The disproportionate impact of COVID-19 on Black, Asian and Minority Ethnic groups is something I discuss at length in my work - Lifting Lockdown: Tips from a GP - available to download https://bit.ly/LiftingLockdownGPGuide

A study released today analyses over 18 million patients across the US and UK and draws this same conclusion. It showed Black people are twice as likely to catch coronavirus and that Asian people are 1.5 times more likely than White people to be infected - and may be more likely to need intensive care. It says we must be careful not to prematurely attribute worse clinical outcomes in ethnic minority groups to genetics.

Read on to the key conclusions drawn from this study.

““Large scale political-economic forces that have played out over generations have resulted in deep-seated social, economic and power inequities, which shape the distribution of risks and resources for health, resulting in social and spatial clustering of infectious diseases amongst certain ethnic groups which have long been underserved “”

Ethnic inequalities in the US and the UK

Over 18 million patients from 50 studies were included in this systematic review and meta-analysis, 42 were from the US and 8 from the UK.

Black and Asian people are more likely to develop COVID-19

Individuals from Black and Asian ethnicities had a higher risk of COVID-19 infection compared to White individuals
Asians may be at higher risk of ITU admission and death.

Discrimination, marginalisation, inequality

SARS-CoV-2 is much more efficiently spread in enclosed and crowded environments - Individuals from ethnic minority backgrounds are more likely

to live in larger household sizes comprised of multiple generations
to have lower socioeconomic status, which may increase the likelihood of living in overcrowded households, or accommodation with shared facilities or communal areas
employed as essential workers, or less able to work from home, and as a result have continued to have contact with others through work or commuting

It’s not just about diabetes

There was some evidence that Asian individuals had a higher risk of severe infection (as marked by an increased risk of ITU admission and possibly death from COVID-19 ) even when common key confounders, such as a higher prevalence of diabetes and cardiovascular disease are taken into account.

Racism

Racism and structural discrimination may also contribute to an increased risk of worse clinical outcomes within ethnic minority communities

These processes are complex and systemic, underpinned by unequal power relations and beliefs, and operating at individual, community, and organisational levels, resulting in stigmatisation, discrimination, and marginalisation of ethnic minorities

Within a healthcare context, this contributes to inequities in the delivery of care, barriers to accessing care, loss of trust, and psychosocial stressors.

There is evidence to suggest that ethnic minorities and migrant groups have been less likely to implement public health measures, be tested, or seek care when experiencing symptoms due to such barriers and inequities in the availability and accessibility of care underscoring critical healthcare disparities

Large scale political-economic forces that have played out over generations have resulted in deep-seated social, economic and power inequities, which shape the distribution of risks and resources for health, resulting in social and spatial clustering of infectious diseases amongst certain ethnic groups which have long been underserved

Reference

Sze, Shirley, et al. "Ethnicity and clinical outcomes in COVID-19 A Systematic Review and Meta-analysis." medRxiv (2020).

Why are Black and Asian people more likely to be impacted by COVID-19?