Xenophobia & Racism: A National Study on the Experiences Among Healthcare Workers During COVID-19

Abstract

Background The COVID-19 pandemic has illuminated the United States (US) healthcare system’s lack of preparedness and put healthcare communities (HCs) at increased risk for adverse outcomes (e.g., discrimination and racism via microaggressions, hate crimes, or even death). In this study, we investigated 1) prevalence of discrimination; 2) the risk of microaggressions and hate crimes (MAHCs) experienced by healthcare workers (HCWSs); 3) which specific subpopulations were affected; 4) the driving factors of these attitudes and actions; and 5) perceived fear of COVID-related complications (e.g., infectivity, illness, death, and etc.). Methods A cross-sectional survey was disseminated to US HCs, incorporating the validated Everyday Discrimination Scale and assessing risk and driving factors behind MAHCs. Logistic regression was used to estimate risk of MAHCs among HCWSs before and during the pandemic. Results 1218 participants were included, with 230 (19%) reporting an increase in everyday discrimination. Most common types of discrimination reported were verbal harassment (42%) and physical assault (25%) with suspected reasons for experiencing and witnessing MAHCs being race (16%), ethnicity (20%), and gender biases (18%). Furthermore, physicians [OR: 1.46 (95% CI: 1.07-1.99)], students [OR: 1.81 (95% CI: 1.03-3.17)], and other medical professionals [OR: 1.30 (95% CI: 0.96-1.77)] had higher risks of ever experiencing a MAHC compared to nurses after adjusting for gender, race, ethnicity, and age. Perceived risk and fear regarding COVID-19 infections were high for Asian/South Asian/Southeast Asian and Native Hawaiian/Pacific Islander HCWSs. Lastly, 19% of participants reported purchasing or knowing someone who purchased a firearm due to COVID-19 related safety concerns. Conclusion COVID-19 has unmasked systemic maladies, especially for HCWSs, who possess a complex duality of roles as healers and potential carriers of disease and illness. More studies are needed to capture xenophobic and racist occurrences which are often overlooked and undocumented. These studies are imperative to inform the development of prevention and intervention programs that will combat systemic injustices and safeguard HCWSs from adverse outcomes.