TY - JOUR
T1 - Association between racial discrimination and delayed or forgone care amid the COVID-19 pandemic
AU - Zhang, Donglan
AU - Li, Gang
AU - Shi, Lu
AU - Martin, Emily
AU - Chen, Zhuo
AU - Li, Jian
AU - Chen, Liwei
AU - Li, Yan
AU - Wen, Ming
AU - Chen, Baojiang
AU - Li, Hongmei
AU - Su, Dejun
AU - Han, Xuesong
N1 - Publisher Copyright:
© 2022
PY - 2022/9
Y1 - 2022/9
N2 - Racial discrimination has intensified in the U.S. during the COVID-19 pandemic, but how it disrupted healthcare is largely unknown. This study investigates the association of racial discrimination with delaying or forgoing care during the pandemic based on data from a nationally representative survey, the Health, Ethnicity and Pandemic (HEAP) study (n = 2552) conducted in October 2020 with Asians, Hispanics and non-Hispanic Blacks oversampled. Racial discrimination during the pandemic was assessed in three domains: experienced racial discrimination, race-related cyberbullying, and Coronavirus racial bias beliefs. Respondents answered whether they had delayed or forgone any type of healthcare due to the pandemic. Overall, 63.7% of respondents reported delaying or forgoing any healthcare during the pandemic. About 20.3% East/Southeast Asians, 18.6% non-Hispanic Blacks and 15.9% Hispanics reported experiences of racial discrimination, compared with 2.8% of non-Hispanic Whites. Experienced racial discrimination was associated with delaying/forgoing care among non-Hispanic Blacks (Adjusted odds ratios[AOR] = 4.58, 95% confidence interval[CI]: 2.22–9.45), Hispanics (AOR = 3.88, 95%CI: 1.51–9.98), and East/Southeast Asians (AOR = 2.14, 95%CI: 1.22–3.77). Experiencing race-related cyberbullying was significantly associated with delaying/forgoing care among non-Hispanic Blacks (AOR = 1.34, 95%CI: 1.02–1.77) and East/Southeast Asians (AOR = 1.51, 95%CI: 1.19–1.90). Coronavirus racial bias was significantly associated with delaying/forgoing care among East/Southeast Asians (AOR = 1.55, 95%CI: 1.16–2.07). The three domains of racial discrimination were consistently associated with delayed or forgone health care among East/Southeast Asians during the COVID-19 pandemic; some of the associations were also seen among non-Hispanic Blacks and Hispanics. These results demonstrate that addressing racism is important for reducing disparities in healthcare delivery during the pandemic and beyond.
AB - Racial discrimination has intensified in the U.S. during the COVID-19 pandemic, but how it disrupted healthcare is largely unknown. This study investigates the association of racial discrimination with delaying or forgoing care during the pandemic based on data from a nationally representative survey, the Health, Ethnicity and Pandemic (HEAP) study (n = 2552) conducted in October 2020 with Asians, Hispanics and non-Hispanic Blacks oversampled. Racial discrimination during the pandemic was assessed in three domains: experienced racial discrimination, race-related cyberbullying, and Coronavirus racial bias beliefs. Respondents answered whether they had delayed or forgone any type of healthcare due to the pandemic. Overall, 63.7% of respondents reported delaying or forgoing any healthcare during the pandemic. About 20.3% East/Southeast Asians, 18.6% non-Hispanic Blacks and 15.9% Hispanics reported experiences of racial discrimination, compared with 2.8% of non-Hispanic Whites. Experienced racial discrimination was associated with delaying/forgoing care among non-Hispanic Blacks (Adjusted odds ratios[AOR] = 4.58, 95% confidence interval[CI]: 2.22–9.45), Hispanics (AOR = 3.88, 95%CI: 1.51–9.98), and East/Southeast Asians (AOR = 2.14, 95%CI: 1.22–3.77). Experiencing race-related cyberbullying was significantly associated with delaying/forgoing care among non-Hispanic Blacks (AOR = 1.34, 95%CI: 1.02–1.77) and East/Southeast Asians (AOR = 1.51, 95%CI: 1.19–1.90). Coronavirus racial bias was significantly associated with delaying/forgoing care among East/Southeast Asians (AOR = 1.55, 95%CI: 1.16–2.07). The three domains of racial discrimination were consistently associated with delayed or forgone health care among East/Southeast Asians during the COVID-19 pandemic; some of the associations were also seen among non-Hispanic Blacks and Hispanics. These results demonstrate that addressing racism is important for reducing disparities in healthcare delivery during the pandemic and beyond.
KW - COVID-19
KW - Care disruption
KW - Ethnicity
KW - Pandemic
KW - Race
KW - Racial discrimination
UR - http://www.scopus.com/inward/record.url?scp=85134406519&partnerID=8YFLogxK
U2 - 10.1016/j.ypmed.2022.107153
DO - 10.1016/j.ypmed.2022.107153
M3 - Article
C2 - 35810933
AN - SCOPUS:85134406519
SN - 0091-7435
VL - 162
JO - Preventive Medicine
JF - Preventive Medicine
M1 - 107153
ER -
