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The Colors of COVID-19: Confronting Health Disparities During a Global Pandemic

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 30126

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Special Issue Editors

Prof. Dr. Stephen B. Thomas

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Guest Editor

Department of Health Services Administration, School of Public Health and Maryland Center for Health Equity, University of Maryland, College Park, MD 20742, USA
Interests: race, ethnicity and health disparities research
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Craig S. Fryer

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Guest Editor

Department of Behavioral and Community Health, Maryland Center for Health Equity, School of Public Health, University of Maryland, College Park, MD 20742, USA
Interests: health equity; intersection of tobacco and marijuana use; youth and young adults; mixed methods research; community-engaged approaches; racism; black men’s health; trauma

Prof. Dr. Tiffany Gary-Webb

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Guest Editor

1. Epidemiology Section, APHA, Washington, D.C., USA;
2. Departments of Epidemiology and Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
Interests: social determinants; health equity; health disparities chronic disease; diabetes; cardiometabolic health; interventions; epidemiology

Prof. Dr. Mindi Spencer

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Guest Editor

Department of Health Promotion, Education, and Behavior , Joint Appointment: Institute for Southern Studies, 915 Greene St., Room 550, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
Interests: health equity; culture and caregiving; regional disparities; American Indian elders; LGBT health; intergenerational trauma; Appalachia; opioid epidemic; ACEs

Special Issue Information

Dear Colleagues,

Never in our lives have we experienced such a global phenomenon. For the first time in history, the world has come together, focused on the same existential threat, consumed by the same fears and uncertainties, eagerly anticipating the same, yet unrealized, promises of medical science. In a matter of months, human civilization has been brought low by the novel SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), a microscopic parasite 10,000 times smaller than a grain of salt. COVID-19 attacks our physical bodies, but also the cultural foundations of our lives. Depending upon how we respond, our lives, and literally our way of life, hangs in the balance.

Today, we are using mitigation interventions designed during the 1918 Flu pandemic 100 years ago. The approach is largely focused on slowing the rate of spread, flattening the curve of morbidity. There are no cures, and the promise of a vaccine is distant. If history is any lesson, the mumps vaccine took four years and that is the fastest vaccine ever developed. The development and deployment of a safe and effective vaccine for COVID-19 at “warp-speed” (12–18 months) is fraught with potential complications.

We must all be mindful that in human history, pandemics and plagues have a way of shifting the course of history, and not always to the benefits of the survivors. As companies eliminate or close, the internet brings entertainment and sporting events into our home, and airline travel becomes ever more problematic and miserable, people will adapt. The financial uncertainty caused by the COVID-19 pandemic will cast a long shadow, especially on populations made more vulnerable due to poverty and discrimination.

While COVID-19 does not discriminate, it exposes what is wrong and right in how different societies are organized and structured. As a result, health inequities have been exacerbated by this pandemic. We may all be in the same storm, but everyone is not in the same boat. What can we learn when success in one nation is rejected by another? How do we create prevention strategies and messages tailored for the most disadvantaged and least privileged?

The purpose of this Special Issue is to highlight the disproportionate effects of COVID-19 on vulnerable populations, especially communities of Color, around the world. We wish for the accepted manuscripts to present the latest interdisciplinary and innovative research, tools, methods, and approaches to assess, reduce, and prevent these environmentally driven social, racial, and ethnic health disparities—the underlying conditions that make COVID-19 such a deadly disease. We welcome review artices focused on, but not limited to: 1) geospatial dimensions of health disparities, 2) community capacity building for environmental justice as a framework for solutions, 3) community-engaged research where potential study participants are working in collaboration with scientists, and 4) the bioethics of COVID-19 clinical trials. We also encourage submissions that address social determinants of health, intersectionality, and critical racial and ethnic analyses, as well as approaches that inform decision-making for legislation and program development/implementation to reduce/prevent health disparities in the era of COVID-19. Our aim is to advance health equity research into the arena of pandemic diseases and help accelerate efforts designed to improve access to healthy communities for all vulnerable populations.

Prof. Dr. Stephen B. Thomas
Prof. Dr. Craig S. Fryer
Prof. Dr. Tiffany Gary-Webb
Prof. Dr. Mindi Spencer
Guest Editors

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. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly 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 2500 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

COVID-19 prevention, treatment and mitigation
health inequities
social determinants of health
racism and discrimination
history infectious/pandemic disease
risk assessment methodology
risk management plans
risk communication
bioethics
culturally tailored strategies for solutions
community-engaged research
environmental justice
community advisory boards
COVID-19 challenge trials
interventions

Published Papers (6 papers)

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Research

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29 pages, 1458 KiB

Open AccessArticle

Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

by Jay J. Xu, Jarvis T. Chen, Thomas R. Belin, Ronald S. Brookmeyer, Marc A. Suchard and Christina M. Ramirez

Int. J. Environ. Res. Public Health 2021, 18(6), 2921; https://doi.org/10.3390/ijerph18062921 - 12 Mar 2021

Cited by 22 | Viewed by 6273

Abstract

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state. Full article

(This article belongs to the Special Issue The Colors of COVID-19: Confronting Health Disparities During a Global Pandemic)

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14 pages, 342 KiB

Open AccessArticle

Mental Health of Parents of Special Needs Children in China during the COVID-19 Pandemic

by Sui-Qing Chen, Shu-Dan Chen, Xing-Kai Li and Jie Ren

Int. J. Environ. Res. Public Health 2020, 17(24), 9519; https://doi.org/10.3390/ijerph17249519 - 18 Dec 2020

Cited by 50 | Viewed by 8010

Abstract

We assessed the mental health of parents (N = 1450, M_age = 40.76) of special needs children during the COVID-19 pandemic. We conducted an online survey comprising items on demographic data; two self-designed questionnaires (children’s behavioral problems/psychological demand of parents during COVID-19); and four standardized questionnaires, including the General Health Questionnaire, Perceived Social Support, Parenting Stress Index, and Neuroticism Extraversion Openness Five Factor Inventory. The results showed that there were significant differences among parents of children with different challenges. Parents of children with autism spectrum disorder were more likely to have mental health problems compared to parents whose children had an intellectual disability or a visual or hearing impairment. Behavioral problems of children and psychological demands of parents were common factors predicting the mental health of all parents. Parent–child dysfunctional interactions and parenting distress were associated with parents of children with autism spectrum disorder. Family support, having a difficult child, and parenting distress were associated with having children with an intellectual disability. It is necessary to pay attention to the parents’ mental health, provide more social and family support, and reduce parenting pressures. Full article

(This article belongs to the Special Issue The Colors of COVID-19: Confronting Health Disparities During a Global Pandemic)

13 pages, 2410 KiB

Open AccessArticle

Community-Level Factors Associated with COVID-19 Cases and Testing Equity in King County, Washington

by Edmund Seto, Esther Min, Carolyn Ingram, BJ Cummings and Stephanie A. Farquhar

Int. J. Environ. Res. Public Health 2020, 17(24), 9516; https://doi.org/10.3390/ijerph17249516 - 18 Dec 2020

Cited by 21 | Viewed by 4675

Abstract

Individual-level Coronavirus Disease 2019 (COVID-19) case data suggest that certain populations may be more impacted by the pandemic. However, few studies have considered the communities from which positive cases are prevalent, and the variations in testing rates between communities. In this study, we assessed community factors that were associated with COVID-19 testing and test positivity at the census tract level for the Seattle, King County, Washington region at the summer peak of infection in July 2020. Multivariate Poisson regression was used to estimate confirmed case counts, adjusted for testing numbers, which were associated with socioeconomic status (SES) indicators such as poverty, educational attainment, transportation cost, as well as with communities with high proportions of people of color. Multivariate models were also used to examine factors associated with testing rates, and found disparities in testing for communities of color and communities with transportation cost barriers. These results demonstrate the ability to identify tract-level indicators of COVID-19 risk and specific communities that are most vulnerable to COVID-19 infection, as well as highlight the ongoing need to ensure access to disease control resources, including information and education, testing, and future vaccination programs in low-SES and highly diverse communities. Full article

(This article belongs to the Special Issue The Colors of COVID-19: Confronting Health Disparities During a Global Pandemic)

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19 pages, 519 KiB

Open AccessArticle

Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States

by Marilyn D. Thomas, Eli K. Michaels, Sean Darling-Hammond, Thu T. Nguyen, M. Maria Glymour and Eric Vittinghoff

Int. J. Environ. Res. Public Health 2020, 17(22), 8695; https://doi.org/10.3390/ijerph17228695 - 23 Nov 2020

Cited by 15 | Viewed by 3947

Abstract

Mounting evidence reveals considerable racial inequities in coronavirus disease 2019 (COVID-19) outcomes in the United States (US). Area-level racial bias has been associated with multiple adverse health outcomes, but its association with COVID-19 is yet unexplored. Combining county-level data from Project Implicit on implicit and explicit anti-Black bias among non-Hispanic Whites, Johns Hopkins Coronavirus Resource Center, and The New York Times, we used adjusted linear regressions to estimate overall COVID-19 incidence and mortality rates through 01 July 2020, Black and White incidence rates through 28 May 2020, and Black–White incidence rate gaps on average area-level implicit and explicit racial bias. Across 2994 counties, the average COVID-19 mortality rate (standard deviation) was 1.7/10,000 people (3.3) and average cumulative COVID-19 incidence rate was 52.1/10,000 (77.2). Higher racial bias was associated with higher overall mortality rates (per 1 standard deviation higher implicit bias b = 0.65/10,000 (95% confidence interval: 0.39, 0.91); explicit bias b = 0.49/10,000 (0.27, 0.70)) and higher overall incidence (implicit bias b = 8.42/10,000 (4.64, 12.20); explicit bias b = 8.83/10,000 (5.32, 12.35)). In 957 counties with race-specific data, higher racial bias predicted higher White and Black incidence rates, and larger Black–White incidence rate gaps. Anti-Black bias among Whites predicts worse COVID-19 outcomes and greater inequities. Area-level interventions may ameliorate health inequities. Full article

(This article belongs to the Special Issue The Colors of COVID-19: Confronting Health Disparities During a Global Pandemic)

Review

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21 pages, 1188 KiB

Open AccessEditor’s ChoiceReview

Comparison of the Mental Health Impact of COVID-19 on Vulnerable and Non-Vulnerable Groups: A Systematic Review and Meta-Analysis of Observational Studies

by Soo-Hyun Nam, Jeong-Hyun Nam and Chan-Young Kwon

Int. J. Environ. Res. Public Health 2021, 18(20), 10830; https://doi.org/10.3390/ijerph182010830 - 15 Oct 2021

Cited by 25 | Viewed by 4275

Abstract

Vulnerable populations may be more vulnerable to mental health problems posed by the coronavirus disease 2019 (COVID-19) pandemic. A systematic review was performed to compare the mental health impact of COVID-19 between vulnerable and non-vulnerable groups. Five electronic databases were searched for observational studies reporting the psychological outcomes of both vulnerable populations and healthy controls during the COVID-19 era. The primary outcomes are the severity of depression and anxiety, and secondary outcomes include other aspects of mental health such as stress or sleep disturbance. Meta-analysis was performed for the severity of mental health symptoms, and the results were presented as standardized mean difference and 95% confidence intervals. A total of 25 studies were included. According to the findings, the elderly generally experienced significantly lower levels of psychological symptoms including depression, anxiety, and perceived stress. Pregnant women, patients with chronic diseases, and patients with pre-existing severe mental disorders showed mixed results according to each mental health outcome. The results indicate that vulnerable groups have been affected differently in the COVID-19 era. Though the insufficient number and heterogeneity of included studies leave the results inconclusive, our findings may contribute to identifying priorities of mental health needs among various vulnerable populations and allocating health resources with efficiency. Full article

(This article belongs to the Special Issue The Colors of COVID-19: Confronting Health Disparities During a Global Pandemic)

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Other

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8 pages, 307 KiB

Open AccessCommentary

Why Re-Invent the Wheel? Social Network Approaches Can Be Used to Mitigate SARS-CoV-2 Related Disparities in Latinx Seasonal Farmworkers

by Mariano Kanamori, Daniel Castaneda, Kyle J. Self, Lucy Sanchez, Yesenia Rosas, Edda Rodriguez, Cho-Hee Shrader, Juan Arroyo-Flores, Ariana Johnson, John Skvoretz, Daniel Gomez and Mark Williams

Int. J. Environ. Res. Public Health 2021, 18(23), 12709; https://doi.org/10.3390/ijerph182312709 - 02 Dec 2021

Cited by 3 | Viewed by 1533

Abstract

Latinx seasonal farmworkers are essential workers and are at elevated risk for SARS-CoV-2 in the United States. Risk factors for SARS-CoV-2 are unique to this population and include crowded living conditions, isolated social networks, and exploitative working environments. The circumstances and cultural values of Latinx seasonal farmworkers pose a unique challenge to public health authorities working to contain the spread of SARS-CoV-2. This community is in dire need of urgent public health research to identify opportunities to prevent SARS-CoV-2 transmission: social network methods could be the solution. Using previously collected and new information provided by a team of experts, this commentary provides a brief description of Latinx seasonal farmworker disparities that affect tracking and treating SARS-CoV-2 in this important group, the challenges introduced by SARS-CoV-2, and how social network approaches learned from other infectious disease prevention strategies can address these disparities. Full article

(This article belongs to the Special Issue The Colors of COVID-19: Confronting Health Disparities During a Global Pandemic)

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The Colors of COVID-19: Confronting Health Disparities During a Global Pandemic

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