A systematic review of racial/ethnic and socioeconomic disparities in COVID-19.
A systematic review of racial/ethnic and socioeconomic disparities in COVID-19.
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DOI：
10.1186/s12939-021-01582-4
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发表时间：
2021-11-24
影响因子：
4.8
通讯作者：
Naghibi D
中科院分区：
文献类型：
--
作者：
Khanijahani A;Iezadi S;Gholipour K;Azami-Aghdash S;Naghibi D
COVID-19 大流行的初步证据表明存在健康差异，特别是在发病率和死亡率方面。本研究旨在系统地审查有关在 COVID-19 大流行期间种族/族裔和社会经济地位 (SES) 与健康结果和获得医疗保健服务之间关系的证据。我们检索了 2019 年 12 月下旬至 2021 年 3 月 1 日期间已发表的证据。目标人群是 COVID-19 大流行期间国家的人口。这些暴露被定义为属于种族/族裔少数群体和/或低社会经济地位。感兴趣的主要结局包括 (1) COVID-19 死亡、(2) COVID-19 发病率/感染、(3) COVID-19 住院治疗、(4) 入住 ICU、(5) 需要机械通气、(6) 确诊和 (7) 接受检测。我们系统地综合了不同研究的结果，并对结果进行了叙述性解释。在去除重复结果并筛选相关标题和摘要后，选择了 77 项研究进行全文审查。最终，52 项研究被纳入该评价。大多数研究来自美国（37 项研究）。尽管这些研究之间存在显着不一致，但大多数研究表明，少数种族/族裔群体感染 COVID-19 以及住院、确诊和死亡的风险较高。此外，大多数研究将教育水平低、贫困、住房条件差、家庭收入低、使用本国语言以外的语言以及居住在过度拥挤的家庭等因素列为COVID-19发病/感染、死亡和确诊的危险因素。然而，关于缺乏健康保险覆盖范围和失业与结果指标之间的关联，以及需要机械通气、入住 ICU 和接受 COVID-19 检测与种族/民族之间的关联的研究结果有限且不一致。很明显，少数种族/族裔群体和社会经济地位低的群体更容易感染 COVID-19；因此，公共卫生决策者、从业者和临床医生应意识到这些不平等，并通过关注弱势群体来努力缩小差距。这项系统回顾还揭示了研究中种族/族裔群体和社会经济地位的定义存在重大不一致。普洛斯彼罗 CRD42020190105。在线版本包含可在 10.1186/s12939-021-01582-4 获取的补充材料。
Preliminary evidence from the COVID-19 pandemic shows the presence of health disparities, especially in terms of morbidity and mortality. This study aimed to systematically review the evidence on the association of racial/ethnic and socioeconomic status (SES) with health outcomes and access to healthcare services during the COVID-19 pandemic. We retrieved published evidence from late December 2019 through March 1, 2021. The target population was the population of the countries during the COVID-19 pandemic. The exposures were defined as belonging to racial/ethnic minority groups and/or low SES. The primary outcomes of interest include (1) death from COVID-19, (2) COVID-19 incidence/infection, (3) COVID-19 hospitalization, (4) ICU admission, (5) need for mechanical ventilation, (6) confirmed diagnosis, and (7) access to testing. We systematically synthesized the findings from different studies and provided a narrative explanation of the results. After removing the duplicate results and screening for relevant titles and abstracts, 77 studies were selected for full-text review. Finally, 52 studies were included in the review. The majority of the studies were from the United States (37 studies). Despite the significant incongruity among the studies, most of them showed that racial/ethnic minority groups had higher risks of COVID-19 infection and hospitalization, confirmed diagnosis, and death. Additionally, most of the studies cited factors such as low level of education, poverty, poor housing conditions, low household income, speaking in a language other than the national language in a country, and living in overcrowded households as risk factors of COVID-19 incidence/infection, death, and confirmed diagnosis. However, findings in terms of the association of lack of health insurance coverage and unemployment with the outcome measures as well as the association of requiring mechanical ventilation, ICU admission, and access to testing for COVID-19 with race/ethnicity were limited and inconsistent. It is evident that racial/ethnic minority groups and those from low SES are more vulnerable to COVID-19; therefore, public health policymakers, practitioners, and clinicians should be aware of these inequalities and strive to narrow the gap by focusing on vulnerable populations. This systematic review also revealed a major incongruity in the definition of the racial/ethnic minority groups and SES among the studies. PROSPERO CRD42020190105. The online version contains supplementary material available at 10.1186/s12939-021-01582-4.
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DOI：
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发表时间：
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10.3961/jpmph.20.256
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期刊：
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