Access to COVID-19 prevention, diagnosis and care for migrants and ethnic minorities in the WHO European Region: a systematic review
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Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A789
ABSTRACT
Background & Objective:
The Covid-19 pandemic has had a major impact on Migrants and Ethnic Minorities (MEMs) population in terms of risk of SARS-CoV-2 infection, morbidity, and mortality. The Covid-19 pandemic was defined as a syndemic for its interaction with pre-existing socio-economic determinants of health, widening health inequalities and worsening health outcomes. The aim of this study is to investigate inequalities in access to healthcare for Covid-19 among MEMs compared to the general population. Migrants represent almost 10% of the population living in the WHO European Region, so the issue is of particular interest to this region.
Methods:
A systematic review was conducted, collecting studies on MEMs’ access to healthcare for Covid- 19 in the WHO European Region in terms of access to prevention, diagnosis, and care, published from January 2020 to February 2022, on the following databases: Medline, Embase, Biosis, Scisearch, Esbiobase.
Results:
Of the 19 studies identified, 11 were about vaccine hesitancy, 5 about vaccine execution, 2 on access to Covid-19 testing and 1 was about access to information on Covid-19. Around 65% of the studies were conducted in UK. Overall, MEMs population faced higher barriers to the access to vaccination, turned out to be more vaccine hesitant and faced more difficulties in access to Covid-19 information and testing.
Conclusion:
These findings highlight the inequalities MEMs population faced accessing healthcare services for Covid-19. Social determinants of health are one of the main factors involved in the genesis of health inequalities: a framework of structural racism leading to lower trust in government choices, together with a disadvantaged socio-economic status, determined inequalities in accessing healthcare services and health information. These findings underline the need for policymakers to prioritize strategies for building trust and engage ethnic minorities, and to overcome the socio-economic barriers when designing health promotion programs.