Abstract
Ethnic minorities have experienced disproportionate COVID-19 mortality rates in the UK and many other countries. We compared the differences in the risk of COVID-19 related death between ethnic groups in the first and second waves the of COVID-19 pandemic in England. We also investigated whether the factors explaining differences in COVID-19 death between ethnic groups changed between the two waves. Using data from the Office for National Statistics Public Health Data Asset, a linked dataset combining the 2011 Census with primary care and hospital records and death registrations, we conducted an observational cohort study to examine differences in the risk of death involving COVID-19 between ethnic groups in the first wave (from 24th January 2020 until 31st August 2020) and the first part of the second wave (from 1st September to 28th December 2020). We estimated age-standardised mortality rates (ASMR) in the two waves stratified by ethnic groups and sex. We also estimated hazard ratios (HRs) for ethnic-minority groups compared with the White British population, adjusted for geographical factors, socio-demographic characteristics, and pre-pandemic health conditions. The study population included over 28.9 million individuals aged 30–100 years living in private households. In the first wave, all ethnic minority groups had a higher risk of COVID-19 related death compared to the White British population. In the second wave, the risk of COVID-19 death remained elevated for people from Pakistani (ASMR: 339.9 [95% CI: 303.7–376.2] and 166.8 [141.7–191.9] deaths per 100,000 population in men and women) and Bangladeshi (318.7 [247.4–390.1] and 127.1 [91.1–171.3] in men and women) background but not for people from Black ethnic groups. Adjustment for geographical factors explained a large proportion of the differences in COVID-19 mortality in the first wave but not in the second wave. Despite an attenuation of the elevated risk of COVID-19 mortality after adjusting for sociodemographic characteristics and health status, the risk was substantially higher in people from Bangladeshi and Pakistani background in both the first and the second waves. Between the first and second waves of the pandemic, the reduction in the difference in COVID-19 mortality between people from Black ethnic background and people from the White British group shows that ethnic inequalities in COVID-19 mortality can be addressed. The continued higher rate of mortality in people from Bangladeshi and Pakistani background is alarming and requires focused public health campaign and policy changes.
Highlights
A recent systematic review of 50 studies have showed that people from ethnic minority background in the UK and other countries, Black and South Asian groups, have been disproportionately affected by the Coronavirus (COVID19) pandemic compared to people of White ethnic background [1] While several studies have investigated whether adjusting for socio-demographic and economic factors and medical history reduces the estimated difference in risk of mortality and1 3 Vol.:(0123456789)hospitalisation [2,3,4], the reasons for the differences in the risk of experiencing harms from COVID-19 are still being explored during the course of the pandemic
We investigated whether the factors explaining differences in COVID-19 death between ethnic groups changed between the two waves
Using data from the Office of National Statistics (ONS) Public Health Data Asset on approximately 29 million adults aged 30–100 years living in private households in England, we conducted an observational cohort study to examine the differences in the risk of death involving COVID-19 between ethnic groups in the first wave and the first part of the second wave of the pandemic
Summary
A recent systematic review of 50 studies have showed that people from ethnic minority background in the UK and other countries, Black and South Asian groups, have been disproportionately affected by the Coronavirus (COVID19) pandemic compared to people of White ethnic background [1] While several studies have investigated whether adjusting for socio-demographic and economic factors and medical history reduces the estimated difference in risk of mortality and1 3 Vol.:(0123456789)hospitalisation [2,3,4], the reasons for the differences in the risk of experiencing harms from COVID-19 are still being explored during the course of the pandemic. As emerging evidence suggest that the longterm consequences of COVID-19 may be severe, especially amongst people from ethnic minority groups [11], it is critical to monitor how ethnic inequalities throughout the course of the pandemic have evolved. Using nationwide population-level data containing detailed socio-demographic characteristics and information on pre-pandemic health status, we compared the difference in risk of COVID-19 related death between ethnic groups in the two waves of the COVID-19 pandemic. It is the first study to examine how the difference in the COVID-19 mortality between ethnic groups changed when adjusting for both detailed socio-demographic factors and pre-pandemic health at a whole population level
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
