How have pandemics exacerbated inequalities, stigmatised certain groups, and prompted social change historically?

  • Darcey Brown
Keywords: Pandemics, The Black Death, health inequalities, The ‘Spanish Flu, COVID-19, African Americans, Jews, racism, stigma, BAME, mortality, NCDs, inequalities


This literature review presents a historical analysis of pandemics. The Black Death, The ‘Spanish Flu’ and COVID-19 are explored to identify patterns of discrimination linked to marginalised minority groups. This dissertation aims to investigate how inequalities experienced by minority groups were exacerbated by the pandemics selected. It hopes to determine the impact on social change as measured by a) shifts in attitudes and behaviour in society, and b) changes in measures imposed by governmental bodies. Chapter One entails a detailed review of The Black Death and the massacres, Anti-Semitism and scapegoating Jewish communities faced at the time. Chapter Two examines racist ideology and segregation policies to understand how these pre-existing inequalities were exacerbated because of The ‘Spanish Flu’. In Chapter Three, COVID-19 is explored to understand how unequal consequences of the pandemic have been experienced by ethnic minorities. Social change is considered throughout these chapters. Learning from history is important in public health. It is hoped that such learning is used to inform policies that might protect populations that are, because of their position in society, more vulnerable during a pandemic. An analysis of the historical literature was chosen in favour of an empirical study as it allowed a comprehensive review of the experiences of minority groups across history and into the present day. A systematic review of the literature was undertaken (using electronic databases). Researching in a comprehensive and systematic manner ensured that literature found was appropriate and as unbiased as possible. Papers were critiqued against inclusion criteria as detailed further within the review. This was to ensure that reliable and credible literature was used. Themes arising from the review were analysed. The review of the literature found that history has repeated itself. COVID-19, like previous pandemics, has exacerbated health inequalities and stigma among ethnic minority group. The review found extensive patterns of stigma and discrimination across all groups analysed. Stigma was found to act as a rationale for racist, discriminatory, and violent behaviour towards marginalised groups. It was also a recurrent finding that, pre-existing inequalities (e.g. racial discrimination and poverty) were exacerbated during the pandemics studied. These issues went on to significantly disadvantage minority groups through higher rates of morbidity and mortality. When analysing social change, the review found little evidence of change in The Black Death or The ‘Spanish Flu’ pandemic. However, there were some indications of societal awakening and increased support of Black Lives Matter groups during COVID-19. Recommendations emerging from the dissertation include the need to address inequalities and stigma, by giving the necessary support and aid to relevant communities. This would significantly benefit both minority groups and society as a whole.