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Evidence of Social and Structural COVID-19 Disparities by Sexual Orientation, Gender Identity, and Race/Ethnicity in an Urban Environment.

ABSTRACT: The ongoing COVID-19 pandemic has had widespread social, psychological, and economic impacts. However, these impacts are not distributed equally: already marginalized populations, specifically racial/ethnic minority groups and sexual and gender minority populations, may be more likely to suffer the effects of COVID-19. The COVID-19 Resiliency Survey was conducted by the city of Chicago to assess the impact of COVID-19 on city residents in the wake of Chicago's initial lockdown, with particular focus on the experiences of minority populations. Chi-square tests of independence were performed to compare COVID-19-related outcomes and impacts on heterosexual vs. sexual minority populations, cisgender vs. gender minority populations, and White vs. racial/ethnic minority subgroups. Marginalized populations experienced significant disparities in COVID-19 exposure, susceptibility, and treatment access, as well as in psychosocial effects of the pandemic. Notably, Black and Latinx populations reported significant difficulties accessing food and supplies (p = 0.002). Healthcare access disparities were also visible, with Black and Latinx respondents reporting significantly lower levels of access to a provider to see if COVID-19 testing would be appropriate (p = 0.013), medical services (p = 0.001), and use of telehealth for mental health services (p = 0.001). Sexual minority respondents reported significantly lower rates of using telehealth for mental health services (p = 0.011), and gender minority respondents reported significantly lower levels of primary care provider access (p = 0.016). There are evident COVID-19 disparities experienced in Chicago especially for Black, Latinx, sexual minority, and gender minority groups. A greater focus must be paid to health equity, including providing increased resources and supplies for affected groups, adapting to inequities in the built environment, and ensuring adequate access to healthcare services to ameliorate the burden of COVID-19 on these marginalized populations.

SUBMITTER: Ruprecht MM

PROVIDER: S-EPMC7706696 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Using social-cognitive career theory, we identified the experiential sources of learning that contribute to research self-efficacy beliefs, outcome expectations, and science identity for culturally diverse undergraduate students in science, technology, engineering, and math (i.e., STEM) majors. We examined group differences by race/ethnicity and gender to investigate potential cultural variations in a model to explain students' research career intentions. Using a sample of 688 undergraduate students, we ran a series of path models testing the relationships between the experiential sources, research self-efficacy beliefs, outcome expectations, and science identity to research career intentions. Findings were largely consistent with our hypotheses in that research self-efficacy and outcome expectancies were directly and positively associated with research career intentions and the associations of the experiential sources to intentions were mediated via self-efficacy. Science identity contributed significant though modest variance to research career intentions indirectly via its positive association with outcome expectations. Science identity also partially mediated the efficacy-outcome expectancies path. The experiential sources of learning were associated in expected directions to research self-efficacy with 3 of the sources emerging as significantly correlated with science identity. An unexpected direct relationship from vicarious learning to intentions was observed. In testing for group differences by race/ethnicity and gender in subsamples of Black/African American and Latino/a students, we found that the hypothesized model incorporating science identity was supported, and most paths did not vary significantly across four Race/Ethnicity × Gender groups, except for 3 paths. Research and practice implications of the findings for supporting research career intentions of culturally diverse undergraduate students are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Project description:BackgroundTo date, research assessing discrimination has employed primarily explicit measures (i.e., self-reports), which can be subject to intentional and social desirability processes. Only a few studies, focusing on sex and race/ethnicity discrimination, have relied on implicit measures (i.e., Implicit Association Test, IAT), which permit assessing mental representations that are outside of conscious control. This study aims to advance measurement of discrimination by extending the application of implicit measures to multiple types of discrimination and optimizing the time required for the administration of these instruments.MethodsBetween September 27th 2019 and February 9th 2020, we conducted six experiments (984 participants) to assess implicit and explicit discrimination based on race/ethnicity, sex, gender identity, sexual orientation, weight, and age. Implicit discrimination was measured by using the Brief-Implicit Association Test (B-IAT), a new validated version of the IAT developed to shorten the time needed (from ≈15 to ≈2 min) to assess implicit mental representations, while explicit discrimination was assessed using self-reported items.ResultsAmong participants (mean age = 37.8), 68.6% were White Non-Hispanic; 69% were females; 76.1% were heterosexual; 90.7% were gender conforming; 52.8% were medium weight; and 41.5% had an advanced level of education. Overall, we found implicit and explicit recognition of discrimination towards all the target groups (stronger for members of the target than dominant groups). Some exceptions emerged in experiments investigating race/ethnicity and weight discrimination. In the racism experiment, only people of Color showed an implicit recognition of discrimination towards the target group, while White people were neutral. In the fatphobia experiment, participants who were not heavy showed a slight implicit recognition of discrimination towards the dominant group, while heavy participants were neutral.ConclusionsThis study provides evidence that the B-IAT is a valuable tool for quickly assessing multiple types of implicit discrimination. It shows also that implicit and explicit measures can display diverging results, thus indicating that research would benefit from the use of both these instruments. These results have important implications for the assessment of discrimination in health research as well as in social and psychological science.

Project description:IntroductionInfant mortality rates are higher in nonmetropolitan areas versus large metropolitan areas. Variation by race/ethnicity and cause of death has not been assessed. Urban-rural infant mortality rate differences were quantified by race/ethnicity and cause of death.MethodsNational Vital Statistics System linked birth/infant death data (2014-2016) were analyzed in 2019 by 3 urban-rural county classifications: large metropolitan, medium/small metropolitan, and nonmetropolitan. Excess infant mortality rates (rate differences) by urban-rural classification were calculated relative to large metropolitan areas overall and for each racial/ethnic group. The number of excess deaths, population attributable fraction, and proportion of excess deaths attributable to underlying causes of death was calculated.ResultsNonmetropolitan areas had the highest excess infant mortality rate overall. Excess infant mortality rates were substantially lower for Hispanic infants than other races/ethnicities. Overall, 7.4% of infant deaths would be prevented if all areas had the infant mortality rate of large metropolitan areas. With more than half of births occurring outside of large metropolitan areas, the population attributable fraction was highest for American Indian/Alaska Natives (20.3%) and whites, non-Hispanic (14.3%). Excess infant mortality rates in both nonmetropolitan and medium/small metropolitan areas were primarily attributable to sudden unexpected infant deaths (42.3% and 31.9%) and congenital anomalies (30.1% and 26.8%). This pattern was consistent for all racial/ethnic groups except black, non-Hispanic infants, for whom preterm-related and sudden unexpected infant deaths accounted for the largest share of excess infant mortality rates.ConclusionsInfant mortality increases with rurality, and excess infant mortality rates are predominantly attributable to sudden unexpected infant deaths and congenital anomalies, with differences by race/ethnicity regarding magnitude and cause of death.

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Evidence of Social and Structural COVID-19 Disparities by Sexual Orientation, Gender Identity, and Race/Ethnicity in an Urban Environment.

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