Racism as the fundamental cause of ethnic inequities in COVID-19 vaccine hesitancy: A theoretical framework and empirical exploration using the UK Household Longitudinal Study.
Racism as the fundamental cause of ethnic inequities in COVID-19 vaccine hesitancy: A theoretical framework and empirical exploration using the UK Household Longitudinal Study.
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DOI：
10.1016/j.ssmph.2022.101150
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发表时间：
2022-09
影响因子：
4.7
通讯作者：
Taylor, Harry
中科院分区：
文献类型：
--
作者：
Becares, Laia;Shaw, Richard J.;Katikireddi, Srinivasa Vittal;Irizar, Patricia;Amele, Sarah;Kapadia, Dharmi;Nazroo, James;Taylor, Harry
据报道，在英国和其他地方，COVID-19疫苗犹豫中存在种族不平等现象。解释主要集中在对副作用的关注程度不同，以及对疫苗的开发和功效缺乏信任。在此，我们提出种族主义是疫苗犹豫中种族不平等的根本原因。我们介绍了一个理论框架，详细说明了结构、制度和人际层面的种族主义导致少数民族群体对疫苗有更高的犹豫。然后，我们使用英国家庭纵向研究COVID-19调查（2020年11月至12月）第6波的数据，对这些途径进行实证研究，并将其应用于机构、社区和个人层面的因素。我们使用Karlson-Holm-Breen方法来正式比较种族和疫苗犹豫之间的关系，一旦考虑到年龄和性别、社会人口变量、制度、社区和个人水平的因素。基于平均部分效应，我们计算了由每组因素解释的种族不平等的百分比。研究结果表明，机构层面的因素（社会经济地位、地区层面的剥夺、过度拥挤）解释了巴基斯坦或孟加拉国人疫苗抗性不平等的最大部分（42%），而社区层面的因素（种族密度、社区凝聚力、政治效力、该地区的种族主义）是印度和黑人群体最重要的因素，分别解释了35%和15%的不平等。我们的研究结果表明，如果政策干预由结构性和体制性种族主义形成的体制和社区层面的因素，可能会在减少种族不平等方面取得相当大的成功。我们认为种族主义是疫苗犹豫中种族不平等的根本原因。我们将种族主义运作为制度、社区和个人层面的因素。制度和社区层面的因素解释了这种不平等的最主要原因。解决制度和社区层面的因素可能会减少种族不平等。这包括解决种族主义，种族不平等的根本原因。
Ethnic inequities in COVID-19 vaccine hesitancy have been reported in the United Kingdom (UK), and elsewhere. Explanations have mainly focused on differences in the level of concern about side effects, and in lack of trust in the development and efficacy of vaccines. Here we propose that racism is the fundamental cause of ethnic inequities in vaccine hesitancy. We introduce a theoretical framework detailing the mechanisms by which racism at the structural, institutional, and interpersonal level leads to higher vaccine hesitancy among minoritised ethnic groups. We then use data from Wave 6 of the UK Household Longitudinal Study COVID-19 Survey (November to December 2020) to empirically examine these pathways, operationalised into institutional, community, and individual-level factors. We use the Karlson–Holm–Breen method to formally compare the relationship between ethnicity and vaccine hesitancy once age and gender, sociodemographic variables, and institutional, community, and individual-level factors are accounted for. Based on the Average Partial Effects we calculate the percentage of ethnic inequities explained by each set of factors. Findings show that institutional-level factors (socioeconomic position, area-level deprivation, overcrowding) explained the largest part (42%) of the inequity in vaccine hesistancy for Pakistani or Bangladeshi people, and community-level factors (ethnic density, community cohesion, political efficacy, racism in the area) were the most important factors for Indian and Black groups, explaining 35% and 15% of the inequity, respectively. Our findings suggest that if policy intervened on institutional and community-level factors – shaped by structural and institutional racism - considerable success in reducing ethnic inequities might be achieved. We theorise racism as a fundamental cause of ethnic inequalities in vaccine hesitancy. We operationalise racism into institutional, community, and individual-level factors. Institutional and community-level factors explained the largest part of the inequality. Addressing institutional and community-level factors may reduce ethnic inequalities. This includes addressing racism, the fundamental cause of ethnic inequalities.
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