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Healthcare
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Health Disparities and Stigma in the Era of COVID-19
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Health Disparities and Stigma in the Era of COVID-19

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Coronaviruses (CoV) and COVID-19 Pandemic".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 48296

Special Issue Editor

Dr. Jocelyn Turner-Musa

E-Mail Website
Guest Editor
Chairperson, Department of Psychology Director, ASCEND Scholars Program Director, REACH LAB PsycIsSTEM Project Morgan State University Martin Jenkins Hall Behavioral and Social Sciences Center, Room 226-H 1600 Havenwood Road Baltimore, MD 21218, USA
Interests: undergraduate research training and development; health disparities; prevention science

Special Issue Information

Dear Colleagues,

Recent statistics suggest disparities in the incidence, prevalence, and mortality rates of the COVID-19 virus among certain racial and ethnic groups. In the United States, Blacks/African Americans, Hispanics, and Native Americans/American Indians are disproportionately diagnosed with and die from COVID-19. Among possible explanations for these findings are comorbidities such as diabetes, hypertension, and respiratory illnesses. However, social determinants underlying many health conditions affecting these populations are also thought to make them more vulnerable to the virus. These determinants include but are not limited to: access to healthcare, economic insecurity, poor neighborhood and housing conditions, and availability of resources.

Additionally, recent news reports document an increase in stigma in the form of stereotyping and harassment directed toward ethnic/racial groups thought to be associated with the spread of the virus. Pandemics such as COVID-19 create fear and anxiety which can lead to social stigma toward certain groups, including people who have travelled abroad, people of Asian descent, or even service and healthcare providers. For example, stigma and discrimination that stems from it can occur when people associate COVID-19 with a nationality, even though not everyone in that nationality is at risk for the disease. Stigma can lead to social avoidance, denial of health care, or perhaps even violence.

Understanding these factors and how they influence incidence, treatment, and health outcomes may aid in mitigating current disparities and stigma associated with the COVID-19 pandemic. To date, there is limited comprehensive data on the influence of social determinants and stigma on health disparities observed in racial/ethnic populations. Data aggregated by race and ethnicity is important for recognizing the extent to which disparities exist, as well as for examining their antecedents so as to help shape and target prevention and treatment efforts.

In this Special Issue we welcome articles and commentaries providing insights into the influence of the social determinants of health, including structural factors such as housing and neighborhood density on mitigation strategies; cultural beliefs about testing; economic constraints; and the influence of access to testing on disparities in diagnosis, treatment, and mortality from COVID-19. Empirical articles or reviews on stigma associated with the virus are also welcomed. Of particular interest is the role of stigma on getting tested for COVID-19, stigma associated with mitigation strategies such as wearing masks, and health outcomes related to stigma for some ethnic/racial groups.

Dr. Jocelyn Turner-Musa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Health Disparities
  • COVID-19/Coronavirus
  • Stigma
  • Race/Ethnicity
  • Social Determinants of Health
  • Blacks/African Americans, Hispanics, Asians, Asian Americans, Native Americans/American Indians

Published Papers (6 papers)

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Editorial

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7 pages, 221 KiB  
Editorial
Examining Social Determinants of Health, Stigma, and COVID-19 Disparities
by Jocelyn Turner-Musa, Oluwatoyin Ajayi and Layschel Kemp
Healthcare 2020, 8(2), 168; https://doi.org/10.3390/healthcare8020168 - 12 Jun 2020
Cited by 117 | Viewed by 20460
Abstract
There is growing attention to disparities in the incidence, prevalence, and mortality associated with COVID-19 (Coronavirus disease 2019) in racial/ethnic communities. The conditions leading to these disparities may be a function of social determinants of health and stigma linked to the disease. It [...] Read more.
There is growing attention to disparities in the incidence, prevalence, and mortality associated with COVID-19 (Coronavirus disease 2019) in racial/ethnic communities. The conditions leading to these disparities may be a function of social determinants of health and stigma linked to the disease. It is important to examine how these factors may be implicated in COVID-19 onset, treatment, and outcomes. A brief overview of these issues allows for a cursory examination of the role of social determinants of health and stigma in COVID-19. Consideration is given to how understanding COVID-19 in the context of social determinants and stigma may be included in interventions to mitigate its transmission within vulnerable populations. Full article
(This article belongs to the Special Issue Health Disparities and Stigma in the Era of COVID-19)

Research

Jump to: Editorial, Other

9 pages, 1461 KiB  
Article
COVID-19 Disparities in Nursing Homes
by Linda Loubert
Healthcare 2021, 9(4), 388; https://doi.org/10.3390/healthcare9040388 - 01 Apr 2021
Cited by 3 | Viewed by 2005
Abstract
Cases of COVID-19, the coronavirus that has spread throughout the world, affect and kill the poor, racial minorities, and the elderly disproportionately. The toll to the elders of our society is extreme and does not seem to relent over time. This work examines [...] Read more.
Cases of COVID-19, the coronavirus that has spread throughout the world, affect and kill the poor, racial minorities, and the elderly disproportionately. The toll to the elders of our society is extreme and does not seem to relent over time. This work examines the statistics of the cases and deaths at the early onset of the disease in nursing homes. It reveals the age disparities seen in the COVID-19 pandemic by using data from nursing homes across the states, and particularly in Maryland, as a source to illustrate the effect on the elderly living in group-like settings. It presents an overview of the disease in the early months as it ravaged across the states, indicating that the older generation was a lot more at risk than the general population. It is necessary to illustrate these disparities even as the numbers of infections and deaths are not static. Full article
(This article belongs to the Special Issue Health Disparities and Stigma in the Era of COVID-19)
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14 pages, 395 KiB  
Article
The Pandemic within a Pandemic: Testing a Sequential Mediation Model to Better Understand Racial/Ethnic Disparities in COVID-19 Preventive Behavior
by James A. Roberts and Meredith E. David
Healthcare 2021, 9(2), 230; https://doi.org/10.3390/healthcare9020230 - 20 Feb 2021
Cited by 4 | Viewed by 2301
Abstract
Recent Centers for Disease Control and Prevention (CDC) data reveal that COVID-19 hospitalization and mortality rates are higher for certain racial/ethnic groups. Labeled as the “pandemic within a pandemic”, African Americans and Hispanics are bearing more of the brunt of the disease compared [...] Read more.
Recent Centers for Disease Control and Prevention (CDC) data reveal that COVID-19 hospitalization and mortality rates are higher for certain racial/ethnic groups. Labeled as the “pandemic within a pandemic”, African Americans and Hispanics are bearing more of the brunt of the disease compared to Caucasians. Testing a new sequential mediation model on a sample of 483 US African American, Caucasian, and Hispanic adults, the present study investigates the role of fear of COVID-19, information receptivity, perceived knowledge, and self-efficacy to explain disparities in preventive behaviors. Study contributions include the specification of a new predictive model that improves upon the long-used Health Belief Model (HBM). The Sequential Mediation Model appears to have greater explanatory capacity than the HBM. Study results also provide important insights into racial/ethnic differences in health-seeking behavior related to the coronavirus. Findings show that African Americans reported higher levels of preventive behaviors and self-efficacy than Caucasians. It is possible that SES, rather than race per se, is more important in explaining differences in COVID-19 preventive behaviors. Certain “cues to action” (precipitating factors) also help explain this somewhat surprising result. Additionally, significant differences were found across the three racial/ethnic groups for all the new model’s variables except perceived knowledge. The new model was supported across all three racial/ethnic groups with notable differences across each group. Given the severity of implications surrounding the COVID-19 pandemic (physical, mental, and economic), it is critical that an improved understanding of what drives individual health-seeking behavior be achieved. Study limitations and future research suggestions are discussed. Full article
(This article belongs to the Special Issue Health Disparities and Stigma in the Era of COVID-19)
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16 pages, 1044 KiB  
Article
Predictors of Death Rate during the COVID-19 Pandemic
by Ian Feinhandler, Benjamin Cilento, Brad Beauvais, Jordan Harrop and Lawrence Fulton
Healthcare 2020, 8(3), 339; https://doi.org/10.3390/healthcare8030339 - 14 Sep 2020
Cited by 20 | Viewed by 9411
Abstract
Coronavirus (COVID-19) is a potentially fatal viral infection. This study investigates geography, demography, socioeconomics, health conditions, hospital characteristics, and politics as potential explanatory variables for death rates at the state and county levels. Data from the Centers for Disease Control and Prevention, the [...] Read more.
Coronavirus (COVID-19) is a potentially fatal viral infection. This study investigates geography, demography, socioeconomics, health conditions, hospital characteristics, and politics as potential explanatory variables for death rates at the state and county levels. Data from the Centers for Disease Control and Prevention, the Census Bureau, Centers for Medicare and Medicaid, Definitive Healthcare, and USAfacts.org were used to evaluate regression models. Yearly pneumonia and flu death rates (state level, 2014–2018) were evaluated as a function of the governors’ political party using a repeated measures analysis. At the state and county level, spatial regression models were evaluated. At the county level, we discovered a statistically significant model that included geography, population density, racial and ethnic status, three health status variables along with a political factor. A state level analysis identified health status, minority status, and the interaction between governors’ parties and health status as important variables. The political factor, however, did not appear in a subsequent analysis of 2014–2018 pneumonia and flu death rates. The pathogenesis of COVID-19 has a greater and disproportionate effect within racial and ethnic minority groups, and the political influence on the reporting of COVID-19 mortality was statistically relevant at the county level and as an interaction term only at the state level. Full article
(This article belongs to the Special Issue Health Disparities and Stigma in the Era of COVID-19)
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Other

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14 pages, 764 KiB  
Perspective
Application of the Weathering Framework: Intersection of Racism, Stigma, and COVID-19 as a Stressful Life Event among African Americans
by Fathima Wakeel and Anuli Njoku
Healthcare 2021, 9(2), 145; https://doi.org/10.3390/healthcare9020145 - 02 Feb 2021
Cited by 23 | Viewed by 6733
Abstract
The disproportionate impact of coronavirus disease 2019 (COVID-19) on African American communities necessitates an increased focus on the intersectional roles of racism, stigma, and other social determinants of health in influencing disease and mortality risk. The Weathering Framework is applied to demonstrate the [...] Read more.
The disproportionate impact of coronavirus disease 2019 (COVID-19) on African American communities necessitates an increased focus on the intersectional roles of racism, stigma, and other social determinants of health in influencing disease and mortality risk. The Weathering Framework is applied to demonstrate the dynamic interrelationships between these factors and to conceptualize COVID-19 as a stressful life event that will have profound health implications over the life course for African Americans. Recommendations for population health research, interventions and policies aimed at reducing COVID-19 incidence and mortality, and mitigation of the long-term impacts of the pandemic on communities of color are discussed. Full article
(This article belongs to the Special Issue Health Disparities and Stigma in the Era of COVID-19)
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9 pages, 215 KiB  
Perspective
Addressing Healthcare Gaps in Sweden during the COVID-19 Outbreak: On Community Outreach and Empowering Ethnic Minority Groups in a Digitalized Context
by Giuseppe Valeriani, Iris Sarajlic Vukovic, Tomas Lindegaard, Roberto Felizia, Richard Mollica and Gerhard Andersson
Healthcare 2020, 8(4), 445; https://doi.org/10.3390/healthcare8040445 - 01 Nov 2020
Cited by 23 | Viewed by 5882
Abstract
Since its early stages, the COVID-19 pandemic has interacted with existing divides by ethnicity and socioeconomic statuses, exacerbating further inequalities in high-income countries. The Swedish public health strategy, built on mutual trust between the government and the society and giving the responsibility to [...] Read more.
Since its early stages, the COVID-19 pandemic has interacted with existing divides by ethnicity and socioeconomic statuses, exacerbating further inequalities in high-income countries. The Swedish public health strategy, built on mutual trust between the government and the society and giving the responsibility to the individual, has been criticized for not applying a dedicated and more diverse strategy for most disadvantaged migrants in dealing with the pandemic. In order to mitigate the unequal burden on the marginalized members of society, increasing efforts have been addressed to digital health technologies. Despite the strong potential of providing collective public health benefits, especially in a highly digitalized context as Sweden, need for a stronger cooperation between the public health authorities and migrant community leaders, representatives of migrant associations, religious leaders and other influencers of disadvantaged groups has emerged. Suggestions are presented on more culturally congruent, patient-centered health care services aimed to empower people to participate in a more effective public health response to the COVID-19 crisis. Full article
(This article belongs to the Special Issue Health Disparities and Stigma in the Era of COVID-19)
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