COVID-19: A Syndemic Requiring an Integrated Approach for Marginalized Populations

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The novel coronavirus, SARS-CoV-2, responsible for the COVID-19 pandemic, has challenged healthcare systems globally. The health inequities experienced by immigrants, refugees, and racial/ethnic minorities have been aggravated during the COVID-19 pandemic. The socioeconomic, political, and demographic profile of these vulnerable populations places them at increased risk of contracting COVID-19 and experiencing significant morbidity and mortality. Thus, the burden of the COVID-19 pandemic is disproportionally higher among these at-risk groups. The purpose of this perspective is to: (1) highlight the interactions among the social determinants of health (SDoH) and their bi-directional relationship with the COVID-19 pandemic which results in the current syndemic and; (2) offer recommendations that consider an integrated approach to mitigate COVID-19 risk for marginalized populations in general. For these at-risk populations, we discuss how individual, structural, sociocultural, and socioeconomic factors interact with each other to result in a disparate risk to contracting and transmitting COVID-19. Marginalized populations are the world's collective responsibility. We recommend implementing the Essential Public Health Services (EPHS) framework to promote those systems and policies that enable optimal health for all while removing systemic and structural barriers that have created health inequities. The pledge of “Health for All” is often well-accepted in theory, but the intricacy of its practical execution is not sufficiently recognized during this COVID-19 syndemic and beyond.
Original languageEnglish
Article number675280
Number of pages8
JournalFrontiers in Public Health
Publication statusPublished - 11 May 2021

Bibliographical note

Copyright © 2021 Caron and Adegboye. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication
in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms


  • Covid-19
  • essential public health services
  • health inequities
  • ethnic minorities
  • immigration
  • refugees
  • syndemic


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