Racial Disparities in the Perceived Risk of COVID-19 and in Getting Needed Medical Care

Background: Widespread disruptions of medical care to mitigate COVID-19 spread and reduce burden on healthcare systems may have deleterious public health consequences.Design and Methods: To examine factors contributing to healthcare interruptions during the pandemic, we conducted a COVID-19 impact survey between 10/7-12/14/2020 among participants of the Southern Community Cohort Study, which primarily enrolled low-income individuals in 12 southeastern states from 2002-2009. COVID survey data were combined with baseline and follow-up data.Results: Among 4,463 respondents, 40% reported having missed/delayed a health appointment during the pandemic; the common reason was provider-initiated cancellation or delay (63%). In a multivariable model, female sex was the strongest independent predictor of interrupted care, with odds ratio (OR) 1.63 (95% confidence interval [CI] 1.40-1.89). Those with higher education (OR 1.27; 95% CI 1.05-1.54 for college graduate vs ≤high school) and household income (OR 1.47; 95% CI 1.16-1.86 for >$50,000 vs <$15,000) were at significantly increased odds of missing healthcare. Having greater perceived risk for acquiring (OR 1.42; 95% CI 1.17-1.72) or dying from COVID-19 (OR 1.25; 95% CI 1.04-1.51) also significantly increased odds of missed/delayed healthcare. Age was inversely associated with missed healthcare among men (OR for 5-year increase in age 0.88; 95% CI 0.80-0.96) but not women (OR 0.97; 95% CI 0.91-1.04; p-interaction=0.04). Neither race/ethnicity nor comorbidities were associated with interrupted healthcare.Conclusions: Disruptions to healthcare disproportionately affected women and were primarily driven by health system-initiated deferrals and individual perceptions of COVID-19 risk, rather than medical co-morbidities or other traditional barriers to healthcare access.

Download Full-text

Accounting for Apparent “Reverse” Racial Disparities in Department of Veterans Affairs (VA)–Based Medical Care: Influence of Out-of-VA Care

American Journal of Public Health ◽

10.2105/ajph.94.12.2076 ◽

2004 ◽

Vol 94 (12) ◽

pp. 2076-2078 ◽

Cited By ~ 12

Author(s):

Andrea D. Gurmankin ◽

Daniel Polsky ◽

Kevin G. Volpp

Keyword(s):

Medical Care ◽

Racial Disparities ◽

Veterans Affairs ◽

Department Of Veterans Affairs

Download Full-text

Redressing Wounds: Finding a Legal Framework to Remedy Racial Disparities in Medical Care

California Law Review ◽

10.2307/3481439 ◽

2002 ◽

Vol 90 (6) ◽

pp. 2047 ◽

Cited By ~ 6

Author(s):

Michael S. Shin

Keyword(s):

Medical Care ◽

Racial Disparities ◽

Legal Framework

Download Full-text

HIV prevalence in South Africa through gender and racial lenses: results from the 2012 population-based national household survey

International Journal for Equity in Health ◽

10.1186/s12939-019-1055-6 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 4

Author(s):

M. Mabaso ◽

L. Makola ◽

I. Naidoo ◽

L. L. Mlangeni ◽

S. Jooste ◽

...

Keyword(s):

South Africa ◽

Condom Use ◽

Racial Disparities ◽

Perceived Risk ◽

Multiple Logistic Regression Analysis ◽

Population Based ◽

Hiv Prevalence ◽

Black African ◽

Hiv Epidemic ◽

Increased Risk

Abstract Background In South Africa, persistence of the HIV epidemic and associated gender and racial disparities is a major concern after more than 20 years of democratic dispensation and efforts to create a more healthy and equal society. This paper profiles HIV prevalence and related factors among Black African men and women compared to other race groups in South Africa using the 2012 population-based national household HIV survey. Methods This secondary data analysis was based on the 2012 population-based nationally representative multi-stage stratified cluster random household sample. Bivariate and multiple logistic regression analysis were used to assess the relationship between HIV prevalence and associated factors by gender and racial profile. Results Overall HIV prevalence was significantly higher (p < 0.001) among both Black African males (16.6%; 95% CI: 15.0–18.4) and females (24.1%; 95% CI: 22.4–26.0) compared to their counterparts from other races. Among Black African males, increased risk of HIV was significantly associated with age group 25–49 years and those 50 years and older compared with young males 15–25 years. Among all males, reported condom use at last sex was significantly associated with increased risk of HIV. High socio-economic status (SES) and perceived risk of HIV were associated with a decreased risk of HIV. Among female condom use at last sex and ever testing for HIV was associated with increased prevalence of HIV only among Black African females. Lower prevalence of HIV was associated with marriage, tertiary education, high SES, having a partner five years younger, perceived risk of HIV, and awareness of HIV status among Black African females. Conclusion Gender and racial disparities rooted in structural and contextual inequalities remain important factors for the maintenance of the generalized HIV epidemic in the country. HIV prevention interventions need to cut across all strata of society but also target risk factors salient for specific groups. Alleviating vulnerability to HIV along gender and racial lines should also be viewed as part of a broader public health strategy.

Download Full-text