British minority groups at high risk of poor COVID-19 results

Ethnic minority groups were at higher risk of positive SARS-CoV-2 and COVID-19-related hospitalizations, intensive care unit (ICU) hospitalizations, and death tests compared to the British white group. Lancet..

The COVID-19 pandemic is understood to have had a disproportionate impact on ethnic minority communities in the United Kingdom and abroad. The study described a number of explanatory variables such as household size, social factors, and health status at various stages of COVID-19, from testing to death, across all ethnic groups. Understanding SARS-CoV-2 infections and COVID-19 drivers in ethnic minority communities is critical to public policy efforts to overcome inequality.

Ethnic minority groups in the United Kingdom are unbalanced by factors that increase the risk of adverse COVID-19 outcomes, such as living in poor areas, front-line work, and poor access to health care. Our study shows that even after considering many of these factors, the risk of positives, hospitalization, ICU admission, and death was still higher in ethnic minority groups compared to whites in the United Kingdom. Improving the outcome of COVID-19 requires addressing the broader disadvantages and structural racism faced by these communities, as well as improving access to care and reducing infections. “

Dr. Rohini Mathur, Principal Writer, London School of Economics and Tropical Medicine, UK

On behalf of the NHS England, the research team used a new secure OpenSAFELY data analysis platform to analyze partially anonymized electronic health data collected by the GP, which covers 40% of England. These GP records were linked to other national coronavirus-related datasets for the first and second waves of the pandemic. This includes testing, hospital data, and mortality records. Ethnicity was self-reported by GP record participants, grouped into 5 census categories (white, South Asia, black, and mixed), and further grouped into 16 subgroups.

Possible explanatory factors, including clinical features such as body mass index, blood pressure, smoking status, and conditions such as asthma and diabetes, were included in the analysis along with demographic information such as age, gender, deprivation, and household size.

Of the 17,288,532 adults included in this study, 63% (10,877,978) were Caucasian, 5.9% (1,025,319) were South Asia, 2% (340,912) were black, 1.8% (320,788) were others, and 1% (170,484). Was mixed. The ethnicity of 26.3% (4,553,051) people was unknown.

During Wave 1, almost all ethnic minority groups had a higher relative risk of testing positive, hospitalization, ICU admission, and death compared to the Caucasian group. The largest disparity was seen in ICU admission, more than doubled in all ethnic minority groups compared to white groups, and blacks were more than three times more likely to be admitted to the ICU after considering other factors. ..

The percentage of people tested positive for SARS-CoV-2 in Wave 1 was high in the South Asian group (0.9% test positive), blacks (0.7%), mixed group (0.5%), and whites (0.4%). Was compared with.

“The high risk of testing positive and subsequent adverse results among ethnic minority groups suggests that people may delay access to testing or care for SARS-CoV-2. May be due to lack of access to test sites or inconsistent health messages. Ethnic minority groups are likely to work in precarious jobs with poor workplace protection and are therefore tested positive. It suggests that some people may be afraid to lose income or employment if quarantine is needed afterwards. It will be better supported if the disparity in COVID-19 results is reduced, “Dr. Mathur said. Stated.

Pandemic Wave 2 in all ethnic minority communities, with the exception of the South Asian group, had a lower relative risk of positivity, hospitalization, ICU admission, and death compared to Caucasians compared to Wave 1. The South Asian group remained at higher risk of positive tests, with a higher relative risk of hospitalization, ICU admission, and death in the second wave compared to the first.

“Despite the improvements seen in most ethnic minority groups in the second wave compared to the first wave, we are concerned that inequality has widened among South Asian groups. This is a need for the United Kingdom. It highlights the urgent need to find an effective preventative measure that suits the needs of the population. Ethnically diverse populations, ”says Dr. Matur.

After considering age and gender, social deprivation was the largest potential account of inequality in all ethnic minority groups except South Asia. In the South Asian group, health factors (BMI, blood pressure, underlying health status, etc.) played a major role in explaining the excess risk of all outcomes. Household size was an important account of the COVID-19 mortality inequality in South Asian groups only.

“Although multi-generational life can increase the risk of exposure and infection (from children and working age adults to the elderly and vulnerable families), such households and extended communities provide a valuable informal care network. Provide and promote engagement with health and community services. Evidence that minority groups are unlikely to take the COVID-19 vaccine is a culturally competent and non-stimulating engagement strategy with these communities. Is becoming more and more important to co-design, “says Dr. Mathur.

The authors warn that there are some limitations to the study, including the inability to capture all potential explanatory variables such as occupation, health-related behavior, and experience of racism and structural discrimination. They call for improving the integrity of ethnic records in health data to further support the implementation of quality research to address health inequality since COVID-19.

In a linked comment, Dr. Daniel Morales of the University of Dundee in the United Kingdom and Dr. Sara Ali of the Royal Free London NHS Foundation Trust in the United Kingdom (who were not involved in the study) said: The COVID-19 vaccination program is effectively deployed in all ethnic minority groups. The key to this is to urgently deal with vaccine hesitation. There are reports of increased hesitation in ethnic minority groups, including those working in front-line health and society. The role of care that is deliberately facing an increased risk of infection with COVID-19. Unless the hesitation of vaccines is addressed head-on, differences in vaccine intake can further exacerbate the health inequality faced by ethnic minority groups. “