Understanding the disproportionate impact of COVID-19 on minority ethnic groups
The COVID-19 pandemic has unequally impacted minority ethnic groups. Although the precise reasons are unknown, it is likely due to numerous factors rather than just one.
Research surrounding ethnic inequalities in healthcare sectors has increased since COVID-19, yet a study published in May 2021 suggests that this research has been limited in their understanding of ethnicity and the possible pathways causing the inequalities and differences.
This study encourages clearer thinking and outlines a new framework to help provide understanding of ethnic inequalities during the pandemic by presenting six pathways to consider:
· differential exposure to the virus
· differential vulnerability to infection/disease
· differential health consequences of the disease
· differential social consequences of the disease
· differential effectiveness of pandemic control measures
· differential adverse consequences of control measures.
Exposure to the coronavirus and risk of infection can be higher for minority ethnic groups due to various factors. For example, certain occupations (such as health and social care workers) or living in overcrowded conditions leads to more frequent contact with people and for a prolonged period, and therefore a greater likelihood of contracting COVID-19.
Factors frequently caused by stress and environmental conditions create dissimilarities in nutritional status, comorbidities such as diabetes, and immune response in minority ethnic groups. These dissimilarities increase the probability of developing disease after exposure.
There is a greater probability of minority ethnic groups needing critical care and mechanical ventilation when compared to white groups.
After contracting a disease, some minority ethnic groups are at greater risk of developing severe disease, experiencing complications, and death.
COVID-19 can lead to long-lasting health issues which cause job loss and reduced earnings. Minority ethnic groups frequently experience greater levels of insecure employment, such as zero-hour contracts. Therefore, people in these minority ethnic groups are more likely to lose their job and experience poverty.
Numerous measures put in place to control the spread of COVID-19 created ethnic health inequalities, also known as intervention-generated inequalities. For example, if health communication is not adapted or aimed towards a minority ethnic group or culture, they are less effective.
Evidence implies that minority ethnic healthcare workers find it harder to access personal protective equipment (PPE). It is also suggested that various minority ethnic groups are more hesitant to get vaccinated.
On the other hand, evidence suggests that during lockdown there was a greater decrease in COVID-19 mortality amongst minority ethnic groups when compared to most of the population.
The impact of control measures, including loss of income, are more likely to impact disadvantaged groups and lead to non-COVID-19 health issues.
Existing inequalities in mental health were worsened due to numerous minority ethnic groups facing a disproportionate rate of unemployment during the first lockdown.
Some of these presented pathways have been considered by existing research, but to a limited extent.
This study provided a clearer understanding of ethnic health inequalities relating to COVID-19 by highlighting gaps in existing research and offering both social and biological pathways to further explore.
The researchers believe that, by considering the suggested pathways and developing an understanding of minority ethnic groups, the disproportionate impact of COVID-19 can be lessened or even diminished.