COVID-19's Disproportionate Impact on Racial and Ethnic Minorities

Introduction

Long-standing social inequalities have placed many individuals from racial and ethnic minority groups at a heightened risk of acquiring COVID-19 and dying from it. Racial and ethnic minority groups include individuals of color with a range of experiences and backgrounds; however, some experiences are common across these groups. Social determinants of health have consistently prevented these populations from having fair opportunities for emotional, physical, and economic well-being.

According to Kirby (2020), there is growing evidence that some racial and ethnic minority groups are affected disproportionately by COVID-19. Factors such as healthcare access and poverty compound this risk. To attain health equity, barriers must be eliminated so that everyone can have a fair opportunity to be healthy. In the United States, Black Americans are acquiring COVID-19 at an alarming rate and have a higher chance of dying from it than White Americans. Infection rates are approximately three times higher, and mortality rates are six times higher in predominantly Black communities than in White communities. Despite Hispanics making up 43% of California's total population, they constituted 70% of COVID-19 deaths in the state. American Indians and Alaska Natives also show higher percentages of infections and deaths compared to White populations.

Factors That Contribute to Increased Risk

There are several reasons why racial and ethnic minorities have been disproportionately affected by COVID-19, but economic and social factors are the primary contributors. Most minorities live in smaller homes where isolating a sick household member is difficult. Many minority frontline workers cannot afford to stay home or work remotely. As Tai et al. (2021) and Shippee et al. (2020) reveal, minority groups are disproportionately represented among essential frontline workers.

Only 20% of Black workers have the ability to work from home, compared to 30% of White workers. A report from New York City's comptroller found that 75% of frontline workers belong to minority groups. Black workers make up 40% of that workforce, and 34% rely on public transportation, compared to 14% of White workers.

The striking disparity in the racial and ethnic impact of COVID-19 underscores the connection between occupation and health. Individuals from racial and ethnic minority groups are disproportionately represented in essential work settings such as healthcare facilities and public transportation (Fairlie, Couch & Xu, 2020). Workers in these settings face higher exposure risk due to factors such as the absence of paid sick days, inability to work from home, and close contact with the public or coworkers. Some individuals from these groups also live in crowded conditions, making prevention measures difficult to follow. In several cultures, it is common for multiple generations to share a single household. Additionally, rising unemployment among minority groups during the pandemic increases the risk of homelessness, eviction, and the need to share housing.

Individuals from racial and ethnic minority groups are also more likely to be uninsured than White Americans and therefore have limited access to and use of health services (Fairlie, Couch & Xu, 2020). Healthcare access is further constrained by discrimination within healthcare systems, cultural differences between providers and patients, language and communication barriers, and lack of transportation. Members of minority groups may hesitate to seek care because of distrust rooted in historical injustices — such as the Tuskegee Study of Untreated Syphilis in Black Males and the documented sterilization of minority women without informed consent. Discrimination persists in systems meant to protect health, and racism can create chronic toxic stress, which itself increases susceptibility to COVID-19.

Gaps in wealth, income, and education have created inequalities in access to high-quality schooling for minority groups. This can create barriers to college entry and lower high school completion rates (Moore et al., 2020), limiting future employment opportunities and resulting in less stable, lower-paying jobs. Workers with limited job options often cannot afford to leave work, even when ill, placing them at heightened risk of viral exposure. The financial necessity of continued work — to cover basic needs such as food and rent — leaves little room for protective health behaviors.

Data on Disproportionate COVID-19 Impact

In June 2020, the CDC reported that 21.8% of COVID-19 cases in the United States were among Black Americans and 33.8% were among Hispanics — groups that represent only approximately 13% and 18% of the U.S. population, respectively (Moore et al., 2020). These figures are limited by underreporting of race and ethnicity in 47% and 43% of cases. Among hospitalized patients, 33% were Black, despite Black Americans comprising only about 18% of the surrounding population. While specific numbers have shifted over time, the pattern of disproportionate impact has remained consistent across the country.

A report from Public Health England found that Black, Chinese, Pakistani, and Indian populations faced a 10–50% higher mortality risk than White populations, even after controlling for factors such as region, deprivation, and age (Shippee et al., 2020). The Institute for Fiscal Studies further found that disproportionate mortality among ethnic minority populations becomes even more pronounced when age is taken into account. Because most minority populations are on average younger than the White population, they would statistically be expected to experience lower death rates — making the elevated mortality all the more significant.

Conclusion

The pandemic may alter some of the ways people support and connect with one another. As communities and individuals respond to COVID-19 guidance — including social distancing, and workplace and school closures — there are often unintended adverse effects on emotional health, such as the erosion of social support and connectedness. Cultural bonds, family ties, and shared faith are well-established sources of social support. Finding ways to maintain connection and support, even when physically apart, can help communities and individuals better cope with stress, keep children healthy, care for the sick, and protect themselves.

Healthcare providers and systems, policymakers, public health agencies, and faith- and community-based organizations all have an important role to play in promoting equitable access to health resources. To prevent the continued spread of COVID-19, people must work together to ensure that individuals have the resources they need to manage both their mental and physical health — including mental health care, affordable testing, and accessible, accurate information. Practices and programs must be designed to fit the communities where minority and racial groups worship, play, work, learn, and live.