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. 2021 Jan-Dec:12:21501327211018354.
doi: 10.1177/21501327211018354.

Understanding and Promoting Racial Diversity in Healthcare Settings to Address Disparities in Pandemic Crisis Management

Azza Sarfraz  1   2 , Zouina Sarfraz  1   3 , Alanna Barrios  1   4 , Kuchalambal Agadi  1 , Sindhu Thevuthasan  1 , Krunal Pandav  1 , Manish Kc  1 , Muzna Sarfraz  1 , Pedram Rad  1 , George Michel  1
Affiliations

Understanding and Promoting Racial Diversity in Healthcare Settings to Address Disparities in Pandemic Crisis Management

Azza Sarfraz et al. J Prim Care Community Health. 2021 Jan-Dec.

Abstract

Background: Health disparities have become apparent since the beginning of the COVID-19 pandemic. When observing racial discrimination in healthcare, self-reported incidences, and perceptions among minority groups in the United States suggest that, the most socioeconomically underrepresented groups will suffer disproportionately in COVID-19 due to synergistic mechanisms. This study reports racially-stratified data regarding the experiences and impacts of different groups availing the healthcare system to identify disparities in outcomes of minority and majority groups in the United States.

Methods: Studies were identified utilizing PubMed, Embase, CINAHL Plus, and PsycINFO search engines without date and language restrictions. The following keywords were used: Healthcare, raci*, ethnic*, discriminant, hosti*, harass*, insur*, education, income, psychiat*, COVID-19, incidence, mortality, mechanical ventilation. Statistical analysis was conducted in Review Manager (RevMan V.5.4). Unadjusted Odds Ratios, P-values, and 95% confidence intervals were presented.

Results: Discrimination in the United States is evident among racial groups regarding medical care portraying mental risk behaviors as having serious outcomes in the health of minority groups. The perceived health inequity had a low association to the majority group as compared to the minority group (OR = 0.41; 95% CI = 0.22 to 0.78; P = .007), and the association of mental health problems to the Caucasian-American majority group was low (OR = 0.51; 95% CI = 0.45 to 0.58; P < .001).

Conclusion: As the pandemic continues into its next stage, efforts should be taken to address the gaps in clinical training and education, and medical practice to avoid the recurring patterns of racial health disparities that become especially prominent in community health emergencies. A standardized tool to assess racial discrimination and inequity will potentially improve pandemic healthcare delivery.

Keywords: COVID-19; discrimination; ethnicity; health disparities; health inequity; race.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flowchart.
Figure 2.
Figure 2.
Forest plot of perceived health inequity in the majority and minority groups. The majority group consists of Caucasian-Americans only. The minority group includes African-Americans, American Indians/Alaska Natives, Asian Americans, Hispanics/Latinos, Native Hawaiians/Other Pacific Islanders, or Not Specified.
Figure 3.
Figure 3.
Forest plot of mental health problems in the majority and minority groups.
Figure 4.
Figure 4.
Forest plot of positive health behaviors in the majority and minority groups.
See this image and copyright information in PMC

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