RT Journal Article SR Electronic T1 Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities JF Journal of Epidemiology and Community Health JO J Epidemiol Community Health FD BMJ Publishing Group Ltd SP 970 OP 974 DO 10.1136/jech-2020-216061 VO 75 IS 10 A1 Srinivasa Vittal Katikireddi A1 Sham Lal A1 Enitan D Carrol A1 Claire L Niedzwiedz A1 Kamlesh Khunti A1 Ruth Dundas A1 Finn Diderichsen A1 Ben Barr YR 2021 UL http://jech.bmj.com/content/75/10/970.abstract AB Minority ethnic groups have been disproportionately affected by the COVID-19 pandemic. While the exact reasons for this remain unclear, they are likely due to a complex interplay of factors rather than a single cause. Reducing these inequalities requires a greater understanding of the causes. Research to date, however, has been hampered by a lack of theoretical understanding of the meaning of ‘ethnicity’ (or race) and the potential pathways leading to inequalities. In particular, quantitative analyses have often adjusted away the pathways through which inequalities actually arise (ie, mediators for the effect of interest), leading to the effects of social processes, and particularly structural racism, becoming hidden. In this paper, we describe a framework for understanding the pathways that have generated ethnic (and racial) inequalities in COVID-19. We suggest that differences in health outcomes due to the pandemic could arise through six pathways: (1) differential exposure to the virus; (2) differential vulnerability to infection/disease; (3) differential health consequences of the disease; (4) differential social consequences of the disease; (5) differential effectiveness of pandemic control measures and (6) differential adverse consequences of control measures. Current research provides only a partial understanding of some of these pathways. Future research and action will require a clearer understanding of the multiple dimensions of ethnicity and an appreciation of the complex interplay of social and biological pathways through which ethnic inequalities arise. Our framework highlights the gaps in the current evidence and pathways that need further investigation in research that aims to address these inequalities.Data sharing not applicable as no datasets generated and/or analysed for this study.