Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jun 26:11:05015.
doi: 10.7189/jogh.11.05015.

Racial disparities in COVID-19 pandemic cases, hospitalisations, and deaths: A systematic review and meta-analysis

William Mude  1 , Victor M Oguoma  2 , Tafadzwa Nyanhanda  3 , Lillian Mwanri  4 , Carolyne Njue  5
Affiliations
Meta-Analysis

Racial disparities in COVID-19 pandemic cases, hospitalisations, and deaths: A systematic review and meta-analysis

William Mude et al. J Glob Health. .

Abstract

Background: People from racial minority groups in western countries experience disproportionate socioeconomic and structural determinants of health disadvantages. These disadvantages have led to inequalities and inequities in health care access and poorer health outcomes. We report disproportionate disparities in prevalence, hospitalisation, and deaths from COVID-19 by racial minority populations.

Methods: We conducted a systematic literature search of relevant databases to identify studies reporting on prevalence, hospitalisations, and deaths from COVID-19 by race groups between 01 January 2020 - 15 April 2021. We grouped race categories into Blacks, Hispanics, Whites and Others. Random effects model using the method of DerSimonian and Laird were fitted, and forest plot with respective ratio estimates and 95% confidence interval (CI) for each race category, and subgroup meta-regression analyses and the overall pooled ratio estimates for prevalence, hospitalisation and mortality rate were presented.

Results: Blacks experienced significantly higher burden of COVID-19: prevalence ratio 1.79 (95% confidence interval (CI) = 1.59-1.99), hospitalisation ratio 1.87 (95% CI = 1.69-2.04), mortality ratio 1.68 (95% CI = 1.52-1.83), compared to Whites: prevalence ratio 0.70 (95% CI = 0.0.64-0.77), hospitalisation ratio 0.74 (95% CI = 0.65-0.82), mortality ratio 0.82 (95% CI = 0.78-0.87). Also, Hispanics experienced a higher burden: prevalence ratio 1.78 (95% CI = 1.63-1.94), hospitalisation ratio 1.32 (95% CI = 1.08-1.55), mortality ratio 0.94 (95% CI = 0.84-1.04) compared to Whites. A higher burden was also observed for Other race groups: prevalence ratio 1.43 (95% CI = 1.19-1.67), hospitalisation ratio 1.12 (95% CI = 0.89-1.35), mortality ratio 1.06 (95% CI = 0.89-1.23) compared to Whites. The disproportionate burden among Blacks and Hispanics remained following correction for publication bias.

Conclusions: Blacks and Hispanics have been disproportionately affected by COVID-19. This is deeply concerning and highlights the systemically entrenched disadvantages (social, economic, and political) experienced by racial minorities in western countries; and this study underscores the need to address inequities in these communities to improve overall health outcomes.

PubMed Disclaimer

Conflict of interest statement

Competing interest: The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of studies included in the review.
Figure 2
Figure 2
Standardised prevalence ratio (SPR) Forest Plots of COVID-19 by selected race groups. Panel A: Blacks. Panel B: Hispanics. Panel C: Other race groups. Panel D: Whites.
Figure 3
Figure 3
Standardised prevalence ratio (SPR) Forest plots of COVID-19 by race, country, year, and study design.
Figure 4
Figure 4
Standardised hospitalisation ratio (SHR) Forest plots of COVID-19 by selected race groups. Panel A: Blacks. Panel B: Hispanics. Panel C: Other race groups. Panel D: Whites.
Figure 5
Figure 5
Standardised hospitalisation ratio (SHR) Forest plots of COVID-19 by race, country, year, and study design.
Figure 6
Figure 6
Standardised mortality ratio (SMR) Forest plots of COVID-19 by selected race groups. Panel A: Blacks. Panel B: Hispanics. Panel C: Other race groups. Panel D: Whites.
Figure 7
Figure 7
Standardised mortality ratio (SMR) Forest plots of COVID-19 by race, country, year, and study design.
See this image and copyright information in PMC

References

    1. Wu Z, McGoogan JM.Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323:1239-42. 10.1001/jama.2020.2648 - DOI - PubMed
    1. Boldog P, Tekeli T, Vizi Z, Dénes A, Bartha FA, Röst G.Risk Assessment of Novel Coronavirus COVID-19 Outbreaks Outside China. J Clin Med. 2020;9:571. 10.3390/jcm9020571 - DOI - PMC - PubMed
    1. WHO. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). 2020. Available: https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-.... Accessed: 10 September 2020.
    1. WHO. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. 2020. Available: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-re.... Accessed: 18 September 2020.
    1. World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard. 2021. Available: https://covid19.who.int/. Accessed: 24 May 2021.