Dataset Information

Socio-economic and Demographic Risk Factors in COVID-19 Hospitalization among Migrants and Ethnic Minorities

ABSTRACT: Abstract

Background

Migrants and ethnic minorities have been shown to be at increased risk of hospitalization from COVID-19, our aim was to analyze the contribution of socioeconomic and demographic risk factors on hospital admissions for COVID-19 among migrants and ethnic minorities compared to the majority population.

Methods

We used nationwide register data on all hospitalized COVID-19 cases between February and June 2020 (n = 2232) and random controls from the general population (n = 498117). We performed logistic regression analyses, adjusting for age, sex, comorbidity, and socioeconomic and demographic factors. Main outcome measure was Hospitalization with COVID-19. Odds ratios (OR) and 95% confidence intervals (95% CI) are estimated by using logistic regression analyses, adjusting for age, sex, comorbidity, and socioeconomic and demographic factors.

Results

Among 2232 COVID-19 cases, the OR of hospitalization with COVID-19 among immigrants and descendants of Non-Western origin was 2.5 times higher (95% CI: 2.23 to 2.89) than that of the majority population, with most pronounced results among individuals from Iraq, Morocco, Pakistan, and Somalia. The OR was largely attributed to comorbidity and socioeconomic factors, especially household size, occupation, and population density.

Conclusion

There is a significantly higher OR of hospitalization with COVID-19 among Non-Western migrants and ethnic minorities compared with ethnic Danes. This knowledge is crucial for health policymakers and practitioners in both the current and future pandemics to identify more vulnerable groups and target prevention initiatives.

SUBMITTER: Islamoska S

PROVIDER: S-EPMC8586727 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThere are widespread concerns that ethnic minorities and migrants may have inadequate access to COVID-19 vaccines. . Improving vaccine uptake among these vulnerable groups is important towards controlling the spread of COVID-19 and reducing unnecessary mortality. Here we perform a systematic review of ethnic minorities' and migrants' access to and acceptance of COVID-19 vaccines.MethodsWe searched PubMed and Web of Science databases for papers published between 1 January 2020 and 7 October 2021. Studies were included if they were peer-reviewed articles; written in English, included data or estimates of ethnic minorities' or migrants' access to vaccines; and employed either qualitative or quantitative methods. Of a total of 248 studies screened, 33 met these criteria and included in the final sample. Risk of bias in the included studies was assessed using Newcastle Ottawa Scale and Critical Appraisal Skills Program tools. We conducted a Synthesis Without Meta-analysis for quantitative studies and a Framework synthesis for qualitative studies.Results31 of the included studies were conducted in high-income countries, including in the US (n = 17 studies), UK (n = 10), Qatar (n = 2), Israel (n = 1) and France (n = 1). One study was in an upper middle-income country -China (n = 1) and another covered multiple countries (n = 1). 26 studies reported outcomes for ethnic minorities while 9 studies reported on migrants. Most of the studies were quantitative -cross sectional studies (n = 24) and ecological (n = 4). The remaining were qualitative (n = 4) and mixed methods (n = 1). There was consistent evidence of elevated levels of COVID-19 vaccine hesitancy among Black/Afro-Caribbean groups in the US and UK, while studies of Hispanic/Latino populations in the US and Asian populations in the UK provided mixed pictures, with levels higher, lower, or the same as their White counterparts. Asians in the US had the highest COVID-19 vaccine acceptance compared to other ethnic groups. There was higher vaccine acceptance among migrant groups in Qatar and China than in the general population. However, migrants to the UK experienced barriers to vaccine access, mainly attributed to language and communication issues. Lack of confidence, mainly due to mistrust of government and health systems coupled with poor communication were the main barriers to uptake among Black ethnic minorities and migrants.ConclusionsOur study found that low confidence in COVID-19 vaccines among Black ethnic minorities driven by mistrust and safety concerns led to high vaccine hesitancy in this group. Such vaccine hesitancy rates constitute a major barrier to COVID-19 vaccine uptake among this ethnic minority. For migrants, convenience factors such as language barriers, fear of deportation and reduced physical access reduced access to COVID-19 vaccines. Building trust, reducing physical barriers and improving communication and transparency about vaccine development through healthcare workers, religious and community leaders can improve access and facilitate uptake of COVID-19 vaccines among ethnic minority and migrant communities.