Page 34 - MJHP MALAYSIAN JOURNAL OF HEALTH PROMOTION Volume 2, 2020

MALAYSIAN JOURNAL OF HEALTH PROMOTION Volume 2, 2020

of Ireland and China. Of all the nine articles included, five are editorials,
three are review articles and only one research article. Almost all articles in
this review highlighted SES are the main determinants of higher incidence
of COVID-19 cases reported among EMGs. Among factors related to SES
including the poverty, living conditions and nature of work. The underlying
health conditions among ethnic minority groups were also emphasized.

4. DISCUSSION
Addressing the SDH is essential for reducing health inequalities especially in
developing countries with weak health systems (Camargo, 2011). However,
to understand the underlying causes of this gaps are complex.

4.1 Socioeconomic Status (SES)
Our findings highlighted SES contribute significantly to high proportion
of COVID-19 cases among EMGs. Data from existing study also
revealed that SES has a significant impact on physical health (Wang
& Geng, 2019). This is in agreement with current study by Khunti et
al. (2020) which reported that the large number of COVID-19 cases
and severity in EMGs may be associated with SES, cultural, or lifestyle
factors, genetic predisposition, or pathophysiological differences in
susceptibility or response to infection. Health differences between
ethnic groups are often due to economic and social conditions that are
more common among some racial and EMGs (Hooper et al., 2020).
Disadvantaged SES is widely associated with disease and mortality
(Khalatbari-Soltani et al., 2020), and this review found certain minority
EMGs are susceptible to COVID-19 because of the SES. However, the
influence of SES on COVID-19 transmission, severity and outcomes
is not yet known and is subject to detail investigation and this warrant
future research focusing on the area.

4.2 Neighbourhood and Built Environment
Apart from SES, this review also found neighbourhood and built
environment also one of the SDH that link with COVID-19 among
EMGs. For EMGs, living conditions may contribute to underlying health
conditions and make it difficult to follow steps to prevent getting infected
with COVID-19 or to seek treatment if they do get sick (Manderson &
Levine, 2020). According to Tai et al. (2020), living conditions in some
minority communities further increase risk for COVID-19 infection

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