Abstract
BackgroundIn the United States, racial and ethnic minorities are disproportionately affected by COVID-19, with persistent social and structural factors contributing to these disparities. At the intersection of race/ethnicity and gender, women of color may be disadvantaged in terms of COVID-19 outcomes due to their role as essential workers, their higher prevalence of pre-existing conditions, their increased stress and anxiety from the loss of wages and caregiving, and domestic violence.ObjectiveThe purpose of this study is to examine racial and ethnic differences in the prevalence of COVID-19 outcomes, stressors, fear, and prevention behaviors among adult women residing in the United States.MethodsBetween May and June 2020, women were recruited into the Capturing Women’s Experiences in Outbreak and Pandemic Environments (COPE) Study, a web-based cross-sectional study, using advertisements on Facebook; 491 eligible women completed a self-administered internet-based cross-sectional survey. Descriptive statistics were used to examine racial and ethnic differences (White; Asian; Native Hawaiian or other Pacific Islander; Black; Hispanic, Latina, or Spanish Origin; American Indian or Alaskan Native; multiracial or some other race, ethnicity, or origin) on COVID-19 outcomes, stressors, fear, and prevention behaviors.ResultsAmong our sample of women, 16% (73/470) reported COVID-19 symptoms, 22% (18/82) were concerned about possible exposure from the people they knew who tested positive for COVID-19, and 51.4% (227/442) knew where to get tested; yet, only 5.8% (27/469) had been tested. Racial/ethnic differences were observed, with racial/ethnic minority women being less likely to know where to get tested. Significant differences in race/ethnicity were observed for select stressors (food insecurity, not enough money, homeschooling children, unable to have a doctor or telemedicine appointment) and prevention behaviors (handwashing with soap, self-isolation if sick, public glove use, not leaving home for any activities). Although no racial/ethnic differences emerged from the Fear of COVID-19 Scale, significant racial/ethnic differences were observed for some of the individual scale items (eg, being afraid of getting COVID-19, sleep loss, and heart racing due to worrying about COVID-19).ConclusionsThe low prevalence of COVID-19 testing and knowledge of where to get tested indicate a critical need to expand testing for women in the United States, particularly among racial/ethnic minority women. Although the overall prevalence of engagement in prevention behaviors was high, targeted education and promotion of prevention activities are warranted in communities of color, particularly with consideration for stressors and adverse mental health.
Highlights
The COVID-19 pandemic has shed light on racial and ethnic disparities in the United States [1,2,3]
Among 44% of US cases with known race or ethnicity, 33% were Latinx, 22% were Black, and 1.3% were American Indian or Alaskan Native (AIAN), despite accounting for 18%, 13%, and 0.7% of the US population, respectively, suggesting these groups are disproportionately affected by the COVID-19 pandemic [1]
Recruitment occurred through Facebook advertisements, designed to recruit adult women currently residing in the United States
Summary
The COVID-19 pandemic has shed light on racial and ethnic disparities in the United States [1,2,3]. Contributing factors to racial and ethnic disparities in COVID-19 outcomes include social and structural vulnerabilities and pre-existing health conditions, affecting socially marginalized populations [6,7]. Toxic stress resulting from racial and social inequities has been magnified during the pandemic, with implications for poor biological function and adverse physical and mental health outcomes [11,14] This culminates in Black, Latinx, and AIAN groups shouldering greater disease burden and the unfolding spread of COVID-19 in areas with larger populations of ethnic minorities [8]. In the United States, racial and ethnic minorities are disproportionately affected by COVID-19, with persistent social and structural factors contributing to these disparities. At the intersection of race/ethnicity and gender, women of color may be disadvantaged in terms of COVID-19 outcomes due to their role as essential workers, their higher prevalence of pre-existing conditions, their increased stress and anxiety from the loss of wages and caregiving, and domestic violence
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