Examining Social Determinants of Health, Stigma, and COVID-19 Disparities

Turner‐Musa, Jocelyn; Ajayi, Oluseyi O.; Kemp, Layschel

doi:10.3390/healthcare8020168

Cited by 164 publications

(161 citation statements)

References 6 publications

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“…Also, with an increasing number of cases in SA, there has been a significant increase in the stigmatization of anyone remotely related to COVID-19. Stigma and discrimination that stems from COVID-19 can occur when people associate it with nationality or being a foreign-born migrants and can lead to further social avoidance, denial of health care, and perhaps even violence fueling secondary health concerns [30]. Stigma also makes people feel isolated; even to the point of feeling abandoned and increases the chances of anxiety and depression [31].…”

Section: Unspoken Inequalitymentioning

confidence: 99%

Unspoken inequality: how COVID-19 has exacerbated existing vulnerabilities of asylum-seekers, refugees, and undocumented migrants in South Africa

Mukumbang

Ambe

Adebiyi

2020

Int J Equity Health

153

143

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An estimated 2 million foreign-born migrants of working age (15-64) were living in South Africa (SA) in 2017. Structural and practical xenophobia has driven asylum-seekers, refugees, and undocumented migrants in SA to abject poverty and misery. The Coronavirus Disease 2019 (COVID-19) containment measures adopted by the SA government through the lockdown of the nation have tremendously deepened the unequal treatment of asylumseekers and refugees in SA. This can be seen through the South African government's lack of consideration of this marginalized population in economic, poverty, and hunger alleviation schemes. Leaving this category of our society out of the national response safety nets may lead to negative coping strategies causing mental health issues and secondary health concerns. An effective response to the socioeconomic challenges imposed by the COVID-19 pandemic should consider the economic and health impact of the pandemic on asylum-seekers, refugees, and undocumented migrants.

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Section: Unspoken Inequalitymentioning

confidence: 99%

Unspoken inequality: how COVID-19 has exacerbated existing vulnerabilities of asylum-seekers, refugees, and undocumented migrants in South Africa

Mukumbang

Ambe

Adebiyi

2020

Int J Equity Health

153

143

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“…Underlying health conditions and comorbidities may partially explain these associations [ 5 ], but do not fully account for the disproportionate burden. Recent studies suggest that social determinants of health and community contextual factors contribute to these disparities, and that socially vulnerable communities are at highest risk for COVID-19 outbreaks [ 6 , 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States

Neelon

Mutiso

Mueller

et al. 2020

Preprint

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Background: Emerging evidence suggests that socially vulnerable communities are at higher risk for coronavirus disease 2019 (COVID-19) outbreaks in the United States. However, no prior studies have examined temporal trends and differential effects of social vulnerability on COVID-19 incidence and death rates. The purpose of this study was to examine temporal trends among counties with high and low social vulnerability and to quantify disparities in these trends over time. We hypothesized that highly vulnerable counties would have higher incidence and death rates compared to less vulnerable counties and that this disparity would widen as the pandemic progressed. Methods: We conducted a retrospective longitudinal analysis examining COVID-19 incidence and death rates from March 1 to August 31, 2020 for each county in the US. We obtained daily COVID-19 incident case and death data from USAFacts and the Johns Hopkins Center for Systems Science and Engineering. We classified counties using the Social Vulnerability Index (SVI), a percentile-based measure from the Centers for Disease Control and Prevention in which higher scores represent more vulnerability. Using a Bayesian hierarchical negative binomial model, we estimated daily risk ratios (RRs) comparing counties in the first (lower) and fourth (upper) SVI quartiles. We adjusted for percentage of the county designated as rural, percentage in poor or fair health, percentage of adult smokers, county average daily fine particulate matter (PM2.5), percentage of primary care physicians per 100,000 residents, and the proportion tested for COVID-19 in the state. Results: In unadjusted analyses, we found that for most of March 2020, counties in the upper SVI quartile had significantly fewer cases per 100,000 than lower SVI quartile counties. However, on March 30, we observed a crossover effect in which the RR became significantly greater than 1.00 (RR = 1.10, 95% PI: 1.03, 1.18), indicating that the most vulnerable counties had, on average, higher COVID-19 incidence rates compared to least vulnerable counties. Upper SVI quartile counties had higher death rates on average starting on March 30 (RR = 1.17, 95% PI: 1.01,1.36). The death rate RR achieved a maximum value on July 29 (RR = 3.22, 95% PI: 2.91, 3.58), indicating that most vulnerable counties had, on average, 3.22 times more deaths per million than the least vulnerable counties. However, by late August, the lower quartile started to catch up to the upper quartile. In adjusted models, the RRs were attenuated for both incidence cases and deaths, indicating that the adjustment variables partially explained the associations. We also found positive associations between COVID-19 cases and deaths and percentage of the county designated as rural, percentage of resident in fair or poor health, and average daily PM2.5. Conclusions: Results indicate that the impact of COVID-19 is not static but can migrate from less vulnerable counties to more vulnerable counties over time. This highlights the importance of protecting vulnerable populations as the pandemic unfolds.

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“…The fact that COVID-19 is perceived by many mental health experts as stigma is dangerous. [ 23 24 25 ] Stigma can undermine social cohesion and generate social isolation of individuals which multiply the negative impact of COVID-19 on mental health. The issue for all HCWs is to change the attitude to patients who are suspected or diagnosed with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

What mental health experts in Slovakia are learning from COVID-19 pandemic?

Izáková

Breznoscakova

Jandova

et al. 2020

Indian J Psychiatry

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Introduction: The COVID-19 pandemic was confirmed to have spread to Slovakia on 6th March 2020. To date of paper submission, it has very favorable course. However, since the beginning healthcare workers have been working under increasing pressure, anxiety and fear. Aim: Authors evaluated the psychosocial impact of COVID-19 pandemic on mental health experts and their clinical practice in Slovakia. Materials and Methods: A total of 157 mental health experts (79% women) submitted their responses via online questionnaire. Results: The most frequent occupation categories were 38.2% outpatient psychiatrists, 26.1% inpatient psychiatrists and 20.4% psychologists. The mental health experts felt maximum of stress during the peak of Slovak COVID-19 crisis, which was identified as the situation just after the declaring the state of emergency by Slovak government. The main sources of stress were statistical data, prognoses and other public presented information. Mental health experts felt mainly personal stress, then general and working stress. They identified also pathological effect of COVID-19 pandemic on the mental status of their patients, especially with anxiety and affective disorders and advantages of use of telemedicine. Conclusion: Psychosocial support in Slovakia was newly organized in COVID-19 pandemic for medical professionals, patients and other inhabitants under high stress within a very short time. This unexpected situation has revealed to Slovakia the need for reform of the mental healthcare system.

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Examining Social Determinants of Health, Stigma, and COVID-19 Disparities

Cited by 164 publications

References 6 publications

Unspoken inequality: how COVID-19 has exacerbated existing vulnerabilities of asylum-seekers, refugees, and undocumented migrants in South Africa

Unspoken inequality: how COVID-19 has exacerbated existing vulnerabilities of asylum-seekers, refugees, and undocumented migrants in South Africa

Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States

What mental health experts in Slovakia are learning from COVID-19 pandemic?

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