Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities.
Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities.
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DOI：
10.1136/jech-2020-216061
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发表时间：
2021-10
影响因子：
6.3
通讯作者：
Barr B
中科院分区：
文献类型：
--
作者：
Katikireddi SV;Lal S;Carrol ED;Niedzwiedz CL;Khunti K;Dundas R;Diderichsen F;Barr B
少数民族群体受到COVID-19大流行的影响尤为严重。虽然造成这种情况的确切原因尚不清楚，但它们很可能是多种因素的复杂相互作用，而不是单一原因造成的。减少这些不平等需要对其原因有更深入的了解。然而，迄今为止的研究一直受到缺乏对“种族”（或种族）含义和导致不平等的潜在途径的理论理解的阻碍。特别是，定量分析经常调整不平等实际产生的途径（即利益效应的中介），导致社会进程的影响，特别是结构性种族主义的影响变得隐藏起来。在本文中，我们描述了一个框架，用于理解在COVID-19中产生族裔（和种族）不平等的途径。我们认为，大流行导致的健康结果差异可能通过以下六个途径产生：(1)不同的病毒暴露；(2)对感染/疾病的不同脆弱性；(3)疾病的不同健康后果；(4)疾病造成的不同社会后果；(5)流行病控制措施的不同效果；(6)控制措施的不同不良后果。目前的研究仅对其中一些途径提供了部分理解。今后的研究和行动将需要更清楚地了解种族的多个方面，并认识到造成种族不平等的社会和生物途径的复杂相互作用。我们的框架突出了当前证据和途径中的差距，这些差距需要在旨在解决这些不平等的研究中进一步调查。
Minority ethnic groups have been disproportionately affected by the COVID-19 pandemic. While the exact reasons for this remain unclear, they are likely due to a complex interplay of factors rather than a single cause. Reducing these inequalities requires a greater understanding of the causes. Research to date, however, has been hampered by a lack of theoretical understanding of the meaning of ‘ethnicity’ (or race) and the potential pathways leading to inequalities. In particular, quantitative analyses have often adjusted away the pathways through which inequalities actually arise (ie, mediators for the effect of interest), leading to the effects of social processes, and particularly structural racism, becoming hidden. In this paper, we describe a framework for understanding the pathways that have generated ethnic (and racial) inequalities in COVID-19. We suggest that differences in health outcomes due to the pandemic could arise through six pathways: (1) differential exposure to the virus; (2) differential vulnerability to infection/disease; (3) differential health consequences of the disease; (4) differential social consequences of the disease; (5) differential effectiveness of pandemic control measures and (6) differential adverse consequences of control measures. Current research provides only a partial understanding of some of these pathways. Future research and action will require a clearer understanding of the multiple dimensions of ethnicity and an appreciation of the complex interplay of social and biological pathways through which ethnic inequalities arise. Our framework highlights the gaps in the current evidence and pathways that need further investigation in research that aims to address these inequalities.
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DOI：
10.1016/j.bbi.2021.03.008
发表时间：
2021-05
期刊：
Brain, behavior, and immunity
影响因子：
--
作者：
Robertson E;Reeve KS;Niedzwiedz CL;Moore J;Blake M;Green M;Katikireddi SV;Benzeval MJ
通讯作者：
Benzeval MJ
影响因子：
9.3
作者：
Niedzwiedz, Claire L.;O'Donnell, Kate A.;Katikireddi, S. Vittal
通讯作者：
Katikireddi, S. Vittal
影响因子：
3.3
作者：
Rzepnikowska, Alina
通讯作者：
Rzepnikowska, Alina
影响因子：
3.3
作者：
Diderichsen, Finn;da Silva Augusto, Lia Giraldo;Perez, Bernadete
通讯作者：
Perez, Bernadete
影响因子：
12.7
作者：
Nazroo, JY
通讯作者：
Nazroo, JY