Department of Health Sciences and Kinesiology, Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, GA 31419, USA.
Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, UT 84132, USA; Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA.
Prog Cardiovasc Dis. 2022 Mar-Apr;71:4-10. doi: 10.1016/j.pcad.2022.04.004. Epub 2022 Apr 28.
Racial and ethnic-related health disparities in the United States have been intensified by the greater burden of Coronavirus Disease 2019 (COVID-19) in racial and ethnic minority populations. Compared to non-Hispanic White individuals, non-Hispanic Black and Hispanic/Latinx individuals infected by COVID-19 are at greater risk for hospitalization, intensive care unit admission, and death. There are several factors that may contribute to disparities in COVID-19-related severity and outcomes in these minority populations, including the greater burden of cardiovascular and metabolic diseases as discussed in our companion review article. Social determinants of health are a critical, yet often overlooked, contributor to racial and ethnic-related health disparities in non-Hispanic Black and Hispanic/Latinx individuals relative to non-Hispanic White individuals. Thus, the purpose of this review is to focus on the essential role of social factors in contributing to health disparities in chronic diseases and COVID-19 outcomes in minority populations. Herein, we begin by focusing on structural racism as a social determinant of health at the societal level that contributes to health disparities through downstream social level (e.g., occupation and residential conditions) and individual level health behaviors (e.g., nutrition, physical activity, and sleep). Lastly, we conclude with a discussion of practical applications and recommendations for future research and public health efforts that seek to reduce health disparities and overall disease burden.
美国的种族和族裔相关健康差异因 2019 年冠状病毒病（COVID-19）在种族和族裔少数群体中的负担加重而加剧。与非西班牙裔白人相比，感染 COVID-19 的非西班牙裔黑人和西班牙裔/拉丁裔个体住院、入住重症监护病房和死亡的风险更高。有几个因素可能导致这些少数群体 COVID-19 相关严重程度和结果存在差异，包括我们在相关综述文章中讨论的心血管和代谢疾病负担加重。健康的社会决定因素是导致非西班牙裔黑人和西班牙裔/拉丁裔个体与非西班牙裔白人相比在种族和族裔相关健康差异中的一个关键但经常被忽视的因素。因此，本综述的目的是重点关注社会因素在导致少数群体慢性疾病和 COVID-19 结果中的健康差异方面的重要作用。在此，我们首先关注社会决定因素中的结构性种族主义，它是一种社会层面的健康决定因素，通过下游的社会层面（例如，职业和居住条件）和个体层面的健康行为（例如，营养、身体活动和睡眠）导致健康差异。最后，我们讨论了减少健康差异和整体疾病负担的实际应用和未来研究与公共卫生工作的建议。
