COVID-19: Exposing and addressing health disparities among ethnic minorities and migrants

Greenaway, Christina; Hargreaves, Sally; Barkati, Sapha; Coyle, Christina M.; Gobbi, Federico; Veizis, Apostolos; Douglas, Paul

doi:10.1093/jtm/taaa113

Cited by 182 publications

(164 citation statements)

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“…We found 35 data sources reporting on our primary clinical outcomes in migrants, including 21 on cases (13–32), 4 on hospitalisations (20, 33–35), and 15 on mortality (3, 20, 33–45). This includes data from Sweden (6 records), Italy (4), the United States (3), Canada (2), Denmark (2), Spain (2), the UK (2), France (2), Kuwait (2), Singapore (2), Norway (2), Germany (2), the Netherlands (1), Greece (1), Saudi Arabia (1) and across the EU/EEA/UK (1). Sources include peer-reviewed journal articles (13 records), pre-prints (3), national statistics (10), and other grey literature (9).…”

Section: Resultsmentioning

confidence: 99%

“…Refugee camps are typically crowded, and are often built quickly and with little regard to such things as tent spacing. In these settings, where social distancing and personal hygiene is difficult, the spread of COVID-19 is facilitated (1, 92–95, 110, 133–143). For example, the Moria camp in Greece had an estimated population density of 133,000 per km 2 , with reports of one water tap shared between 1,300 people in some areas of the camp (95).…”

Section: Resultsmentioning

confidence: 99%

“…Employment as a healthcare worker in Ontario accounted for a disproportionate number of COVID-19 cases among migrants, especially women (13). Concerns have also been raised about inadequate access to or use of PPE, overrepresentation of migrants in low paying paramedical roles, or difficulties in self-isolating because of staff shortages at the start of the pandemic (1, 166).…”

Section: Resultsmentioning

confidence: 99%

“…The COVID-19 pandemic has highlighted the vast ethnic, social, economic and cultural diversity that has come to characterise contemporary high-income countries (HICs), and has served as a reminder of the growing rate of population movement between, as well as within, countries and the new public health opportunities and challenges this is presenting. One of these challenges is the scale of health and social disparities associated with this diversity, with profound consequences for some ethnic minority groups (1). Data from several countries have revealed a much greater risk of infection and adverse outcomes from COVID-19 among Black, Asian, and Minority Ethnic [BAME] groups, South/East Asian, Black Americans, Hispanics, Latinos, racialised groups, people of colour, and indigenous groups compared to the native white population in the same countries (2).…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: a systematic review

Hayward

Deal

Cheng

et al. 2020

Preprint

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BackgroundMigrants, including refugees, asylum seekers, labour migrants, and undocumented migrants, now constitute a considerable proportion of most high-income countries’ populations, including their skilled and unskilled workforces. Migrants may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are being affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations (cases, hospitalisations, deaths), indirect health and social impacts, and to determine key risk factors.MethodsWe did a systematic review following PRISMA guidelines, registered with PROSPERO (CRD42020222135). We searched databases including PubMed, Global Health, Scopus, CINAHL, and pre-print databases (medRxiv) via the WHO Global Research on COVID-19 database to Nov 18, 2020 for peer-reviewed and grey literature pertaining to migrants (defined as foreign born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on our primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts, and risk factors, using narrative synthesis.Results3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps and labour compounds may have been especially affected. In general, migrants have higher levels of many risk factors and vulnerabilities relevant to COVID-19, including increased exposure to SARS-CoV-2 due to high-risk occupations and overcrowded accommodation, and barriers to health care including inadequate information, language barriers, and reduced entitlement to healthcare coverage related to their immigration status.ConclusionsMigrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health responses to the pandemic and should inform policymaking on strategies for reducing transmission of COVID-19 in this population. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: a systematic review

Hayward

Deal

Cheng

et al. 2020

Preprint

Self Cite

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“…Many refugees live in overcrowded housing and are disproportionately represented in workplaces that place them at risk of exposure to Covid-19 such as factories, production plants, and frontline healthcare work. 7 , 8 To date, international health policies affecting refugees have varied considerably. In a few notable cases, governments have taken steps to mitigate the impact of the pandemic on their refugee and migrant populations.…”

Section: Introductionmentioning

confidence: 99%

Refugee Health During the Covid-19 Pandemic: A Review of Global Policy Responses

Lupieri¹

2021

RMHP

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Refugees and displaced persons have been severely affected by the Covid-19 pandemic. Yet findings from this narrative review reveal that the health needs of refugees have been largely neglected within global healthcare responses. Such gaps include: (1) responding to the needs of refugees in camps and detention centers; (2) providing adequate public health information; (3) providing access to healthcare and mental health services; (4) and including refugees as decision-makers within health responses. More research is urgently needed to investigate why these gaps exists and to provide recommendations for improving the inclusiveness of healthcare policies during a pandemic.

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Twenty‐first century bioarchaeology: Taking stock and moving forward

Buikstra

DeWitte

Baker

et al. 2022

American Journal of Biological Anthropology

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This article presents outcomes from a Workshop entitled “Bioarchaeology: Taking Stock and Moving Forward,” which was held at Arizona State University (ASU) on March 6–8, 2020. Funded by the National Science Foundation (NSF), the School of Human Evolution and Social Change (ASU), and the Center for Bioarchaeological Research (CBR, ASU), the Workshop's overall goal was to explore reasons why research proposals submitted by bioarchaeologists, both graduate students and established scholars, fared disproportionately poorly within recent NSF Anthropology Program competitions and to offer advice for increasing success. Therefore, this Workshop comprised 43 international scholars and four advanced graduate students with a history of successful grant acquisition, primarily from the United States. Ultimately, we focused on two related aims: (1) best practices for improving research designs and training and (2) evaluating topics of contemporary significance that reverberate through history and beyond as promising trajectories for bioarchaeological research. Among the former were contextual grounding, research question/hypothesis generation, statistical procedures appropriate for small samples and mixed qualitative/quantitative data, the salience of Bayesian methods, and training program content. Topical foci included ethics, social inequality, identity (including intersectionality), climate change, migration, violence, epidemic disease, adaptability/plasticity, the osteological paradox, and the developmental origins of health and disease. Given the profound changes required globally to address decolonization in the 21st century, this concern also entered many formal and informal discussions.

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COVID-19: Exposing and addressing health disparities among ethnic minorities and migrants

Cited by 182 publications

References 6 publications

Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: a systematic review

Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: a systematic review

Refugee Health During the Covid-19 Pandemic: A Review of Global Policy Responses

Twenty‐first century bioarchaeology: Taking stock and moving forward

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