The Role of Poverty and Racial Discrimination in Exacerbating the Health Consequences of COVID-19

Parolin, Zachary; Lee, Emma K.

doi:10.1016/j.lana.2021.100178

Cited by 53 publications

(37 citation statements)

References 34 publications

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“…The prevailing paradigm that highly specialized medicine and high total spending lead to better care for the entire population must be questioned in light of the data presented here. Social equity may be more relevant than the degree of specialization and overall health care spending (33). This means that in addition to classic risk factors, social determinants should be considered as the more relevant factors for improving and maintaining health (34).…”

Section: Discussionmentioning

confidence: 99%

Differences in mortality in Switzerland by citizenship during the first and second COVID-19 waves: Analysis of death statistics

Plümecke

Mikosch

Mohrenberg³

et al. 2022

Front. Public Health

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BackgroundEarly in the COVID-19 pandemic, it became apparent that members of marginalized populations and immigrants were also at risk of being hospitalized and dying more frequently from COVID-19. To examine how the pandemic affected underserved and marginalized populations, we analyzed data on changes in the number of deaths among people with and without Swiss citizenship during the first and second SARS-CoV-2 waves.MethodWe analyzed the annual number of deaths from the Swiss Federal Statistical Office from 2015 to 2020, and weekly data from January 2020 to May 2021 on deaths of permanent residents with and without Swiss citizenship, and we differentiated the data through subdivision into age groups.ResultsPeople without Swiss citizenship show a higher increase in the number of deaths in 2020 than those who were Swiss citizens. The increase in deaths compared to the previous year was almost twice as high for people without Swiss citizenship (21.8%) as for those with it (11.4%). The breakdown by age group indicates that among people between the ages of 64 and 75, those without Swiss citizenship exhibited an increase in mortality (21.6%) that was four times higher than that for people with Swiss citizenship (4.7%).ConclusionThis study confirms that a highly specialized health care system, as is found in Switzerland, does not sufficiently guarantee that all parts of the population will be equally protected in a health crisis such as COVID-19.

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Section: Discussionmentioning

confidence: 99%

Differences in mortality in Switzerland by citizenship during the first and second COVID-19 waves: Analysis of death statistics

Plümecke

Mikosch

Mohrenberg³

et al. 2022

Front. Public Health

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“…These observed associations reflected the differential impacts of COVID-19-specific sequelae that have significant policy implications. Our findings may also reflect a consequence of pre-existing systemic and structural racism that was further exacerbated differentially at multiple levels during the pandemic [36][37][38].…”

Section: Principal Findingsmentioning

confidence: 81%

Racial Bias Beliefs Related to COVID-19 Among Asian Americans, Native Hawaiians, and Pacific Islanders: Findings From the COVID-19 Effects on the Mental and Physical Health of Asian Americans and Pacific Islanders Survey Study (COMPASS)

Park¹,

Tsoh²,

Dougan³

et al. 2022

J Med Internet Res

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Background During the COVID-19 pandemic, there have been increased reports of racial biases against Asian American and Native Hawaiian and Pacific Islander individuals. However, the extent to which different Asian American and Native Hawaiian and Pacific Islander groups perceive and experience (firsthand or as a witness to such experiences) how COVID-19 has negatively affected people of their race has not received much attention. Objective This study used data from the COVID-19 Effects on the Mental and Physical Health of Asian Americans and Pacific Islanders Survey Study (COMPASS), a nationwide, multilingual survey, to empirically examine COVID-19–related racial bias beliefs among Asian American and Native Hawaiian and Pacific Islander individuals and the factors associated with these beliefs. Methods COMPASS participants were Asian American and Native Hawaiian and Pacific Islander adults who were able to speak English, Chinese (Cantonese or Mandarin), Korean, Samoan, or Vietnamese and who resided in the United States during the time of the survey (October 2020 to May 2021). Participants completed the survey on the web, via phone, or in person. The Coronavirus Racial Bias Scale (CRBS) was used to assess COVID-19–related racial bias beliefs toward Asian American and Native Hawaiian and Pacific Islander individuals. Participants were asked to rate the degree to which they agreed with 9 statements on a 5-point Likert scale (ie, 1=strongly disagree to 5=strongly agree). Multivariable linear regression was used to examine the associations between demographic, health, and COVID-19–related characteristics and perceived racial bias. Results A total of 5068 participants completed the survey (mean age 45.4, SD 16.4 years; range 18-97 years). Overall, 73.97% (3749/5068) agreed or strongly agreed with ≥1 COVID-19–related racial bias belief in the past 6 months (during the COVID-19 pandemic). Across the 9 racial bias beliefs, participants scored an average of 2.59 (SD 0.96, range 1-5). Adjusted analyses revealed that compared with Asian Indians, those who were ethnic Chinese, Filipino, Hmong, Japanese, Korean, Vietnamese, and other or multicultural had significantly higher mean CRBS scores, whereas no significant differences were found among Native Hawaiian and Pacific Islander individuals. Nonheterosexual participants had statistically significant and higher mean CRBS scores than heterosexual participants. Compared with participants aged ≥60 years, those who were younger (aged <30, 30-39, 40-49, and 50-59 years) had significantly higher mean CRBS scores. US-born participants had significantly higher mean CRBS scores than foreign-born participants, whereas those with limited English proficiency (relative to those reporting no limitation) had lower mean CRBS scores. Conclusions Many COMPASS participants reported racial bias beliefs because of the COVID-19 pandemic. Relevant sociodemographic contexts and pre-existing and COVID-19–specific factors across individual, community, and society levels were associated with the perceived racial bias of being Asian during the pandemic. The findings underscore the importance of addressing the burden of racial bias on Asian American and Native Hawaiian and Pacific Islander communities among other COVID-19–related sequelae.

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“…The COVID-19 pandemic has exacerbated pre-existing socioeconomic and health disparities worldwide [ 30 ] which, in turn, increase the risk of SARS-CoV-2 infection and COVID-19 morbidity in children. This is due to poverty-related comorbidities (e.g., malnutrition), reduced access to healthcare, low-quality and overcrowded housing, and parents′ exposure to high-risk occupations [ 31 ]. We note, however, that some SARS-CoV-2 seropositive children may have been misclassified as having experienced clinically apparent COVID-19 in our study if they had other poverty-related respiratory infections leading to cough, shortness of breath, or loss of taste or smell.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 seropositivity and COVID-19 among 5 years-old Amazonian children and their association with poverty and food insecurity

et al. 2022

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Background The epidemiology of childhood SARS-CoV-2 infection and COVID-19-related illness remains little studied in high-transmission tropical settings, partly due to the less severe clinical manifestations typically developed by children and the limited availability of diagnostic tests. To address this knowledge gap, we investigate the prevalence and predictors of SARS-CoV-2 infection (either symptomatic or not) and disease in 5 years-old Amazonian children. Methodology/Principal findings We retrospectively estimated SARS-CoV-2 attack rates and the proportion of infections leading to COVID-19-related illness among 660 participants in a population-based birth cohort study in the Juruá Valley, Amazonian Brazil. Children were physically examined, tested for SARS-CoV-2 IgG and IgM antibodies, and had a comprehensive health questionnaire administered during a follow-up visit at the age of 5 years carried out in January or June-July 2021. We found serological evidence of past SARS-CoV-2 infection in 297 (45.0%; 95% confidence interval [CI], 41.2–48.9%) of 660 cohort participants, but only 15 (5.1%; 95% CI, 2.9–8.2%) seropositive children had a prior medical diagnosis of COVID-19 reported by their mothers or guardians. The period prevalence of clinically apparent COVID-19, defined as the presence of specific antibodies plus one or more clinical symptoms suggestive of COVID-19 (cough, shortness of breath, and loss of taste or smell) reported by their mothers or guardians since the pandemic onset, was estimated at 7.3% (95% CI, 5.4–9.5%). Importantly, children from the poorest households and those with less educated mothers were significantly more likely to be seropositive, after controlling for potential confounders by mixed-effects multiple Poisson regression analysis. Likewise, the period prevalence of COVID-19 was 1.8-fold (95%, CI 1.2–2.6-fold) higher among cohort participants exposed to food insecurity and 3.0-fold (95% CI, 2.8–3.5-fold) higher among those born to non-White mothers. Finally, children exposed to household and family contacts who had COVID-19 were at an increased risk of being SARS-CoV-2 seropositive and–even more markedly–of having had clinically apparent COVID-19 by the age of 5 years. Conclusions/Significance Childhood SARS-CoV-2 infection and COVID-19-associated illness are substantially underdiagnosed and underreported in the Amazon. Children in the most socioeconomically vulnerable households are disproportionately affected by SARS-CoV-2 infection and disease.

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The Role of Poverty and Racial Discrimination in Exacerbating the Health Consequences of COVID-19

Cited by 53 publications

References 34 publications

Differences in mortality in Switzerland by citizenship during the first and second COVID-19 waves: Analysis of death statistics

Differences in mortality in Switzerland by citizenship during the first and second COVID-19 waves: Analysis of death statistics

Racial Bias Beliefs Related to COVID-19 Among Asian Americans, Native Hawaiians, and Pacific Islanders: Findings From the COVID-19 Effects on the Mental and Physical Health of Asian Americans and Pacific Islanders Survey Study (COMPASS)

SARS-CoV-2 seropositivity and COVID-19 among 5 years-old Amazonian children and their association with poverty and food insecurity

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