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Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities

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. Resear...

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Autores principales: Katikireddi, Srinivasa Vittal, Lal, Sham, Carrol, Enitan D, Niedzwiedz, Claire L, Khunti, Kamlesh, Dundas, Ruth, Diderichsen, Finn, Barr, Ben
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8458062/
https://www.ncbi.nlm.nih.gov/pubmed/33883198
http://dx.doi.org/10.1136/jech-2020-216061
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author Katikireddi, Srinivasa Vittal
Lal, Sham
Carrol, Enitan D
Niedzwiedz, Claire L
Khunti, Kamlesh
Dundas, Ruth
Diderichsen, Finn
Barr, Ben
author_facet Katikireddi, Srinivasa Vittal
Lal, Sham
Carrol, Enitan D
Niedzwiedz, Claire L
Khunti, Kamlesh
Dundas, Ruth
Diderichsen, Finn
Barr, Ben
author_sort Katikireddi, Srinivasa Vittal
collection PubMed
description 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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spelling pubmed-84580622021-10-07 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 J Epidemiol Community Health Essay 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. BMJ Publishing Group 2021-10 2021-04-21 /pmc/articles/PMC8458062/ /pubmed/33883198 http://dx.doi.org/10.1136/jech-2020-216061 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Essay
Katikireddi, Srinivasa Vittal
Lal, Sham
Carrol, Enitan D
Niedzwiedz, Claire L
Khunti, Kamlesh
Dundas, Ruth
Diderichsen, Finn
Barr, Ben
Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities
title Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities
title_full Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities
title_fullStr Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities
title_full_unstemmed Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities
title_short Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities
title_sort unequal impact of the covid-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities
topic Essay
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8458062/
https://www.ncbi.nlm.nih.gov/pubmed/33883198
http://dx.doi.org/10.1136/jech-2020-216061
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