How can we understand and reduce the differential impact of COVID-19 on minority ethnic and migrant groups?

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The COVID-19 pandemic has highlighted extreme health inequalities in the UK. People from minority ethnic backgrounds have been impacted by an excess risk of severe disease and death. Migrant groups may also be at increased risk and face barriers to accessing health care. Analyses of data collected from community settings are needed to better understand the complex relationships between the biological, behavioural and socio-economic factors that contribute to inequality in COVID-19 mortality and to assess the differential impact of the pandemic on minority ethnic and migrant communities. High quality evidence is urgently needed in order to inform policies that benefit communities that have been hardest hit by the pandemic to improve resilience to future health crises. This thesis will use data from Virus Watch, a comprehensive household community cohort study, following up all household members over 12 months with detailed characterisation of risk factors, household transmission, changing behaviours and socio-economic impacts. Specific objectives include:1. To describe the incidence of COVID-19 infection and mortality in the community by ethnicity and migration groups2. To explore risk factors of infection and mortality including migration, occupation, intergenerational households, overcrowding, respiratory and hand hygiene, social distancing and contact behaviour3. To evaluate the differential effects of infection control measures and policy decisions by race and migration groups4. To use findings to propose evidence-based recommendations for future pandemic preparedness