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

Abstract

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.

Exploring the intersection of racism, antimicrobial resistance, and vaccine equity

“…1,2 Also, minoritized individuals are more likely to have comorbidities that further complicate their disease severity and may compromise their humoral immune response functions. 4,5,37 Furthermore, severe illness and complications, leading to prolonged hospital lengths of stay, have been linked to the development of AMR infections secondary to the primary infectious disease (viral infection). 38 More recently, hospitalizations due to severe coronavirus disease-19 (COVID-19) have been shown to result in the development of AMR infections.…”

So you say our work is essential: Essential workers and the potential for transformative learning in the wake of COVID‐19 social and economic disruption

“…As a result of systematic forms of injustice, racism, and sexism, women, Blacks, and people of color make up a disproportionate share of essential workers (Bahn & Cumming, 2020 ; Economic Policy Institute, 2021 ). It is troubling that these are the same communities that have been hit most hard by COVID‐19 (Obinna, 2021 ). Essential workers perform jobs without effective workplace protection and proper wages, making it difficult for them to survive (Nicholson, 2022 ; Sell, 2020 ).…”

COVID-19 testing, infection, and vaccination among deported Mexican migrants: Results from a survey on the Mexico-U.S. border

“…According to the 2021 Census, 18% of the United States (U.S.) population is Latino/Hispanic, and one of every three Latinos is foreign-born (1). Migration status constitutes a social determinant of health (2,3) because of its relation to stigma, language (4), lower social and economic status, cultural barriers (5,6), and legal status. Among Latino immigrants, two in three are not U.S. citizens and around eight million are unauthorized immigrants (7).…”

“…Data from around the world has shown a disproportionate impact of the COVID-19 pandemic on migrants (9). In the U.S., while availability of disaggregated data by nativity has been limited (10), there is mounting evidence that foreignborn Latinos have borne a heavy burden of the COVID-19 pandemic and have experienced significant barriers to testing and treatment (2,10,11).…”

“…For Latino immigrants, increased COVID-19 risk is related to social and structural determinants of health (12)(13)(14)(15). These include occupational profile (2,10), such as inability to work remotely, lack of sustainable and safe working conditions (10, 16), overrepresentation in "essential" frontline jobs (2,10,17), lack of paid leave if they get sick, (16) lack of flexible working hours, lack of leisure time (12), lack of health insurance or healthcare through work, (10, 18) and/or ability to miss work (19). Other risk factors are limited healthcare access and insurance rates (20, 21), overcrowding, (11,22,23) immigration enforcement (3,10,11,(24)(25)(26), and lack of legal protections (27).…”