scholarly journals The Disproportionate Impact of COVID-19 on Racial and Ethnic Minorities in the United States

2020 ◽  
Author(s):  
Don Bambino Geno Tai ◽  
Aditya Shah ◽  
Chyke A Doubeni ◽  
Irene G Sia ◽  
Mark L Wieland
Keyword(s):  
Native American ◽  
Minority Groups ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Ethnic Minority Groups ◽  
Short Term ◽  
Minority Communities ◽  
Societal Factors ◽  
Racial And Ethnic Minorities ◽  
Racial And Ethnic Minority

Abstract The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected racial and ethnic minority groups, with high rates of death in African American, Native American, and LatinX communities. Although the mechanisms of these disparities are being investigated, they can be conceived as arising from biomedical factors as well as social determinants of health. Minority groups are disproportionately affected by chronic medical conditions and lower access to healthcare that may portend worse COVID-19 outcomes. Furthermore, minority communities are more likely to experience living and working conditions that predispose them to worse outcomes. Underpinning these disparities are long-standing structural and societal factors that the COVID-19 pandemic has exposed. Clinicians can partner with patients and communities to reduce the short-term impact of COVID-19 disparities while advocating for structural change.

scholarly journals Racial and Ethnic Digital Divides in Posting COVID-19 Content on Social Media Among US Adults: Secondary Survey Analysis (Preprint)

2020 ◽  
Author(s):  
Celeste Campos-Castillo ◽  
Linnea I. Laestadius
Keyword(s):  
Older Adults ◽  
Social Media ◽  
Ethnic Minority ◽  
Race And Ethnicity ◽  
Minority Groups ◽  
The United States ◽  
Ethnic Minority Groups ◽  
Digital Divides ◽  
Gender And Age ◽  
Racial And Ethnic Minority

BACKGROUND Public health surveillance experts are leveraging user-generated content on social media to track the spread and effects of COVID-19. However, racial and ethnic digital divides, which are disparities among people who have internet access and post on social media, can bias inferences. This bias is particularly problematic in the context of the COVID-19 pandemic because due to structural inequalities, members of racial and ethnic minority groups are disproportionately vulnerable to contracting the virus and to the deleterious economic and social effects from mitigation efforts. Further, important demographic intersections with race and ethnicity, such as gender and age, are rarely investigated in work characterizing social media users; however, they reflect additional axes of inequality shaping differential exposure to COVID-19 and its effects. OBJECTIVE The aim of this study was to characterize how the race and ethnicity of US adults are associated with their odds of posting COVID-19 content on social media and how gender and age modify these odds. METHODS We performed a secondary analysis of a survey conducted by the Pew Research Center from March 19 to 24, 2020, using a national probability sample (N=10,510). Respondents were recruited from an online panel, where panelists without an internet-enabled device were given one to keep at no cost. The binary dependent variable was responses to an item asking whether respondents “used social media to share or post information about the coronavirus.” We used survey-weighted logistic regressions to estimate the odds of responding in the affirmative based on the race and ethnicity of respondents (white, black, Latino, other race/ethnicity), adjusted for covariates measuring sociodemographic background and COVID-19 experiences. We examined how gender (female, male) and age (18 to 30 years, 31 to 50 years, 51 to 64 years, and 65 years and older) intersected with race and ethnicity by estimating interactions. RESULTS Respondents who identified as black (odds ratio [OR] 1.29, 95% CI 1.02-1.64; <i>P</i>=.03), Latino (OR 1.66, 95% CI 1.36-2.04; <i>P</i>&lt;.001), or other races/ethnicities (OR 1.33, 95% CI 1.02-1.72; <i>P</i>=.03) had higher odds than respondents who identified as white of reporting that they posted COVID-19 content on social media. Women had higher odds of posting than men regardless of race and ethnicity (OR 1.58, 95% CI 1.39-1.80; <i>P</i>&lt;.001). Among men, respondents who identified as black, Latino, or members of other races/ethnicities were significantly more likely to post than respondents who identified as white. Older adults (65 years or older) had significantly lower odds (OR 0.73, 95% CI 0.57-0.94; <i>P</i>=.01) of posting compared to younger adults (18-29 years), particularly among those identifying as other races/ethnicities. Latino respondents were the most likely to report posting across all age groups. CONCLUSIONS In the United States, members of racial and ethnic minority groups are most likely to contribute to COVID-19 content on social media, particularly among groups traditionally less likely to use social media (older adults and men). The next step is to ensure that data collection procedures capture this diversity by encompassing a breadth of search criteria and social media platforms.

Expanding PrEP Services for Men Who Have Sex With Men and Transgender Persons Through Health Department Programs: Key Processes and Outcomes From Project PrIDE, 2015-2019

2022 ◽  
pp. 003335492110581
Author(s):  
Mesfin S. Mulatu ◽  
Jarvis W. Carter ◽  
Stephen A. Flores ◽  
Shaliondel Benton ◽  
Carla A. Galindo ◽  
...  
Keyword(s):  
Ethnic Minority ◽  
Health Equity ◽  
Minority Groups ◽  
The United States ◽  
Health Departments ◽  
Ethnic Minority Groups ◽  
Transgender Persons ◽  
Sex With Men ◽  
Building Program ◽  
Racial And Ethnic Minority

Objective: Pre-exposure prophylaxis (PrEP) Implementation, Data to Care, and Evaluation (PrIDE) was a demonstration project implemented by 12 state and local health departments during 2015-2019 to expand PrEP services for men who have sex with men (MSM) and transgender persons at risk for HIV infection. We describe findings from the cross-jurisdictional evaluation of the project. Methods: We analyzed work plans, annual progress reports, and aggregate quantitative program data submitted by funded health departments (n = 12) to identify key activities implemented and summarize key project outcomes. Results: PrIDE jurisdictions implemented multiple health equity–focused activities to expand PrEP services to priority populations, including building program capacity, conducting knowledge and awareness campaigns, providing PrEP support services, and addressing barriers to PrEP use. Overall, PrIDE jurisdictions identified 44 813 persons with PrEP indications. Of these, 74.8% (n = 33 500) were referred and 33.1% (n = 14 821) were linked to PrEP providers, and 25.3% (n = 11 356) were prescribed PrEP. Most persons prescribed PrEP were MSM or transgender persons (87.9%) and persons from racial and ethnic minority groups (65.6%). However, among persons with PrEP indications, non-Hispanic Black/African American persons (14.9% of 18 782) were less likely than non-Hispanic White persons (31.0% of 11 633) to be prescribed PrEP ( z = −33.57; P < .001). Conclusions: PrIDE jurisdictions successfully expanded PrEP services for MSM, transgender persons, and racial and ethnic minority groups by implementing health equity–focused activities that addressed barriers to PrEP services. However, PrEP prescription was generally low, with significant disparities by demographic characteristics. Additional targeted interventions are needed to expand PrEP services, achieve equity in PrEP use, and contribute to ending the HIV epidemic in the United States.

scholarly journals Racial and Ethnic Digital Divides in Posting COVID-19 Content on Social Media Among US Adults: Secondary Survey Analysis

10.2196/20472 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e20472 ◽  
Author(s):  
Celeste Campos-Castillo ◽  
Linnea I Laestadius
Keyword(s):  
Older Adults ◽  
Social Media ◽  
Ethnic Minority ◽  
Race And Ethnicity ◽  
Minority Groups ◽  
The United States ◽  
Ethnic Minority Groups ◽  
Digital Divides ◽  
Gender And Age ◽  
Racial And Ethnic Minority

Background Public health surveillance experts are leveraging user-generated content on social media to track the spread and effects of COVID-19. However, racial and ethnic digital divides, which are disparities among people who have internet access and post on social media, can bias inferences. This bias is particularly problematic in the context of the COVID-19 pandemic because due to structural inequalities, members of racial and ethnic minority groups are disproportionately vulnerable to contracting the virus and to the deleterious economic and social effects from mitigation efforts. Further, important demographic intersections with race and ethnicity, such as gender and age, are rarely investigated in work characterizing social media users; however, they reflect additional axes of inequality shaping differential exposure to COVID-19 and its effects. Objective The aim of this study was to characterize how the race and ethnicity of US adults are associated with their odds of posting COVID-19 content on social media and how gender and age modify these odds. Methods We performed a secondary analysis of a survey conducted by the Pew Research Center from March 19 to 24, 2020, using a national probability sample (N=10,510). Respondents were recruited from an online panel, where panelists without an internet-enabled device were given one to keep at no cost. The binary dependent variable was responses to an item asking whether respondents “used social media to share or post information about the coronavirus.” We used survey-weighted logistic regressions to estimate the odds of responding in the affirmative based on the race and ethnicity of respondents (white, black, Latino, other race/ethnicity), adjusted for covariates measuring sociodemographic background and COVID-19 experiences. We examined how gender (female, male) and age (18 to 30 years, 31 to 50 years, 51 to 64 years, and 65 years and older) intersected with race and ethnicity by estimating interactions. Results Respondents who identified as black (odds ratio [OR] 1.29, 95% CI 1.02-1.64; P=.03), Latino (OR 1.66, 95% CI 1.36-2.04; P<.001), or other races/ethnicities (OR 1.33, 95% CI 1.02-1.72; P=.03) had higher odds than respondents who identified as white of reporting that they posted COVID-19 content on social media. Women had higher odds of posting than men regardless of race and ethnicity (OR 1.58, 95% CI 1.39-1.80; P<.001). Among men, respondents who identified as black, Latino, or members of other races/ethnicities were significantly more likely to post than respondents who identified as white. Older adults (65 years or older) had significantly lower odds (OR 0.73, 95% CI 0.57-0.94; P=.01) of posting compared to younger adults (18-29 years), particularly among those identifying as other races/ethnicities. Latino respondents were the most likely to report posting across all age groups. Conclusions In the United States, members of racial and ethnic minority groups are most likely to contribute to COVID-19 content on social media, particularly among groups traditionally less likely to use social media (older adults and men). The next step is to ensure that data collection procedures capture this diversity by encompassing a breadth of search criteria and social media platforms.

scholarly journals Cross-site Monitoring and Evaluation of the Care and Prevention in the United States Demonstration Project, 2012-2016: Selected Process and Short-term Outcomes

2018 ◽  
Vol 133 (2_suppl) ◽  
pp. 87S-100S ◽  
Author(s):  
Mesfin S. Mulatu ◽  
Tamika Hoyte ◽  
Kim M. Williams ◽  
Raekiela D. Taylor ◽  
Thomas Painter ◽  
...  
Keyword(s):  
United States ◽  
Hiv Infection ◽  
Minority Groups ◽  
Monitoring And Evaluation ◽  
The United States ◽  
Demonstration Project ◽  
Ethnic Minority Groups ◽  
Short Term ◽  
Racial Ethnic ◽  
Cross Site

Objective: The Care and Prevention in the United States (CAPUS) Demonstration Project was a 4-year (2012-2016) cross-agency demonstration project that aimed to reduce HIV/AIDS-related morbidity and mortality among racial/ethnic minority groups in 8 states (Georgia, Illinois, Louisiana, Mississippi, Missouri, North Carolina, Tennessee, and Virginia). Its goals were to increase the identification of undiagnosed HIV infections and optimize the linkage to, reengagement with, and retention in care and prevention services for people with HIV (PWH). We present descriptive findings to answer selected cross-site process and short-term outcome monitoring and evaluation questions. Methods: We answered a set of monitoring and evaluation questions by using data submitted by grantees. We used a descriptive qualitative method to identify key themes of activities implemented and summarized quantitative data to describe program outputs and outcomes. Results: Of 155 343 total HIV tests conducted by all grantees, 558 (0.36%) tests identified people with newly diagnosed HIV infection. Of 4952 PWH who were presumptively not in care, 1811 (36.6%) were confirmed as not in care through Data to Care programs. Navigation and other linkage, retention, and reengagement programs reached 10 382 people and linked to or reengaged with care 5425 of 7017 (77.3%) PWH who were never in care or who had dropped out of care. Programs offered capacity-building trainings to providers to improve cultural competency, developed social marketing and social media campaigns to destigmatize HIV testing and care, and expanded access to support services, such as transitional housing and vocational training. Conclusions: CAPUS grantees substantially expanded their capacity to deliver HIV-related services and reach racial/ethnic minority groups at risk for or living with HIV infection. Our findings demonstrate the feasibility of implementing novel and integrated programs that address social and structural barriers to HIV care and prevention.

scholarly journals Racial and Ethnic Disparities in Patient Experiences in the United States: 4-Year Content Analysis of Twitter

10.2196/17048 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e17048
Author(s):  
Yulin Hswen ◽  
Jared B Hawkins ◽  
Kara Sewalk ◽  
Gaurav Tuli ◽  
David R Williams ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Groups ◽  
Patient Experience ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
The United States ◽  
Patient Experiences ◽  
Ethnic Minority Groups ◽  
Twitter Users ◽  
Racial And Ethnic Minority

Background Racial and ethnic minority groups often face worse patient experiences compared with the general population, which is directly related to poorer health outcomes within these minority populations. Evaluation of patient experience among racial and ethnic minority groups has been difficult due to lack of representation in traditional health care surveys. Objective This study aims to assess the feasibility of Twitter for identifying racial and ethnic disparities in patient experience across the United States from 2013 to 2016. Methods In total, 851,973 patient experience tweets with geographic location information from the United States were collected from 2013 to 2016. Patient experience tweets included discussions related to care received in a hospital, urgent care, or any other health institution. Ordinary least squares multiple regression was used to model patient experience sentiment and racial and ethnic groups over the 2013 to 2016 period and in relation to the implementation of the Patient Protection and Affordable Care Act (ACA) in 2014. Results Racial and ethnic distribution of users on Twitter was highly correlated with population estimates from the United States Census Bureau’s 5-year survey from 2016 (r2=0.99; P<.001). From 2013 to 2016, the average patient experience sentiment was highest for White patients, followed by Asian/Pacific Islander, Hispanic/Latino, and American Indian/Alaska Native patients. A reduction in negative patient experience sentiment on Twitter for all racial and ethnic groups was seen from 2013 to 2016. Twitter users who identified as Hispanic/Latino showed the greatest improvement in patient experience, with a 1.5 times greater increase (P<.001) than Twitter users who identified as White. Twitter users who identified as Black had the highest increase in patient experience postimplementation of the ACA (2014-2016) compared with preimplementation of the ACA (2013), and this change was 2.2 times (P<.001) greater than Twitter users who identified as White. Conclusions The ACA mandated the implementation of the measurement of patient experience of care delivery. Considering that quality assessment of care is required, Twitter may offer the ability to monitor patient experiences across diverse racial and ethnic groups and inform the evaluation of health policies like the ACA.

scholarly journals Racial and Ethnic Disparities in Patient Experiences in the United States: 4-Year Content Analysis of Twitter (Preprint)

2019 ◽  
Author(s):  
Yulin Hswen ◽  
Jared B Hawkins ◽  
Kara Sewalk ◽  
Gaurav Tuli ◽  
David R Williams ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Groups ◽  
Patient Experience ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
The United States ◽  
Patient Experiences ◽  
Ethnic Minority Groups ◽  
Twitter Users ◽  
Racial And Ethnic Minority

BACKGROUND Racial and ethnic minority groups often face worse patient experiences compared with the general population, which is directly related to poorer health outcomes within these minority populations. Evaluation of patient experience among racial and ethnic minority groups has been difficult due to lack of representation in traditional health care surveys. OBJECTIVE This study aims to assess the feasibility of Twitter for identifying racial and ethnic disparities in patient experience across the United States from 2013 to 2016. METHODS In total, 851,973 patient experience tweets with geographic location information from the United States were collected from 2013 to 2016. Patient experience tweets included discussions related to care received in a hospital, urgent care, or any other health institution. Ordinary least squares multiple regression was used to model patient experience sentiment and racial and ethnic groups over the 2013 to 2016 period and in relation to the implementation of the Patient Protection and Affordable Care Act (ACA) in 2014. RESULTS Racial and ethnic distribution of users on Twitter was highly correlated with population estimates from the United States Census Bureau’s 5-year survey from 2016 (<i>r</i><sup>2</sup>=0.99; <i>P</i>&lt;.001). From 2013 to 2016, the average patient experience sentiment was highest for White patients, followed by Asian/Pacific Islander, Hispanic/Latino, and American Indian/Alaska Native patients. A reduction in negative patient experience sentiment on Twitter for all racial and ethnic groups was seen from 2013 to 2016. Twitter users who identified as Hispanic/Latino showed the greatest improvement in patient experience, with a 1.5 times greater increase (<i>P</i>&lt;.001) than Twitter users who identified as White. Twitter users who identified as Black had the highest increase in patient experience postimplementation of the ACA (2014-2016) compared with preimplementation of the ACA (2013), and this change was 2.2 times (<i>P</i>&lt;.001) greater than Twitter users who identified as White. CONCLUSIONS The ACA mandated the implementation of the measurement of patient experience of care delivery. Considering that quality assessment of care is required, Twitter may offer the ability to monitor patient experiences across diverse racial and ethnic groups and inform the evaluation of health policies like the ACA.

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