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Beyond Information Provision: A Critical Analysis of the Roles of Structure and Agency in Decision-Making about COVID-19 Vaccination in ETHNIC minority Communities and Recommendations for Primary Care
Poduval, S.; Kamal, A.; Martin, S.; Islam, A.; Kaviraj, C.; Gill, P. Beyond Information Provision: Analysis of the Roles of Structure and Agency in COVID-19 Vaccine Confidence in Ethnic Minority Communities. Int. J. Environ. Res. Public Health2023, 20, 7008.
Poduval, S.; Kamal, A.; Martin, S.; Islam, A.; Kaviraj, C.; Gill, P. Beyond Information Provision: Analysis of the Roles of Structure and Agency in COVID-19 Vaccine Confidence in Ethnic Minority Communities. Int. J. Environ. Res. Public Health 2023, 20, 7008.
Poduval, S.; Kamal, A.; Martin, S.; Islam, A.; Kaviraj, C.; Gill, P. Beyond Information Provision: Analysis of the Roles of Structure and Agency in COVID-19 Vaccine Confidence in Ethnic Minority Communities. Int. J. Environ. Res. Public Health2023, 20, 7008.
Poduval, S.; Kamal, A.; Martin, S.; Islam, A.; Kaviraj, C.; Gill, P. Beyond Information Provision: Analysis of the Roles of Structure and Agency in COVID-19 Vaccine Confidence in Ethnic Minority Communities. Int. J. Environ. Res. Public Health 2023, 20, 7008.
Abstract
People from Black and Asian backgrounds are more likely to die from Covid-19 but less likely to be vaccinated, threatening to exacerbate health inequalities already experienced by ethnic minority groups. Literature suggests that mistrust rooted in structural inequality may be a key barrier to Covid-19 vaccine uptake. We need to better understand how structural inequalities influence vaccine confidence. Understanding and addressing these processes is likely to lead to longer-term impacts than information alone. We draw on health and sociological theories of structure and agency to inform our understanding of structural factors. We conducted qualitative interviews and focus groups with 22 people from London and surrounding areas in December 2021 to March 2022. Fifteen participants were members of the public from ethnic minority backgrounds and 7 were professionals working with the public to address concerns and encourage vaccine uptake. Our findings suggest that people from ethnic minority backgrounds make decisions regarding Covid-19 vaccination based on a combination of how they experience external social structures (including political authority, social positioning and racial inequality) and internal processes (what they believe and understand about Covid-19 vaccines). We may be able to support knowledge accumulation through the provision of reliable and accessible information, particularly through primary and community care. But we recommend a number of changes to research, policy and practice which address structural inequalities. These include working with communities to improve ethnicity data collection, increasing funding allocation to health conditions where ethnic minority communities experience poorer outcomes, greater transparency and public engagement in the vaccine development process, and culturally adapted research recruitment processes.
Keywords
Ethnic and Racial Minorities; Ethnicity; Covid-19; Covid-19 Vaccines; Vaccination Hesitancy; Health Inequities; Primary Health Care; Public Health; Health Promotion; Systemic Racism
Subject
Public Health and Healthcare, Public Health and Health Services
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
