COVID-Related Discrimination and Health Care Access among a Nationally Representative, Diverse Sample of US Adults.

IF 3.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Racial and Ethnic Health Disparities Pub Date : 2024-12-17 DOI:10.1007/s40615-024-02260-1

Miciah J Wilkerson, Alexis L Green, Allana T Forde, Stephanie A Ponce, Anita L Stewart, Anna M Nápoles, Paula D Strassle

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引用次数: 0

Abstract

Background: In the United States, COVID-related discrimination towards racial and ethnic minority populations is well documented; however, its impact on healthcare access during the pandemic has not been assessed.

Methods: We used data from our nationally representative, online survey of 5,500 American Indian/Alaska Native (AIAN), Asian, Black, Native Hawaiian/Pacific Islander, Latino, White, and multiracial adults conducted between 12/2020-2/2021 (baseline) and 8/2021-9/2021 (6-month follow-up; 35.1% response rate). At baseline, participants were asked how often they experienced discriminatory behaviors "because they think you might have COVID-19" (modified Everyday Discrimination Scale). Participants were asked if they were unable to get needed health care (e.g., cancer screening), or COVID-19 testing at both time-points. Vaccine willingness was assessed at baseline and uptake at follow-up.

Results: Experiencing COVID-related discrimination was associated with not being able to get health care at baseline (OR = 3.66, 95% CI = 2.91-4.59) and follow-up (OR = 1.86, 95% CI = 1.16-2.97) and not being able to get a COVID-19 test at baseline (OR = 2.11, 95% CI = 1.68-2.65) and follow-up (OR = 4.12, 95% CI = 2.20-7.72). Experiencing discrimination was also associated with being less likely to have received a COVID-19 vaccine (OR = 0.52, 95% CI = 0.30-0.90), despite individuals who experienced discrimination being more willing to vaccinate at baseline (OR = 1.56, 95% CI = 1.10-2.22).

Conclusions: COVID-related discrimination was associated with an increased likelihood of being unable to get health care across all racial and ethnic populations, although associations were strongest among Asian, AIAN, and Latino adults. Healthcare providers should be aware of the impact of discrimination on healthcare utilization, delays, and health-seeking behaviors, especially among racial and ethnic minorities.

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在具有全国代表性的不同美国成年人样本中，与冠状病毒相关的歧视和医疗保健获取

背景：在美国，与 COVID 相关的针对少数种族和少数民族人口的歧视已被充分记录在案；然而，其对大流行期间医疗保健获取的影响尚未得到评估：我们使用了在 2020 年 12 月至 2021 年 2 月（基线）和 2021 年 8 月至 2021 年 9 月（6 个月随访；回复率为 35.1%）期间对 5500 名美国印第安人/阿拉斯加原住民、亚裔、黑人、夏威夷原住民/太平洋岛民、拉丁裔、白人和多种族成年人进行的具有全国代表性的在线调查数据。在基线调查中，参与者被问及 "因为他们认为您可能患有 COVID-19"（修改后的日常歧视量表）而遭受歧视行为的频率。在两个时间点，参与者都被问及是否无法获得所需的医疗保健（如癌症筛查）或 COVID-19 检测。在基线时评估接种疫苗的意愿，在随访时评估接种疫苗的情况：结果：在基线（OR = 3.66，95% CI = 2.91-4.59）和随访（OR = 1.86，95% CI = 1.16-2.97）和随访（OR = 4.12，95% CI = 2.20-7.72）时，遭受与 COVID 相关的歧视与无法获得医疗保健服务有关；在基线（OR = 2.11，95% CI = 1.68-2.65）和随访（OR = 4.12，95% CI = 2.20-7.72）时，遭受与 COVID-19 相关的歧视与无法获得 COVID-19 检测有关。尽管遭受歧视的人在基线时更愿意接种疫苗（OR = 1.56，95% CI = 1.10-2.22），但遭受歧视也与接种 COVID-19 疫苗的可能性较低有关（OR = 0.52，95% CI = 0.30-0.90）：结论：在所有种族和民族中，COVID 相关歧视与无法获得医疗保健的可能性增加有关，但在亚裔、亚裔美国人和拉丁裔成年人中相关性最强。医疗保健提供者应该意识到歧视对医疗保健利用、延迟和寻求健康行为的影响，尤其是在少数种族和民族中。

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来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.