Irizar, P. et al. (2023) Pathways to ethnic inequalities in COVID-19 health outcomes in the United Kingdom: a systematic map. Social Science and Medicine, 329, 116044. (doi: 10.1016/j.socscimed.2023.116044) (PMID:37364448) (PMCID:PMC10284430)
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Abstract
Background: Marked ethnic inequalities in COVID-19 infection and its consequences have been documented. The aim of this paper is to identify the range and nature of evidence on potential pathways which lead to ethnic inequalities in COVID-19 related health outcomes in the United Kingdom (UK). Methods: We searched six bibliographic and five grey literature databases from 1st December 2019 to 23rd February 2022 for research on pathways to ethnic inequalities in COVID-19 health outcomes in the UK. Meta-data were extracted and coded, using a framework informed by a logic model. Open Science Framework Registration: DOI 10.17605/OSF.IO/HZRB7. Results: The search returned 10,728 records after excluding duplicates, with 123 included (83% peer-reviewed). Mortality was the most common outcome investigated (N = 79), followed by infection (N = 52). The majority of studies were quantitative (N = 93, 75%), with four qualitative studies (3%), seven academic narrative reviews (6%), nine third sector reports (7%) and five government reports (4%), and four systematic reviews or meta-analyses (3%). There were 78 studies which examined comorbidities as a pathway to mortality, infection, and severe disease. Socioeconomic inequalities (N = 67) were also commonly investigated, with considerable research into neighbourhood infrastructure (N = 38) and occupational risk (N = 28). Few studies examined barriers to healthcare (N = 6) and consequences of infection control measures (N = 10). Only 11% of eligible studies theorised racism to be a driver of inequalities and 10% (typically government/third sector reports and qualitative studies) explored this as a pathway. Conclusion: This systematic map identified knowledge clusters that may be amenable to subsequent systematic reviews, and critical gaps in the evidence-base requiring additional primary research. Most studies do not incorporate or conceptualise racism as the fundamental cause of ethnic inequalities and therefore the contribution to literature and policy is limited.
| Item Type: | Articles |
|---|---|
| Additional Information: | This work was supported by the ESRC (grant number ES/W000849/1). DP is supported by a NIHR Doctoral Research Fellowship (NIHR302338). MP is supported by a NIHR Development and Skills Enhancement Award, by the NIHR Leicester Biomedical Research Centre (BRC), and by the NIHR Applied Research Collaboration East Midlands (ARC EM). SVK acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_00022/2) and the Scottish Government Chief Scientist Office (SPHSU17). LBN is supported by an Academy of Medical Sciences Springboard Award (SBF005/1047). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Katikireddi, Professor Vittal and McCabe, Dr Ronan and Kibuchi, Dr Eliud and Amele, Ms Sarah |
| Authors: | Irizar, P., Kapadia, D., Amele, S., Bécares, L., Divall, P., Katikireddi, S. V., Kibuchi, E., Kneale, D., McCabe, R., Nazroo, J., Nellums, L. B., Taylor, H., Sze, S., Pan, D., and Pareek, M. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
| Journal Name: | Social Science and Medicine |
| Publisher: | Elsevier |
| ISSN: | 0277-9536 |
| ISSN (Online): | 1873-5347 |
| Published Online: | 21 June 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in Social Science and Medicine 329: 116044 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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