scholarly journals Confronting Disparities: Race, Ethnicity, and Immigrant Status as Intersectional Determinants in the COVID-19 Era

2021 ◽  
pp. 109019812110115
Author(s):  
Denise N. Obinna

The COVID-19 (coronavirus disease–2019) pandemic has exposed long-standing inequalities in U.S. health care. Historically, racial and ethnic minorities have been the most likely to suffer from inadequate health care access and insurance coverage. With the spread of COVID-19, these disparities have dramatically increased. Focusing on native and foreign-born racial/ethnic minorities, this article discusses how entrenched health inequities and structural discrimination have led to COVID-19 morbidities and mortalities. Considering that “essential” frontline workers are disproportionately native and foreign-born racial/ethnic minorities, this work evaluates the impact(s) of social exclusion and the lack of support systems for these workers. Using the framework of intersectionality, this work also examines how race and immigrant status affect COVID-19 spread in prisons and immigration detention centers—facilities that often lack effective health and sanitary conditions and where inmates are also likely to be racial/ethnic minorities.

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S308-S308
Author(s):  
Patricia RaccamarichClaudia S Uribe ◽  
Ana S Salazar Zetina ◽  
Emily K Montgomerie ◽  
Douglas Salguero ◽  
Alejandro M Mantero ◽  
...  

Abstract Background As the COronaVIrus Disease 2019 (COVID-19) continues to unfold, drastic changes in daily life pose significant challenges on mental and clinical health. While public health interventions such as national lockdowns and social distancing are enforced to reduce the spread of COVID-19, the psychosocial and physical consequences have yet to be determined that may disproportionately affect people living with HIV (PLWH). Methods To evaluate the impact of COVID-related stress on mental and clinical health, we conducted a 20-minute questionnaire eliciting sociodemographic information, clinical and psychological factors from people living in Miami, Fl. All individuals >18 years with or without a history of COVID-19 were included. Participating PLWH were recruited from an existing HIV registry and HIV uninfected participants from community flyers and word of mouth. Results A total of 135 participants were recruited from 05/2020-06/2020. The mean age was 50 years old, 73/135 (54%) were female, and 102/135 (75%) were PLWH. Among participating PLWH, 60/102 (58.8%) self-identified as African American, and 9/102 (8.8%) were positive for COVID-19 by a commercially approved test. Among HIV-negative participants, 15/33 (45.5%) self-identified as White and 11/33 (33%) were positive for COVID-19. Both PLWH and HIV-negative participants described significant disruptions in health care access (47%), difficulty paying basic needs (41%), and feelings of anxiety and depression (48%); there was no statistically significant difference by HIV status. However, HIV negative participants were less likely to experience job loss and income disruption compared to PLWH during the pandemic (70% for HIV-negative vs 48% for PLWH; OR 0.40, p=0.03). Conclusion The impact of COVID-19 on emotional and clinical health is significant in both PLWH and HIV-negative groups. These findings highlight the need for providing mental and physical health care during the pandemic, especially for coping with stress and anxiety during these difficult times and ensuring adequate access to health care. Disclosures All Authors: No reported disclosures


Author(s):  
Haochuan Xu ◽  
Han Yang ◽  
Hui Wang ◽  
Xuefeng Li

Due to the limitations in the verifiability of individual identity, migrant workers have encountered some obstacles in access to public health care services. Residence permits issued by the Chinese government are a solution to address the health care access inequality faced by migrant workers. In principle, migrant workers with residence permits have similar rights as urban locals. However, the validity of residence permits is still controversial. This study aimed to examine the impact of residence permits on public health care services. Data were taken from the China Migrants Dynamic Survey (CMDS). Our results showed that the utilization of health care services of migrant workers with residence permits was significantly better than others. However, although statistically significant, the substantive significance is modest. In addition, megacities had significant negative moderating effects between residence permits and health care services utilization. Our research results emphasized that reforms of the household registration system, taking the residence permit system as a breakthrough, cannot wholly address the health care access inequality in China. For developing countries with uneven regional development, the health care access inequality faced by migrant workers is a structural issue.


2019 ◽  
Author(s):  
koku Tamirat ◽  
Zemenu Tadesse Tessema ◽  
Fentahun Bikale Kebede

Abstract Background Health care access is timely use of personal health services to achieve best health outcomes. Difficulties to access health care among reproductive age women may led to different negative health outcomes to death and disability. Therefore, this study aimed to assess factors associated with problems of accessing health care among reproductive age women in Ethiopia.Method This study was based on 2016 Ethiopia Demography and Health Survey. Individual women record (IR) file was used to extract the dataset and 15, 683 women were included in the final analysis. A composite variable of problem of accessing health care were created from four questions used to rate problem of accessing health care among reproductive age women. Generalized estimating equation (GEE) model was fitted to identify factors associated with problem of accessing health care. Crude and Adjusted odds ratio with a 95%CI computed to assess the strength of association between independent and outcome variables.Result In this study the magnitude of problem in accessing health care among reproductive age women was 69.9% of with 95%CI (69.3 to 70.7). Rural residence (AOR= 2.13, 95%CI: 1.79 to 2.53), women age 35-49 years (AOR= 1.24, 95%CI: 1.09 to 1.40), married/live together (AOR= 0.72, 95%CI: 0.64 to 0.81), had health insurance coverage (AOR=0.83, 95%CI: 0.70 to 0.95), wealth index [middle (AOR=0.75,95%CI: 0.66 to 0.85) and rich (AOR=0.47,95%CI:0.42 to 0.53)], primary education(AOR= 0.80, 95%CI: 0.73 to 0.88), secondary education (AOR= 0.57, 95%CI:0.50 to 0.64) and diploma and higher education (AOR= 0.43, 95%CI: 0.37 to 0.50) were factors associated with problem of health care access among reproductive age women.Conclusion Despite better coverage of health system, problems of health care access among reproductive age women were considerably high. Health insurance coverage, middle and rich wealth, primary and above educational level were negatively associated with problems health care access. In contrast, older age and rural residence were positively associated with problems of health care access among reproductive age women. This suggests that further interventions are necessary to increase universal reproductive health care access for the achievement of sustainable development goals.


2019 ◽  
Vol 89 (1) ◽  
pp. 3-21
Author(s):  
Jane J. Lee ◽  
Hyun-Jun Kim ◽  
Karen Fredriksen Goldsen

Lesbian, gay, bisexual, and transgender (LGBT) aging research is growing around the globe. Yet, few studies have examined the interconnectedness of different populations and cultures. This study examines whether LGBT foreign-born older adults experience greater health disparities than their U.S.-born counterparts. We conducted a cross-sectional analysis of the National Health, Aging, and Sexuality/Gender Study: Aging with Pride from 2014, which assessed measures of health and well-being among LGBT adults aged 50 years and older ( n = 2,441). We compared sociodemographic characteristics, health-care access, health behaviors, and health outcomes between foreign-born and U.S.-born participants. Foreign-born LGBT older adults reported greater socioeconomic disadvantage and higher levels of experiencing barriers to health-care access than U.S.-born LGBT older adults. Groups did not significantly differ in health behaviors and health outcomes when controlling for sociodemographic factors. Greater understanding of the mechanisms that shape the relationship between migration and health among the LGBT population is warranted.


2011 ◽  
Vol 27 (3) ◽  
pp. 204-212 ◽  
Author(s):  
E. Richardson ◽  
B. Roberts ◽  
V. Sava ◽  
R. Menon ◽  
M. McKee

1984 ◽  
Vol 4 (4) ◽  
pp. 293-302 ◽  
Author(s):  
E. Richard Brown

Cutbacks in public health care programs at federal, state, and local levels have reduced the health care access of many low-income persons. Based on findings from several California studies, this article suggests several roles for health educators intended to prevent cutbacks or mitigate their impact. Methods of preventing cutbacks rely on community organization methods and coalitions including health education professional groups. When preventive actions are unsuccessful, health educators may ease the impact of cutbacks by developing adequate education interventions for users of affected services and community organization strategies to improve access to remaining services. Specific methods are suggested and discussed.


Sign in / Sign up

Export Citation Format

Share Document