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

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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
Pages (from-to)1-15
Number of pages15
JournalJournal of Global Health
Publication statusPublished - 2 Jul 2021


  • racial minority groups
  • social inequality
  • COVID-19


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