Socioeconomic Inequity and Inequality Results in Disproportionate Detrimental Impact to Racialized Populations in North America and the UK (original) (raw)
Disparities in COVID-19 Outcomes by Race, Ethnicity, and Socioeconomic Status
JAMA Network Open, 2021
IMPORTANCE COVID-19 has disproportionately affected racial and ethnic minority groups, and race and ethnicity have been associated with disease severity. However, the association of socioeconomic determinants with racial disparities in COVID-19 outcomes remains unclear. OBJECTIVE To evaluate the association of race and ethnicity with COVID-19 outcomes and to examine the association between race, ethnicity, COVID-19 outcomes, and socioeconomic determinants.
2020
Background: Initial reports suggest that ethnic minorities may be experiencing more severe clinical outcomes of coronavirus disease 2019 (COVID19) infections. We therefore assessed the association between ethnic composition, income deprivation and COVID19 mortality rates in England. Methods: We performed a cross-sectional ecological analysis across upper tier local authorities in England. We assessed the association between the proportion of the population from Black, Asian and Minority Ethnic (BAME) backgrounds, income deprivation and COVID19 mortality rates using negative binomial regression models, whilst adjusting for population density, proportion of the population aged 50-79 and 80+ years, and the duration of the epidemic in each area. Findings: Local authorities with a greater proportion of residents from ethnic minority backgrounds had statistically significantly higher COVID19 mortality rates, as did local authorities with a greater proportion of residents experiencing deprivation relating to low income. After adjusting for income deprivation and other covariates, each percentage point increase in the proportion of the population from BAME backgrounds was associated with a 1% increase in the COVID19 mortality rate [IRR=1.01, 95%CI 1.01-1.02]. Each percentage point increase in the proportion of the population experiencing income deprivation was associated with a 2% increase in the COVID19 mortality rate [IRR=1.02, 95%CI 1.01-1.04]. Interpretation: This study provides evidence that both income deprivation and ethnicity are associated with greater COVID19 mortality. To reduce these inequalities governments need to target effective control measures at these disadvantaged communities, ensuring investment of resources reflects their greater need and vulnerability to the pandemic.
Inequalities in COVID19 mortality related to ethnicity and socioeconomic deprivation
2020
BackgroundInitial reports suggest that ethnic minorities may be experiencing more severe coronavirus disease 2019 (COVID19) outcomes. We therefore assessed the association between ethnic composition, income deprivation and COVID19 mortality rates in England.MethodsWe performed a cross-sectional ecological analysis across England’s upper-tier local authorities. We assessed the association between the proportion of the population from Black, Asian and Minority Ethnic (BAME) backgrounds, income deprivation and COVID19 mortality rates using multivariable negative binomial regression, adjusting for population density, proportion of the population aged 50–79 and 80+ years, and the duration of the epidemic in each area.FindingsLocal authorities with a greater proportion of residents from ethnic minority backgrounds had statistically significantly higher COVID19 mortality rates, as did local authorities with a greater proportion of residents experiencing deprivation relating to low income. ...
2021
The SARS-CoV-2 infection, which causes the coronavirus disease (COVID-19), has affected lives, with very adverse outcomes in specific populations in the United States of America (USA), a high-income country, and two middle-income countries, Brazil and South Africa. This paper aims to discuss the relationship of race/ethnicity with COVID-19-associated factors in the three countries. The information is based on data collected from infectious disease/epidemiological centers in the USA, Brazil, and South Africa. Adverse COVID-19 outcomes have been associated with the burden of exposure and disease, linked to socioeconomic determinants, among specific ethnicities in all three countries. The prevalence of comorbidities before and the likelihood of work-related exposure in the context of COVID-19 infection puts ethnic minorities in the USA and some ethnic majorities and minorities in Brazil and South Africa at greater risk. We envisage that this work will contribute to ongoing discussions related to addressing socioeconomic determinants of health, and the need for stakeholders in various sectors to work on addressing observed health disparities for overall improvement in health and healthcare given the current pandemic.
Health disparity and COVID ‐19—A retrospective analysis
Health Science Reports, 2021
Background and Aims: According to the World Health Organization (WHO), more than 75.7 million confirmed cases of coronavirus disease 2019 (COVID-19), a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been reported so far. Researchers are working relentlessly to find effective solutions to this catastrophe, using genomic sequence-based investigation, immunological analysis, and more. The role of health disparity has also emerged as an intriguing factor that made a huge impact on the lives of people. Methods: We analyzed various factors that triggered the health disparity in the United States of America along with the rate of COVID-19 morbidity and mortality. Furthermore, we have also focused on the State of Mississippi, which is suffering from an extreme health disparity. Data have been obtained from publicly available data sources including, Center for Disease Control and Prevention and Mississippi State Department of Health. Correlation analysis of the dataset has been performed using R software. Results: Our analysis suggested that the COVID-19 infection rate per 100 000 people is directly correlated with the increasing number of the African American population in the United States. We have found a strong correlation between the obesity and the COVID-19 cases as well. All the counties in Mississippi demonstrate a strong correlation between a higher number of African American population to COVID-19 cases and obesity. Our data also indicate that a higher number of African American populations are facing socioeconomic disadvantages, which enhance their chances of becoming vulnerable to pre-existing ailments such as obesity, type-2 diabetes, and cardiovascular diseases. Conclusion: We proposed a possible explanation of increased COVID-19 infectivity in the African American population in the United States. This work has highlighted the intriguing factors that increased the health disparity at the time of the COVID-19 pandemic.
Lessons from the COVID-19 pandemic on the role of socioeconomic status in health outcomes
Anthos, 2021
This open access Article is distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0). All documents in PDXScholar should meet accessibility standards. If we can make this document more accessible to you, contact our team. Lessons from the COVID-19 Pandemic on the Role of Socioeconomic Status in Health Outcomes Leila Karout Current Characteristics and Outcomes of COVID-19 The SARS-CoV-2 (COVID-19) pandemic has evoked extreme circumstances for many around the world. As of the time of this writing, the World Health Organization has reported 159,319,384 confirmed cases of COVID-19 and 3,311,780 deaths globally. The United States alone has seen a total of 32,424,637 confirmed cases and 576,814 total deaths. 1 While risk factors, clinical characteristics of patients, mortality, and morbidity are all under consistent study, the information we have now on the pandemic and its effects on various populations shows similar patterns and themes. Current research has shown that severe obesity, hypertension, diabetes, cardiovascular diseases (CVDs), and kidney disease are the most prevalent underlying health conditions for individuals with COVID-19. These conditions have demonstrated an increase in morbidity of the virus. 2, 3, 4, 5, 6, 7. 8, 9 As of May 18th, 2020, the CDC reported 8,134 (76.4%) of deaths from COVID 19 to be associated with at least one underlying medical condition (including 83.1% of deaths for those under 65 years). The most common being cardiovascular disease (60.9%), diabetes mellitus (39.5%), chronic kidney disease (20.8%), and chronic lung disease (19.2%). 7 SES is a complex composition of social and economic factors that influence an individual, or a community's experiences. Socioeconomic status (SES) plays a substantial role in an individual's life due to the resources and opportunities that come along with it such as education, quality healthcare access, financial stability, social status, and race/ethnicity as a socioeconomic factor. 38 Individuals from lower SES are at a higher risk for illness susceptibility and severity. 12,13 This is especially prevalent during the current pandemic, where daily life has drastically changed, including detrimental social and financial challenges for many. Psychological stress due to restrictions on social behavior, the ability to see loved ones, and having an unstable occupation, has created outcomes such as depression, health anxiety, and financial worry. 18 Low SES can aggravate these outcomes due to the higher likelihood of risk factors such as pre-existing financial instability, lack of healthcare access, and the higher prevalence of pre-existing diseases associated with COVID-19 such as asthma, CVD, hypertension, chronic kidney disease (CKD), diabetes, and obesity. 10, 9, 19, 20 Therefore, it is essential to examine the role of SES during the COVID-19 pandemic to be better prepared to protect the most at-risk populations and find room for improvement in the
2021
COVID-19 has uncovered the vulnerabilities, inequalities and fragility present within our social community which has exposed and exacerbated the pre-existing racial and socioeconomic inequalities that disproportionately affect health outcomes for Black, Asian and Minority Ethnic (BAME) people. Such disparities are fuelled by complex socioeconomic health determinants and longstanding structural inequalities. This paper aims to explore the inequalities and vulnerabilities of BAME communities laid bare by the Public Health England (PHE) reports published in June 2020, concluding with suggested strategies to address inequalities in a post COVID-19 recovery.
Social Determinants Associated with COVID-19 Mortality in the United States
2020
This study examines social determinants associated with disparities in COVID-19 mortality rates in the United States. Using county-level data, 42 negative binomial mixed models were used to evaluate the impact of social determinants on COVID-19 outcome. First, to identify proper controls, the effect of 24 high-risk factors on COVID-19 mortality rate was quantified. Then, the high-risk terms found to be significant were controlled for in an association study between 41 social determinants and COVID-19 mortality rates. The results describe that ethnic minorities, immigrants, socioeconomic inequalities, and early exposure to COVID-19 are associated with increased COVID-19 mortality, while the prevalence of asthma, suicide, and excessive drinking is associated with decreased mortality. Overall, we recognize that social inequality places disadvantaged groups at risk, which must be addressed through future policies and programs. Additionally, we reveal possible relationships between lung ...
International Journal of General Medicine, 2021
The COVID-19 pandemic continues to impact the health-care system in the United States and has brought further light on health disparities within it. However, only a few studies have examined hospitalization risk with regard to social determinants of health. Objective: We aimed to identify how health disparities affect hospitalization rates among patients with COVID-19. Design: This observational study included all individuals diagnosed with COVID-19 from February 25, 2020 to December 31, 2020. Uni-and multivariate analyses were utilized to evaluate associations between demographic data and inpatient versus outpatient status for patients with COVID-19. Setting: Multicenter (8 hospitals), largest size health system in Southeast Michigan, a region highly impacted by the pandemic. Participants: All outpatients and inpatients with a positive RT-PCR for SARS-CoV-2 on nasopharyngeal swab were included. Exclusion criteria included missing demographic data or status as a non-permanent Michigan resident. Exposure: Patients who met inclusion and exclusion criteria were divided in 2 groups: outpatients and inpatients. Main Outcome and Measures: We described the comparative demographics and known disparities associated with hospitalization status. Results: Of 30,292 individuals who tested positive for SARS-CoV-2, 34.01% were admitted to the hospital. White or Caucasian race was most prevalent (57.49%), and 23.35% were African-American. The most common ethnicity was non-Hispanic or Latino (70.48%). English was the primary language for the majority of patients (91.60%). Private insurance holders made up 71.11% of the sample. Within the hospitalized patients, lower socioeconomic status, African-American race and Hispanic and Latino ethnicity, non-English speaking status, and Medicare and Medicaid were more likely to be admitted to the hospital. Conclusions and Relevance: Several health disparities were associated with greater rates of hospitalization due to COVID-19. Addressing these inequalities from an individual to system level may improve health-care outcomes for those with health disparities and COVID-19.