The interaction of ethnicity and deprivation on COVID-19 mortality risk: a retrospective ecological study

Kausik Chaudhuri,Jose Martin Lima,Anindita Chakrabarti,Joht Singh Chandan,Siddhartha Bandyopadhyay

doi:10.1038/s41598-021-91076-8

Kausik Chaudhuri, Jose Martin Lima + Show 3 more

Open Access

https://doi.org/10.1038/s41598-021-91076-8

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Journal: Scientific Reports	Publication Date: Jun 2, 2021
Citations: 10	License type: open-access

Affiliation: University of Leeds, University of Birmingham

Abstract

Black, Asian and Minority Ethnic (BAME) populations are at an increased risk of developing COVID-19 and consequentially more severe outcomes compared to White populations. The aim of this study was to quantify how much of the disproportionate disease burden can be attributed to ethnicity and deprivation as well as its interaction. An ecological study was conducted using data derived from the Office for National Statistics data at a Local Authority District (LAD) level in England between 1st March and 17th April 2020. The primary analysis examined how age adjusted COVID-19 mortality depends on ethnicity, deprivation, and the interaction between the two using linear regression. The secondary analysis using spatial regression methods allowed for the quantification of the extent of LAD spillover effect of COVID-19 mortality. We find that in LADs with the highest deprivation quartile, where there is a 1 percentage point increase in “Black-African (regression coefficient 2.86; 95% CI 1.08–4.64)”, “Black-Caribbean (9.66: 95% CI 5.25–14.06)” and “Bangladeshi (1.95: 95% CI 1.14–2.76)” communities, there is a significantly higher age-adjusted COVID-19 mortality compared to respective control populations. In addition, the spatial regression results indicated positive significant correlation between the age-adjusted mortality in one LAD and the age-adjusted mortality in a neighbouring LAD, suggesting a spillover effect. Our results suggest targeted public health measures to support those who are deprived and belong to BAME communities as well as to encourage restricted movement between different localities to limit disease propagation.

Highlights

Black, Asian and Minority Ethnic (BAME) populations are at an increased risk of developing COVID-19 and consequentially more severe outcomes compared to White populations
The United Kingdom (UK) is an ethnically diverse country, and as the pandemic has progressed we find that the risk of both COVID-19 susceptibility and mortality varies with ethnicity
Medical records from primary and secondary care as well as death certificates examined by the Office for National Statistics (ONS), Public Health England (PHE) and other academics make it clear that those from Black, Asian and Minority Ethnic (BAME) communities are at the highest risk of both COVID-19 susceptibility and associated mortality[4,5,6]

Summary

Introduction

Asian and Minority Ethnic (BAME) populations are at an increased risk of developing COVID-19 and consequentially more severe outcomes compared to White populations. Medical records from primary and secondary care as well as death certificates examined by the Office for National Statistics (ONS), Public Health England (PHE) and other academics make it clear that those from Black, Asian and Minority Ethnic (BAME) communities are at the highest risk of both COVID-19 susceptibility and associated mortality[4,5,6]. These findings have been replicated internationally and raise concern for urgent public health action to identify the cause for such a correlation[7,8]. Variable Age-adjusted Mortality (per 100,000 people) IMD (Average score) Black-Africana Black-Caribbeana Black-Othera Chinesea Bangladeshia Indiana Pakistania Asian-Othera Mixeda Araba Other Ethnic Groupa Whitea Observations association with socio-economic characteristics in more detail and for the urgent need to identify cultural risk factors which may be susceptible for intervention[10,11]

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