COVID-19: A syndemic requiring an integrated approach for marginalized populations: Caucus on Refugee and Immigrant Health. Session on Living with and Addressing the COVID-19 Pandemic in Immigrant, Refugee and Forcibly Displaced Communities

The emerging coronavirus, SARS-CoV-2, responsible for the COVID-19 pandemic, has challenged healthcare systems globally. The health inequalities of immigrants, asylum seekers and refugees 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 groups. The purpose of this work is to: 1) highlight the bidirectional interaction between the social determinants of health (SDoH) and 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. For these at-risk populations, we propose how individual, structural, socio-cultural and relationship 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 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.