This Is America: Systemic Racism and Health Inequities Amidst the COVID-19 Pandemic

García, Moctezuma

doi:10.1080/19371918.2021.1981509

Cited by 18 publications

(20 citation statements)

References 30 publications

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“…In Germany, Haase (2020) pointed out that discrimination-free access to green spaces is shaped differently across groups, thereby emphasizing socioeconomic status and poverty. In the United States, access to green spaces was more often seen on the nexus to racism, which was related to low socioeconomic status ( Bikomeye et al, 2021 ; Garcia, 2021 ). In Latin America, inequality in resource allocation and the lack of financial aid by the state resulted in the higher vulnerability of the population ( Andia and Chorev, 2021 ).…”

Section: Resultsmentioning

confidence: 99%

“…In addition to current inequalities, United States perspectives emphasized that historic events influence vulnerabilities ( Krishnan et al, 2020 ; Garcia, 2021 ) regardless of elapsed time. For example, United States-based commentaries pointed out that racism toward BIPOC patients deteriorates trust in the health care system ( Walubita et al, 2021 ); recounts of the 1918 influenza pandemic reveal neglect and erasure of BIPOC in documentation of diseases and civic and healthcare participation.…”

Section: Resultsmentioning

confidence: 99%

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Using an Intersectional Lens on Vulnerability and Resilience in Minority and/or Marginalized Groups During the COVID-19 Pandemic: A Narrative Review

Siller

Aydin

2022

Front. Psychol.

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Throughout the pandemic, the media and scholars have widely discussed increasing social inequality and thereby publicly pointed to often hidden and neglected forms of inequality. However, the “newly” arisen awareness has not yet been put into action to reduce this inequality. Dealing with social inequality implies exploring and confronting social privileges, which are often seen as the other side of inequality. These social constructs, inequality and privilege, are often discussed in light of vulnerability and resilience. This is particularly important in the context of the worldwide coronavirus disease 2019 (COVID-19) pandemic and efforts to end the pandemic, as both constructs are discussed regarding access to healthcare, vaccination, and education and knowledge, misinformation, social resources, economic resources, and so forth. Minority and/or marginalized groups may be particularly vulnerable to the impact of the COVID-19 pandemic. However, resilience factors in these groups may be neglected and underreported. This narrative review aims at illustrating the specific and intertwined aspects of resilience and vulnerability in minority and/or marginalized groups during the COVID-19 pandemic. To achieve this, we use an intersectional lens based on recommendations made by Moradi and Grzanka. A total of 48 articles were included in the narrative review. Most of them were commentaries focusing on social inequality, vulnerability, and/or resilience. Based on the dissection of articles at structural, systemic, and individual levels, we propose three hypothesis on vulnerability and resilience in minority and marginalized individuals and groups: (1) social inequality must be considered at a global level; inequality at a global level translates into a vulnerable context for an individual; (2) vulnerability is historically situated: vulnerability (experienced during the pandemic) is maintained and reinforced by history; (3) strength through collective (historical) hardship: vulnerability is not the opposite of resilience but may serve as an aspect of resilience. The conclusions drawn from this review show that we need to include diverse voices to advance concepts, such as vulnerability and resilience, in minority and marginalized groups. Additionally, these concepts are not necessarily in opposition to each other, but vulnerability should be understood as an integral part of resilience.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Using an Intersectional Lens on Vulnerability and Resilience in Minority and/or Marginalized Groups During the COVID-19 Pandemic: A Narrative Review

Siller

Aydin

2022

Front. Psychol.

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“…In the USA, non-White race and Hispanic ethnicity are associated with adverse health exposures, poorer access to healthcare, and discrimination in their interactions with the health system due to systemic racism. 13 – 19 Studying healthcare delivery by racial/ethnic group should not be interpreted as reflecting any genetic or biologic risk for COVID-19 illness severity. We collected race and ethnicity data following NIH guidelines; race: White, Black or African American, Asian, American Indian or Alaska Native, and Native Hawaiian or Pacific Islander and ethnicity: Hispanic or non-Hispanic.…”

Section: Methodsmentioning

confidence: 99%

Advance Care Planning and Treatment Intensity Before Death Among Black, Hispanic, and White Patients Hospitalized with COVID-19

Barnato

Johnson²,

Birkmeyer

et al. 2022

J GEN INTERN MED

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Background Black and Hispanic people are more likely to contract COVID-19, require hospitalization, and die than White people due to differences in exposures, comorbidity risk, and healthcare access. Objective To examine the association of race and ethnicity with treatment decisions and intensity for patients hospitalized for COVID-19. Design Retrospective cohort analysis of manually abstracted electronic medical records. Patients 7,997 patients (62% non-Hispanic White, 16% non-Black Hispanic, and 23% Black) hospitalized for COVID-19 at 135 community hospitals between March and June 2020 Main Measures Advance care planning (ACP), do not resuscitate (DNR) orders, intensive care unit (ICU) admission, mechanical ventilation (MV), and in-hospital mortality. Among decedents, we classified the mode of death based on treatment intensity and code status as treatment limitation (no MV/DNR), treatment withdrawal (MV/DNR), maximal life support (MV/no DNR), or other (no MV/no DNR). Key Results Adjusted in-hospital mortality was similar between White (8%) and Black patients (9%, OR=1.1, 95% CI=0.9–1.4, p =0.254), and lower among Hispanic patients (6%, OR=0.7, 95% CI=0.6–1.0, p =0.032). Black and Hispanic patients were significantly more likely to be treated in the ICU (White 23%, Hispanic 27%, Black 28%) and to receive mechanical ventilation (White 12%, Hispanic 17%, Black 16%). The groups had similar rates of ACP (White 12%, Hispanic 12%, Black 11%), but Black and Hispanic patients were less likely to have a DNR order (White 13%, Hispanic 8%, Black 7%). Among decedents, there were significant differences in mode of death by race/ethnicity (treatment limitation: White 39%, Hispanic 17% ( p =0.001), Black 18% ( p <0.0001); treatment withdrawal: White 26%, Hispanic 43% ( p =0.002), Black 28% ( p =0.542); and maximal life support: White 21%, Hispanic 26% ( p =0.308), Black 36% ( p <0.0001)). Conclusions Hospitalized Black and Hispanic COVID-19 patients received greater treatment intensity than White patients. This may have simultaneously mitigated disparities in in-hospital mortality while increasing burdensome treatment near death.

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“…Concomitantly, Olivier, Honorary Professor at University of the Free State in South Africa, denounced in a preprint that some authorities pitted the vaccinees against the unvaccinated with specious statements, regardless of the fact that the virus mutates in the vaccinees ( 38 ). Additionally, Dr. Garcia criticized that U.S. CDC concluded better understanding the biological-social implications due to systemic racism ( 39 ).…”

Section: Resultsmentioning

confidence: 99%

Open Debates Conducive for Vaccination Rate Flatlines: A Scoping Review and Convergent Cross Mapping

Chen

2022

Front. Public Health

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COVID-19 pandemic is fueling digital health transformation—accelerating innovations of digital health services, surveillance, and interventions, whereas hastening social contagion of deliberate infodemic. The USA and many other countries are experiencing a resurgent wave of the COVID-19 pandemic with vaccination rate slowdown, making policymaking fraught with challenges. Political leaders and scientists have publicly warned of a “pandemic of the unvaccinated,” reinforcing their calls for citizens to get jabs. However, some scientists accused elites of stigmatizing the unvaccinated people and undermining the moral pillars of public health. Following the PRISMA-ScR guidelines, we first reviewed the nuances of stakeholders involved in the ongoing debates and revealed the potential consequences of divisive pronouncements to provide perspectives to reframe extensible discussions. Then, we employed the convergent cross mapping (CCM) model to reveal the uncharted knock-on effects of the contentious tsunami in a stakeholders-oriented policymaking framework, coupled with rich metadata from the GDELT project and Google Trends. Our experimental findings suggest that current news coverage may shape the mindsets of the vaccines against the unvaccinated, thereby exacerbating the risk of dualistic antagonism in algorithmically infused societies. Finally, we briefly summarized how open debates are conducive to increasing vaccination rates and bolstering the outcomes of impending policies for pandemic preparedness.

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This Is America: Systemic Racism and Health Inequities Amidst the COVID-19 Pandemic

Cited by 18 publications

References 30 publications

Using an Intersectional Lens on Vulnerability and Resilience in Minority and/or Marginalized Groups During the COVID-19 Pandemic: A Narrative Review

Using an Intersectional Lens on Vulnerability and Resilience in Minority and/or Marginalized Groups During the COVID-19 Pandemic: A Narrative Review

Advance Care Planning and Treatment Intensity Before Death Among Black, Hispanic, and White Patients Hospitalized with COVID-19

Open Debates Conducive for Vaccination Rate Flatlines: A Scoping Review and Convergent Cross Mapping

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