Social Justice in Pandemic Preparedness

DeBruin, Debra A.; Liaschenko, Joan; Marshall, Mary Faith

doi:10.2105/ajph.2011.300483

Cited by 88 publications

(75 citation statements)

References 15 publications

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“…In order to mitigate the negative consequences of stigmatization during pandemic outbreaks, public health officials must learn to recognize the dynamics that underlie this process, with special emphasis on protecting members of disadvantaged population groups [7,15]. Hence, it is important to understand how people’s fear of contagion during the 2009 H1N1 outbreak became associated with a broader set of fears about Latinos and the roles they play in American society.…”

Section: Introductionmentioning

confidence: 99%

The H1N1 pandemic: media frames, stigmatization and coping

2013

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BackgroundThroughout history, people have soothed their fear of disease outbreaks by searching for someone to blame. Such was the case with the April 2009 H1N1 flu outbreak. Mexicans and other Latinos living in the US were quickly stigmatized by non-Latinos as carriers of the virus, partly because of news reports on the outbreak’s alleged origin in Mexican pig farms.MethodsIn this exploratory study we examined the psychological processes of cue convergence and associative priming, through which many people likely conflated news of the H1N1 outbreak with pre-existing cognitive scripts that blamed Latino immigrants for a variety of social problems. We also used a transactional model of stress and coping to analyze the transcripts from five focus groups, in order to examine the ways in which a diverse collection of New England residents appraised the threat of H1N1, processed information about stereotypes and stigmas, and devised personal strategies to cope with these stressors.ResultsTwelve themes emerged in the final wave of coding, with most of them appearing at distinctive points in the stress and coping trajectories of focus group participants. Primary and secondary appraisals were mostly stressful or negative, with participants born in the USA reporting more stressful responses than those who were not. Latino participants reported no stressful primary appraisals, but spoke much more often than Whites or Non-Hispanic Blacks about negative secondary appraisals. When interactions between participants dealt with stigmas regarding Latinos and H1N1, Latinos in our focus groups reported using far more negative coping strategies than Whites or Non-Hispanic Blacks. When discussions did not focus on stereotypes or stigmas, Latino participants spoke much more often about positive coping strategies compared to members of these same groups.ConclusionsParticipants in all five focus groups went through a similar process of stress and coping in response to the threat of H1N1, though individual responses varied by race and ethnicity. Stigmatization has often been common during pandemics, and public health and emergency preparedness practitioners can help to mitigate its impacts by developing interventions to address the social stressors that occur during outbreaks in highly-localized geographic regions.

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Section: Introductionmentioning

confidence: 99%

The H1N1 pandemic: media frames, stigmatization and coping

2013

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“…For example, the availability and acceptability of interventions will depend on a host of social and political factors, which may change as the pandemic progresses [55][56][57][58]. Jurisdictional and community values must be carefully elicited and incorporated into the decision support system, not least because we know that pandemic response policies have the potential to perpetuate and exacerbate existing social disparities [59]. As shown in Fig 1, certain decision-maker priorities can be incorporated in system design (such as whether one type of evidence is more trusted than another), but ultimately, it is not expected that all social, political, and ethical considerations will be captured by system structures or parameters.…”

Section: The Decision Contextmentioning

confidence: 99%

Infectious disease pandemic planning and response: Incorporating decision analysis

et al. 2020

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“…Pandemics have historically disproportionately affected the most vulnerable people, highlighting lines of disadvantage based on race, economics, social class, and gender (DeBruin et al 2012). Indeed, the Zika pandemic in Brazil resulted from a "perfect storm" of causation.…”

Section: Paradox Of Pandemic Responsementioning

confidence: 99%

The Paradigm of the Paradox: Women, Pregnant Women, and the Unequal Burdens of the Zika Virus Pandemic

Harris

Silverman²,

Marshall

2016

The American Journal of Bioethics

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The inequalities of outcome are, by and large, biological reflections of social fault lines (Paul Farmer, 1999, 5) Three paradoxes characterize the Zika virus pandemic and clinical and policy responses to it:1. Zika virus has been shown to cause severe developmental anomalies in the fetuses of infected women. As a result, both women and men in endemic areas are asked to avoid or delay pregnancy. However, access to effective contraception and safe pregnancy termination is either not available (especially for those living below the poverty line) or a crime for many women in Zikaendemic regions. The Brazilian government is confiscating international shipments of pills for medical abortion and is reportedly aiming to increase sentencing minimums for women who obtain abortions for fetal anomalies linked to Zika infection. 2. Global approaches to pandemic planning and response, including those for the current Zika outbreak, are generally concerned with nominal fairness and the neutrality of procedural justice (i.e., response and allocation strategies equalize chances for those among the general population to receive benefits [or experience burdens]). Pandemic planners strive for systematic fairness by using (ostensibly) random processes (such as firstcome, first-served or a lottery) to allocate resources for those who are similarly prioritized. However, pandemics disproportionately affect the disadvantaged, meaning that neutral approaches to global Zika virus pandemic planning and resource allocation will perpetuate and in fact increase existing gender, social, and health disparities.3. Historically, concerns for the "vulnerability" of pregnant women and fetuses have resulted in the systematic exclusion of pregnant women from research. In addition, political opposition to abortion has made it increasingly difficult to conduct research using fetal tissue. However, research on Zika virus in fetal tissue collected at the time of pregnancy termination or loss could potentially help many pregnant women and their fetuses. Reluctance to engage in such research potentially exposes all pregnant women and their fetuses to unquantifiable risk.In this editorial, we examine and critique each of these paradoxes and reflect on the burdens that they inflict on women, especially pregnant women. International responses to the pandemic, and more specifically to the paradoxes embedded in these responses, have the potential to either advance reproductive justice or exacerbate existing reproductive injustice. BACKGROUND

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Social Justice in Pandemic Preparedness

Cited by 88 publications

References 15 publications

The H1N1 pandemic: media frames, stigmatization and coping

The H1N1 pandemic: media frames, stigmatization and coping

Infectious disease pandemic planning and response: Incorporating decision analysis

The Paradigm of the Paradox: Women, Pregnant Women, and the Unequal Burdens of the Zika Virus Pandemic

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