Mitigating ethnic disparities in covid-19 and beyond

Razai, Mohammad S; Kankam, Hadyn; Majeed, Azeem; Esmail, Aneez; Williams, David R.

doi:10.1136/bmj.m4921

Cited by 197 publications

(201 citation statements)

References 34 publications

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“…This has serious implications. The pandemic continues to have a disproportionate effect on people from ethnic minorities, with higher covid-19 morbidity and mortality and greater adverse socioeconomic consequences 10. Without an effective vaccination strategy to mitigate the risks, the situation will worsen.…”

Section: Reasons For Vaccine Hesitancymentioning

confidence: 99%

“…Trust is eroded by systemic racism and discrimination,10 previous unethical healthcare research in black populations,13 under-representation of minorities in health research and vaccine trials,9 and negative experiences within a culturally insensitive healthcare system 10. The disregard for non-Christian religious festivals has further undermined trust.…”

Section: Reasons For Vaccine Hesitancymentioning

confidence: 99%

“…The disregard for non-Christian religious festivals has further undermined trust. Residential segregation, a form of systemic racism, affects health and access to resources to enhance health in multiple ways, creating conditions that amplify mistrust 10. Segregation is rising in Europe, and in the UK the Bangladeshi and Pakistani communities are the most segregated 14.…”

Section: Reasons For Vaccine Hesitancymentioning

confidence: 99%

“…Segregation is rising in Europe, and in the UK the Bangladeshi and Pakistani communities are the most segregated 14. Ethnicity intersects with socioeconomic status and educational attainment, accentuating the effects 1014. Access barriers, including location of vaccine delivery and time, are other factors that could aggravate the disparities in uptake.…”

Section: Reasons For Vaccine Hesitancymentioning

confidence: 99%

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Covid-19 vaccine hesitancy among ethnic minority groups

Razai

Osama

McKechnie

et al. 2021

BMJ

Self Cite

360

335

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With mass covid-19 vaccination efforts under way in many countries, including the UK, we need to understand and redress the disparities in its uptake. Data to 14 February 2021 show that over 90% of adults in Britain have received or would be likely to accept the covid-19 vaccine if offered. 1 However, surveys have indicated much greater vaccine hesitancy among people from some ethnic minorities. 2-4 In a UK survey in December 2020, vaccine hesitancy was highest among black (odds ratio 12.96, 95% confidence interval 7.34 to 22.89), Bangladeshi, and Pakistani (both 2.31, 1.55 to 3.44) populations compared with people from a white ethnic background. 5 Even more worryingly, data up to 15 January 2021 show substantially lower rates of covid-19 vaccinations among over 80s in ethnic minority (white people 42.5%, black people 20.5%) and deprived communities (least deprived 44.7%, most deprived 37.9%) in England. 6 Similarly, data from an NHS trust show lower covid-19 vaccination rates among ethnic minority healthcare workers (70.9% in white workers v 58.5% in South Asian and 36.8% in black workers; P<0.001 for both). 7

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Section: Reasons For Vaccine Hesitancymentioning

confidence: 99%

Section: Reasons For Vaccine Hesitancymentioning

confidence: 99%

Section: Reasons For Vaccine Hesitancymentioning

confidence: 99%

Section: Reasons For Vaccine Hesitancymentioning

confidence: 99%

See 2 more Smart Citations

Covid-19 vaccine hesitancy among ethnic minority groups

Razai

Osama

McKechnie

et al. 2021

BMJ

Self Cite

360

335

View full text Add to dashboard Cite

show abstract

“…Elderly people, at greatest risk for COVID-19 related mortality and morbidity, from municipalities with a lower socioeconomic status (SES) may suffer from lower availability of healthcare resources, leading to poorer health and lower acceptance of public healthcare measures such as vaccines 9 . Concurrently, some of these populations at low SES and of rural locations are more severely affected by the COVID-19 pandemic in Israel and worldwide 10-12 . The overarching hypothesis of our research is that population with a lower SES are subject to a double hit risk in the setting of the current pandemic, a higher rate of contagious disease coupled with a lower rate of vaccination…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic Disparities and COVID-19 Vaccination Acceptance: Experience from Israel

Caspi

Dayan²,

Eshal³

et al. 2021

Preprint

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COVID-19 vaccination acceptance has a key role in mitigating the pandemic. Concern has been raised that vaccination rates will be limited in demographically defined areas of lower income. Israel’s rapid vaccination campaign may allow to assess these assumptions in real-world and to devise tools for effectively focusing the vaccination efforts. We analyzed the correlation between COVID-19 vaccination rates, socioeconomic status (SES) and active COVID-19 disease burden. We carried out a nationwide study, based on data provided by Ministry of Health of COVID-19 vaccination rates in all municipalities in Israel up to January 12th, 2021. Municipal Vaccination rates of population older than 60 significantly correlated with the socioeconomic status (r=0.83, 95% confidence interval [0.79 to 0.87]). Finally, we established a novel metric for focusing the vaccination efforts based on % vaccinations and active disease burden. In Israel, a case-model country for COVD-19 vaccinations, vaccination rates were strongly correlated with SES. The study findings demonstrate the need to directly target vaccination acceptance to socio-economically disadvantaged populations and suggest potential tools for policymakers to focus their efforts.

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Differences in Health Professionals’ Engagement With Electronic Health Records Based on Inpatient Race and Ethnicity

Yan,

Zhang,

Yang

et al. 2023

JAMA Netw Open

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ImportanceUS health professionals devote a large amount of effort to engaging with patients’ electronic health records (EHRs) to deliver care. It is unknown whether patients with different racial and ethnic backgrounds receive equal EHR engagement.ObjectiveTo investigate whether there are differences in the level of health professionals’ EHR engagement for hospitalized patients according to race or ethnicity during inpatient care.Design, Setting, and ParticipantsThis cross-sectional study analyzed EHR access log data from 2 major medical institutions, Vanderbilt University Medical Center (VUMC) and Northwestern Medicine (NW Medicine), over a 3-year period from January 1, 2018, to December 31, 2020. The study included all adult patients (aged ≥18 years) who were discharged alive after hospitalization for at least 24 hours. The data were analyzed between August 15, 2022, and March 15, 2023.ExposuresThe actions of health professionals in each patient’s EHR were based on EHR access log data. Covariates included patients’ demographic information, socioeconomic characteristics, and comorbidities.Main Outcomes and MeasuresThe primary outcome was the quantity of EHR engagement, as defined by the average number of EHR actions performed by health professionals within a patient’s EHR per hour during the patient’s hospital stay. Proportional odds logistic regression was applied based on outcome quartiles.ResultsA total of 243 416 adult patients were included from VUMC (mean [SD] age, 51.7 [19.2] years; 54.9% female and 45.1% male; 14.8% Black, 4.9% Hispanic, 77.7% White, and 2.6% other races and ethnicities) and NW Medicine (mean [SD] age, 52.8 [20.6] years; 65.2% female and 34.8% male; 11.7% Black, 12.1% Hispanic, 69.2% White, and 7.0% other races and ethnicities). When combining Black, Hispanic, or other race and ethnicity patients into 1 group, these patients were significantly less likely to receive a higher amount of EHR engagement compared with White patients (adjusted odds ratios, 0.86 [95% CI, 0.83-0.88; P &lt; .001] for VUMC and 0.90 [95% CI, 0.88-0.92; P &lt; .001] for NW Medicine). However, a reduction in this difference was observed from 2018 to 2020.Conclusions and RelevanceIn this cross-sectional study of inpatient EHR engagement, the findings highlight differences in how health professionals distribute their efforts to patients’ EHRs, as well as a method to measure these differences. Further investigations are needed to determine whether and how EHR engagement differences are correlated with health care outcomes.

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Mitigating ethnic disparities in covid-19 and beyond

Abstract: Although socioeconomic status partly explains ethnic disparities seen with covid-19, cultural and structural racism also adversely affect health, argue Mohammad Razai and colleagues

Cited by 197 publications

References 34 publications

Covid-19 vaccine hesitancy among ethnic minority groups

Covid-19 vaccine hesitancy among ethnic minority groups

Socioeconomic Disparities and COVID-19 Vaccination Acceptance: Experience from Israel

Differences in Health Professionals’ Engagement With Electronic Health Records Based on Inpatient Race and Ethnicity

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