Black People Narrate Inequalities in Healthcare Systems that Hinder COVID-19 Vaccination: Evidence from the USA and the UK

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global health emergency. As a novel condition, there is no known definitive treatment for the condition, except for the use of vaccines as a control measure. In the literature, the issue of inequalities in healthcare systems has been documented as a hindrance to COVID-19 vaccination; however, the specific inequalities in healthcare systems that hinder COVID-19 vaccination are poorly understood. Guided by the fundamental cause theory (FCT), this study aims to address this gap among Black people, a minority group vulnerable to inequalities in healthcare systems. Thirty-five Black people (age range = 21-58 years) residing in either the United States of America (USA) or the United Kingdom (UK) participated in this study. Qualitative data were collected and analyzed using thematic analysis. Most USA participants and a few UK participants narrated that no inequalities in healthcare systems hinder them from receiving COVID-19 vaccines. Contrarily, most UK participants and a few USA participants narrated inequalities in healthcare systems that hinder them from receiving COVID-19 vaccines. These are mistrust of the healthcare system, health policies regarding COVID-19 vaccination, historical factors (such as historical abuse of Black bodies by health professionals), residential location, and dissatisfaction with health services. In terms of what governments must do to correct these inequalities, participants recommended the need for acknowledgment and community engagement. This is the first international collaboration to examine this problem. Important implications for theory, healthcare systems, and COVID-19 vaccination program planning are highlighted. Finally, there are members of other minority groups and vulnerable communities who are not Black people. Such groups could face unique inequalities that hinder COVID-19 vaccination. Therefore, future studies should include such groups.

Using a Latent Variable Method to Develop a Composite, Multidimensional Measure of Structural Racism at the City Level

“…It may also aid public health practitioners in bringing attention to the important role that structural racism plays in creating and maintaining racial health disparities. Ogueji et al recently reported that U.S. adults have little appreciation for the influence of structural racism on COVID-19 vaccination rates [ 33 ]. Providing people with actual numbers to document the magnitude of racial health disparities and the magnitude of structural racism may help the public and policy makers to acknowledge [ 33 ] structural racism as a fundamental cause of adverse health.…”

Does education influence COVID-19 vaccination? A global view

“…In this sense, some studies have analyzed vulnerable minority groups. Thus, Ogueji et al [ 37 ] examined a narrow sample of 35 Black people, aged between 21 and 58, from the USA and the UK, to see to what extent they felt the injustices in the health system, reflected in the absorption of COVID-19 vaccines; it turned out that more participants from the UK reported blockages related to historical factors, residence, uniform application of health policies or differentiated actions, compared to those from the USA [ 37 ]. Other researches identified racial disparities in relation to the acceptability of the COVID-19 vaccine.…”

Reflections on inequalities: the pandemic, cost-of-living crisis, and vaccines

“…It is well reported that inequalities will arise because of the barriers people and communities face when accessing health and care services, which then leads to mistrust of these systems. 29 This can then lead to inequalities in terms of access to information and the creation of the types of services which best suit particular communities. 30…”