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Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities.
Katikireddi, Srinivasa Vittal; Lal, Sham; Carrol, Enitan D; Niedzwiedz, Claire L; Khunti, Kamlesh; Dundas, Ruth; Diderichsen, Finn; Barr, Ben.
  • Katikireddi SV; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK vittal.katikireddi@glasgow.ac.uk.
  • Lal S; Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
  • Carrol ED; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
  • Niedzwiedz CL; Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
  • Khunti K; Primary Care and Public Health, Imperial College London, London, UK.
  • Dundas R; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
  • Diderichsen F; Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen K, Denmark.
  • Barr B; Public Health and Policy, University of Liverpool, Liverpool, UK.
J Epidemiol Community Health ; 75(10): 970-974, 2021 10.
Article in English | MEDLINE | ID: covidwho-1197275
ABSTRACT
Minority ethnic groups have been disproportionately affected by the COVID-19 pandemic. While the exact reasons for this remain unclear, they are likely due to a complex interplay of factors rather than a single cause. Reducing these inequalities requires a greater understanding of the causes. Research to date, however, has been hampered by a lack of theoretical understanding of the meaning of 'ethnicity' (or race) and the potential pathways leading to inequalities. In particular, quantitative analyses have often adjusted away the pathways through which inequalities actually arise (ie, mediators for the effect of interest), leading to the effects of social processes, and particularly structural racism, becoming hidden. In this paper, we describe a framework for understanding the pathways that have generated ethnic (and racial) inequalities in COVID-19. We suggest that differences in health outcomes due to the pandemic could arise through six pathways (1) differential exposure to the virus; (2) differential vulnerability to infection/disease; (3) differential health consequences of the disease; (4) differential social consequences of the disease; (5) differential effectiveness of pandemic control measures and (6) differential adverse consequences of control measures. Current research provides only a partial understanding of some of these pathways. Future research and action will require a clearer understanding of the multiple dimensions of ethnicity and an appreciation of the complex interplay of social and biological pathways through which ethnic inequalities arise. Our framework highlights the gaps in the current evidence and pathways that need further investigation in research that aims to address these inequalities.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ethnicity / Health Status Disparities / Pandemics / COVID-19 / Minority Groups Type of study: Experimental Studies / Randomized controlled trials Limits: Humans Language: English Journal: J Epidemiol Community Health Year: 2021 Document Type: Article Affiliation country: Jech-2020-216061

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ethnicity / Health Status Disparities / Pandemics / COVID-19 / Minority Groups Type of study: Experimental Studies / Randomized controlled trials Limits: Humans Language: English Journal: J Epidemiol Community Health Year: 2021 Document Type: Article Affiliation country: Jech-2020-216061