Usher Institute

Covid risk study pinpoints ethnic inequalities

Scotland’s White Gypsy/Traveller ethnic minority group were at greater risk of Covid-19 hospitalisation or death than the majority of the population, research reveals.

Graphic illustration of the SARS-CoV-2 virus in blue

The nationwide study also found Pakistani and African people were more likely to be hospitalised or die as a result of Covid-19, compared with the White Scottish group.

Research until now has considered the risks of Covid-19 using broad ethnic groups, meaning the risk to some minority ethnic groups has been hidden within broader ethnic categories.

Severe outcomes

The findings show that White Gypsy/Traveller and Pakistani groups have a particularly high risk of severe Covid-19 outcomes compared with White Scottish people.

However, no ethnic differences in the risk of Covid-19-related deaths were found following Covid-19 hospitalisation, suggesting the provision of hospital care did not contribute to ethnic variations.

Understanding the stage at which ethnic inequalities in Covid-19 outcomes arise could help inform policy within this pandemic and in the future, researchers say.

Ethnic inequalities

The team focused on cases in Scotland from March 2020 to April 2022. They investigated ethnic inequalities in people who had tested positive for the SARS-CoV-2 virus; had severe Covid-19, leading to hospitalisation or death; and those who had severe Covid-19 following a positive SARS-CoV-2 test.

Researchers analysed data from the 2011 Scottish Census alongside health, surveillance and death records from the EAVE II study, which uses anonymised linked patient data to track the pandemic and covers 99 per cent of the Scottish population.

The international research team included scientists from the Universities of Edinburgh, Glasgow, Aberdeen, Strathclyde, and St Andrew’s.

Also taking part were Public Health Scotland, Research Data Scotland, King’s College London, the University of Manchester, Victoria University of Wellington, the University of Ibadan, and Hawler Medical University.


While research has previously shown that ethnic minority groups are disproportionately at a higher risk of Covid-19 outcomes in the UK, this study found differences in risks of Covid-19 outcomes within important subcategories of ethnicity.

This finding is important for policy making as it highlights the existence of differences in risk within broad ethnic groups and the need for tailored interventions.

Professor Sir Aziz SheikhDirector of the University of Edinburgh’s Usher Institute and EAVE II study lead

Our findings provide a more representative picture of how some of the most disadvantaged individuals in our communities, such as White Gypsy/Traveller individuals, may remain invisible to decision makers when they are aggregated to broad ethnic groups. It is particularly important to enhance and improve the health of the White Gypsy/Traveller Community by recognising and tackling the stigma and discrimination that they often experience.

Dr Eliud KibuchiUniversity of Glasgow’s School of Health and Wellbeing

The study was funded by the Medical Research Council (MRC), the Scottish Government Chief Scientist Office, ESRC and Wellcome.

Related links

Read the study in the Journal of Epidemiology & Community Health

Lay summary of the paper



Image credit: Hendra Su via Getty Images