Racial disparities in COVID-19 pandemic cases, hospitalisations, and deaths: A systematic review and meta-analysis

William Mude, Victor Ouguma, Tafadzwa Nyanhanda, Lillian Mwanri, Carolyne Njue

Research output: Contribution to journalArticlepeer-review

Abstract

Background People from racial minority groups in western countries experience disproportionate socioeconomic and structural determinants of health disadvantag-es. These disadvantages have led to inequalities and inequities in health care access and poorer health outcomes. We report disproportionate disparities in prevalence, hospitalisation, and deaths from COVID-19 by racial minority populations.
Methods We conducted a systematic literature search of relevant databases to iden-tify studies reporting on prevalence, hospitalisations, and deaths from COVID-19 by race groups between 01 January 2020 – 15 April 2021. We grouped race cate-gories into Blacks, Hispanics, Whites and Others. Random effects model using the method of DerSimonian and Laird were fitted, and forest plot with respective ratio estimates and 95% confidence interval (CI) for each race category, and subgroup meta-regression analyses and the overall pooled ratio estimates for prevalence, hos-pitalisation and mortality rate were presented.
Results Blacks experienced significantly higher burden of COVID-19: prevalence ra-tio 1.79 (95% confidence interval (CI) = 1.59-1.99), hospitalisation ratio 1.87 (95% CI = 1.69-2.04), mortality ratio 1.68 (95% CI = 1.52-1.83), compared to Whites: prevalence ratio 0.70 (95% CI = 0.0.64-0.77), hospitalisation ratio 0.74 (95% CI = 0.65-0.82), mortality ratio 0.82 (95% CI = 0.78-0.87). Also, Hispanics experi-enced a higher burden: prevalence ratio 1.78 (95% CI = 1.63-1.94), hospitalisation ratio 1.32 (95% CI = 1.08-1.55), mortality ratio 0.94 (95% CI = 0.84-1.04) compared to Whites. A higher burden was also observed for Other race groups: prevalence ratio 1.43 (95% CI = 1.19-1.67), hospitalisation ratio 1.12 (95% CI = 0.89-1.35), mortal-ity ratio 1.06 (95% CI = 0.89-1.23) compared to Whites. The disproportionate bur-den among Blacks and Hispanics remained following correction for publication bias.
Conclusions Blacks and Hispanics have been disproportionately affected by COVID-19. This is deeply concerning and highlights the systemically entrenched disadvantages (social, economic, and political) experienced by racial minorities in western countries; and this study underscores the need to address inequities in these communities to improve overall health outcomes.
Original languageEnglish
Article number05015
Number of pages15
JournalJournal of Global Health
Volume11
DOIs
Publication statusPublished - 2 Jul 2021

Keywords

  • racial minority groups
  • social inequality
  • COVID-19

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