Ethnic minorities and COVID-19: examining whether excess risk is mediated through deprivation.
Ethnic minorities and COVID-19: examining whether excess risk is mediated through deprivation.
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DOI：
10.1093/eurpub/ckab041
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发表时间：
2021-07-13
影响因子：
4.4
通讯作者：
Yates T
中科院分区：
文献类型：
--
作者：
Razieh C;Zaccardi F;Islam N;Gillies CL;V Chudasama Y;Rowlands A;Kloecker DE;Davies MJ;Khunti K;Yates T
来自南亚和黑人少数族裔群体的人受到COVID-19大流行的影响不成比例。目前尚不清楚剥夺是否会介导这种过度的种族风险。我们使用英国生物样本库（UK Biobank），其与2020年3月16日至2020年8月24日期间发生的COVID-19结果相关。使用四向分解中介分析来建模，如果人口中的高物质匮乏水平降低，南亚和黑人个体相对于白色个体的COVID-19检测阳性、严重疾病和死亡率的过度风险将在多大程度上被消除。我们纳入了15044名（53.0%女性）南亚人和黑人以及392786名（55.2%女性）白色人。南亚和黑人个体中有151例（1.0%）阳性检测，91例（0.6%）严重病例和31例（0.2%）因COVID-19死亡，而白色个体中分别为1471例（0.4%），895例（0.2%）和313例（0.1%）。与白色个体相比，南亚人和黑人个体COVID-19检测阳性、发生重症和COVID-19死亡的相对风险分别为2.73（95% CI：2.26，3.19）、2.96（2.31，3.61）和4.04（2.54，5.55）。一项假设的干预措施使25%最贫困的人口摆脱贫困，以消除南亚和黑人人口中40%至50%的COVID-19后果的过度风险，而使50%最贫困的人口摆脱贫困将消除80%以上的COVID-19后果的过度风险。南亚和黑人社区的COVID-19后果的过度风险可以通过针对物质匮乏的人口水平政策大幅降低。
People from South Asian and black minority ethnic groups are disproportionately affected by the COVID-19 pandemic. It is unknown whether deprivation mediates this excess ethnic risk. We used UK Biobank with linked COVID-19 outcomes occurring between 16th March 2020 and 24th August 2020. A four-way decomposition mediation analysis was used to model the extent to which the excess risk of testing positive, severe disease and mortality for COVID-19 in South Asian and black individuals, relative to white individuals, would be eliminated if levels of high material deprivation were reduced within the population. We included 15 044 (53.0% women) South Asian and black and 392 786 (55.2% women) white individuals. There were 151 (1.0%) positive tests, 91 (0.6%) severe cases and 31 (0.2%) deaths due to COVID-19 in South Asian and black individuals compared with 1471 (0.4%), 895 (0.2%) and 313 (0.1%), respectively, in white individuals. Compared with white individuals, the relative risk of testing positive for COVID-19, developing severe disease and COVID-19 mortality in South Asian and black individuals were 2.73 (95% CI: 2.26, 3.19), 2.96 (2.31, 3.61) and 4.04 (2.54, 5.55), respectively. A hypothetical intervention moving the 25% most deprived in the population out of deprivation was modelled to eliminate between 40 and 50% of the excess risk of all COVID-19 outcomes in South Asian and black populations, whereas moving the 50% most deprived out of deprivation would eliminate over 80% of the excess risk of COVID-19 outcomes. The excess risk of COVID-19 outcomes in South Asian and black communities could be substantially reduced with population level policies targeting material deprivation.
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影响因子：
5
作者：
Fry A;Littlejohns TJ;Sudlow C;Doherty N;Adamska L;Sprosen T;Collins R;Allen NE
通讯作者：
Allen NE
影响因子：
4.4
作者：
Raisi-Estabragh, Zahra;McCracken, Celeste;Petersen, Steffen E.
通讯作者：
Petersen, Steffen E.
影响因子：
5.2
作者：
Marmot, M.;Bell, R.
通讯作者：
Bell, R.
影响因子：
168.9
作者：
Marmot, M
通讯作者：
Marmot, M
影响因子：
15.8
作者：
Sudlow C;Gallacher J;Allen N;Beral V;Burton P;Danesh J;Downey P;Elliott P;Green J;Landray M;Liu B;Matthews P;Ong G;Pell J;Silman A;Young A;Sprosen T;Peakman T;Collins R
通讯作者：
Collins R