for Biologics Evaluation and Research (CBER) worked overtime to clarify the size and diversity of efficacy trials and key analytical assessments needed to gain EUA status and later full approval, establishing standards and procedures that will shape research for health emergencies to come. Officials at FDA's Office of Regulatory Affairs (ORA) indicate that the agency will continue to utilize many of these strategies for streamlining oversight of manufacturing operations, even as on-site visits increase overseas and at home, leading to a more "hybrid" inspection process going forward.

New development: A ‘journey of personal and professional emotions'—emergency ambulance professionals during Covid-19

IMPACTThis article explores the consequences of emotional labour on UK NHS ambulance staff and their response to the Covid-19 pandemic. It highlights the challenges faced by ambulance crews while dealing with their emotional labour within the context of organizational settings. Research findings also explain the importance of emergency responders' psychosocial wellbeing. The article has clear relevance as to how frontline staff manage their emotional labour in other emergency service settings, such as the police and fire and rescue services.Alternate :Managing emotions are essential aspect of many jobs, and frontline healthcare workers have to manage and control their emotions while caring for critically ill patients and working in an emotionally-charged dynamic environment;this was particularly the case during Covid-19. Ambulance workers are an important group in this respect but they are currently under-researched. Evidence behind this article comes from data collected from an NHS ambulance trust in England. One of the key contributions of this article is to highlight how frontline ambulance professionals manage their emotional labour while working within the stipulations of organizational constraints.

The COVID-19 Pandemic and the State of Emergency: Lessons from Portugal

The present chapter analyses the normative response of Portugal to the coronavirus crisis. As in other European Member States, the reaction to the pandemic was developed through a combination of enactment of the constitutional state of emergency with the statutory administrative emergency regime. Under both frameworks, there has been a strengthening of the executive at the expense of a parliamentary retreat. This chapter covers both responses to the pandemic and their shortcomings, mainly regarding the lack of democratic legitimation of the fight against the pandemic in face of a parliamentary circumvention and abdication. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Development of Teaching Digital Skills: possibilities in Distance Education

The objective of this investigation is to understand how online distance education can contribute to promoting the development of digital skills, in particular, teaching digital skills. Contemporary society increasingly demands the use of digital technologies in the various areas of life, including in the teaching and learning process, even more evident in the pandemic context of COVID-19, which caused the suspension of face-to-face classes worldwide and imposed a new educational model, facilitated by digital technologies and based on online education methodologies, designated as emergency remote teaching. Among the many challenges, teachers had to adapt and reformulate their pedagogical practices and teaching methodologies in a virtual learning environment, often without having fundamental digital skills to promote quality learning. Through a narrative bibliographic review of an exploratory nature and qualitative methodology, studies, programs and models were identified that could be used as a reference to enable training propositions for the development of teaching digital skills, a key factor for pedagogical innovation.

Collaborative mapping of the noise level in Guayaquil during COVID-19

The SARS-CoV-2 virus triggered a never-before-seen scenario worldwide. Ecuador declared a state of emergency to contain coronavirus transmission by applying social isolation policies and mobility limitations. During this period, noise pollution decreased in Guayaquil city. This study proposes the use of smartphones to collect noise data and generate soundscape maps of Guayaquil during different time slots. The results revealed traffic as the predominant type of noise, followed by vehicles, buses, and people´s voices. This article demonstrates the feasibility of crowdsourcing for the collection of environmental variables. © 2022 National Institute for Space Research, INPE. All rights reserved.

Assessment of palliative approach in the pain management in endodontic emergencies during Covid-19 outbreak: Retrospective cohort study

Aim: During the coronavirus disease, a palliative approach was recommended for the management of endodontic emergencies. This retrospective cohort study was conducted to investigate the effectiveness of dexamethasone or ibuprofen-acetaminophen combination for pain management in endodontic emergencies. Material(s) and Method(s): One hundred and eight records of patients who presented to the emergency department with dental pain were evaluated retrospectively. Since interventional procedures were not performed during the pandemic period, Specific analgesics/antibiotics for the management of pain were preferred. A follow-up protocol with a questionnaire was developed to observe the effectiveness of palliative treatment and make changes if necessary. All participants received a questionnaire to rate the pain levels 6, 12, 18, 24, 48, and 72 hours after taking the drug. All data were collected from the patient file and assessed. After inclusion and exclusion criteria, 32 patients were included (n = 19, ibuprofen + acetaminophen;n = 13, dexamethasone). Data were analyzed using the chi-square test (P = 0.05). Result(s): In both groups, a significant decrease in pain was experienced immediately after medication and at 6, 12, and 18 hours, with no significant difference (P >.05). However, dexamethasone (Group II) resulted in lower pain levels than ibuprofen\acetaminophen (Group I) at 24 and 48 hours (P <.05) Discussion: Both dexamethasone and ibuprofen-acetaminophen can be good palliative choices in endodontic emergencies in pandemic conditions. However, at 24 and 48 hours, dexamethasone resulted in lower pain levels.Copyright © 2022, Derman Medical Publishing. All rights reserved.

Immersive Technologies - The future for tracheostomy education?

Introduction: The need for standardised education on tracheostomy care is well recognised.1 Staff frequently report a lack of confidence in caring for those with tracheostomies, as well as the management of adverse events as they occur.2 Over the past decade, healthcare providers have developed strategies to educate staff, however, the covid-19 pandemic has severely hampered the ability to provide this necessary training due to restrictions on access to training rooms, the need for social distancing and the significant clinical demands placed on both trainers and trainees.3 The potential for immersive technologies to augment healthcare training is gaining interest exponentially.4 However, its effectiveness is yet to be clearly understood and as such it is not yet common within healthcare education.5 Based on the above, we aimed to explore the potential of these immersive technologies to overcome the current challenges of tracheostomy education, and to develop future strategies to use immersive technology in healthcare education. Method(s): We received a 400,000 grant from Cardiff Capital Region (CCR) to undertake a rapid innovation project overseen by the SBRI centre of excellence. The project consisted of 3 main phases: 1) feasibility;2) development;and 3) testing. The project was officially launched in April 2021 and lasted 12 months. Project governance was provided via the SBRI for clinical excellence, a project board with representation from Welsh Government, Cardiff University and Cardiff and Vale UHB, and a project team with clinical expertise in both the delivery of tracheostomy education and the provision of simulation training in healthcare. Result(s): Phase 1: During phase one 4 industries were successful and received up to 30,000 to explore the feasibility of immersive technology to support tracheostomy education. The industries were Rescape, TruCorp, Aspire2Be and Nudge Reality. During the feasibility phase all industries focused on the emergency management process utilising existing NHS Wales tracheostomy education resources and the national tracheostomy safety programme. Phase 2: For phase 2, Rescape and Nudge Reality were chosen to develop the technology. These industries continued to work in conjunction with the project team to capture the core elements of tracheostomy care, including multi-user emergency management scenarios. Additional content was also added for bronchoscopy and insertion of intercostal drains. Phase 3: Testing of both solutions was undertaken over an 8-week period, across 6 Health Boards in NHS Wales. The results of the testing will be analysed and available for presentation in due course. Provision findings demonstrate good face and content validity with high levels of user satisfaction. Discussion / Conclusion(s): The provision of essential tracheostomy education has been severely affected by the covid-19 pandemic. Evolving immersive technologies have the potential to overcome these challenges and improve the effectiveness and efficiency of education packages in tracheostomy care and wider. Through this CCR grant, in conjunction with industry, we have developed two solutions with the potential for widescale procurement and future research on the use of immersive technologies within healthcare.

Preoperative COVID-19 RT-PCR Testing of Asymptomatic Patients for Ophthalmic Surgery: Experience from Two Tertiary Referral Centers

Purpose: The aim of this study was to evaluate how prevalent asymptomatic SARS-CoV-2 virus infection (COVID-19) is among patients undergoing ophthalmic surgery at two tertiary referral hospitals. Material(s) and Method(s): This retrospective study included patients without COVID-19 symptoms who underwent preoperative screening using reverse transcription-polymerase chain reaction (RT-PCR) before ophthalmic surgery at the Kocaeli University and Gaziantep University departments of ophthalmology [between September 1, 2020, and December 15, 2020 (group 1);between March 1, 2021, and May 30, 2021 (group 2)]. Patients scheduled for surgery and followed up in the retina, glaucoma, pediatric ophthalmology and strabismus, cataract and refractive surgery, and cornea departments were examined. Result(s): RT-PCR was positive for SARS-CoV-2 in 12 (1.4%) of 840 patients in group 1 and 7 (1.1%) out of 600 patients in group 2. None of the patients were symptomatic of COVID-19. The majority of the patients were scheduled for retina or cataract and refractive surgery in both groups (group 1;retina: 29.2%, cataract and refractive: 57.0%, group-2;retina: 31.3%, cataract and refractive: 54.5%). SARS-CoV-2 RT-PCR testing was positive for seven patients in group 1 (7/245, 2.9%) and five patients in group 2 (5/188, 2.6%) who were scheduled for retinal surgery. Conclusion(s): The necessity, availability, and practicality of COVID-19 RT-PCR testing prior to ophthalmic surgeries varies depending on the protocols of each institution. COVID-19 RT-PCR testing is suggested especially before vitreoretinal surgeries and general anesthesia procedures, because of the difficulty in managing postoperative complications.Copyright © 2023 Gazi Eye Foundation. All rights reserved.

Ethnic, racial and migrant inequalities in respiratory health

Disparities in the incidence, prevalence, and morbidity and mortality rates of many respiratory diseases are evident among ethnic groups. Biological, cultural and environmental factors related to ethnicity can all contribute to the differences in respiratory health observed among ethnic minority groups, but the inequalities observed are most commonly due to lower socioeconomic position. People who migrate within a country or across an international border may experience an improvement in respiratory health associated with improvements in socioeconomic position. However, migrants may also experience worse health outcomes in destination countries, as they are faced by barriers in language and culture, discrimination, exclusion and limited access to health services. While some high-quality studies investigating ethnicity and respiratory health are available, further research into ethnic differences is needed. Improving the recording of ethnicity in health records, addressing barriers to accessing respiratory healthcare and improving cultural literacy more generally are some of the ways that inequalities can be tackled.Copyright © ERS 2023.