Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Urban Health. 2021 Feb;98(1):27-40. doi: 10.1007/s11524-020-00497-9. Epub 2020 Dec 1.
The ongoing COVID-19 pandemic has had widespread social, psychological, and economic impacts. However, these impacts are not distributed equally: already marginalized populations, specifically racial/ethnic minority groups and sexual and gender minority populations, may be more likely to suffer the effects of COVID-19. The COVID-19 Resiliency Survey was conducted by the city of Chicago to assess the impact of COVID-19 on city residents in the wake of Chicago's initial lockdown, with particular focus on the experiences of minority populations. Chi-square tests of independence were performed to compare COVID-19-related outcomes and impacts on heterosexual vs. sexual minority populations, cisgender vs. gender minority populations, and White vs. racial/ethnic minority subgroups. Marginalized populations experienced significant disparities in COVID-19 exposure, susceptibility, and treatment access, as well as in psychosocial effects of the pandemic. Notably, Black and Latinx populations reported significant difficulties accessing food and supplies (p = 0.002). Healthcare access disparities were also visible, with Black and Latinx respondents reporting significantly lower levels of access to a provider to see if COVID-19 testing would be appropriate (p = 0.013), medical services (p = 0.001), and use of telehealth for mental health services (p = 0.001). Sexual minority respondents reported significantly lower rates of using telehealth for mental health services (p = 0.011), and gender minority respondents reported significantly lower levels of primary care provider access (p = 0.016). There are evident COVID-19 disparities experienced in Chicago especially for Black, Latinx, sexual minority, and gender minority groups. A greater focus must be paid to health equity, including providing increased resources and supplies for affected groups, adapting to inequities in the built environment, and ensuring adequate access to healthcare services to ameliorate the burden of COVID-19 on these marginalized populations.
持续的 COVID-19 大流行对社会、心理和经济产生了广泛影响。然而,这些影响并非平均分布:已经处于边缘地位的人群,特别是少数族裔和性少数群体,可能更容易受到 COVID-19 的影响。芝加哥市进行了 COVID-19 复原力调查,以评估 COVID-19 对芝加哥居民的影响,特别是关注少数族裔群体的经历。进行了卡方独立性检验,以比较异性恋与性少数群体、顺性别与性别少数群体以及白人与少数族裔亚群之间与 COVID-19 相关的结果和影响。边缘化人群在 COVID-19 的暴露、易感性和治疗机会方面以及大流行的心理社会影响方面经历了显著的差异。值得注意的是,黑人和拉丁裔人口报告说,在获得食物和用品方面存在重大困难(p=0.002)。医疗保健机会的差异也很明显,黑人及拉丁裔受访者报告称,获得医生就诊以确定是否进行 COVID-19 检测(p=0.013)、医疗服务(p=0.001)和使用远程医疗进行心理健康服务(p=0.001)的机会明显较少。性少数群体受访者报告说,使用远程医疗进行心理健康服务的比例明显较低(p=0.011),而性别少数群体受访者报告说,获得初级保健提供者的机会明显较低(p=0.016)。在芝加哥,尤其是在黑人、拉丁裔、性少数群体和性别少数群体中,存在明显的 COVID-19 差异。必须更加关注健康公平,包括为受影响群体提供更多资源和用品,适应建筑环境中的不平等现象,并确保获得充足的医疗保健服务,以减轻这些边缘化群体的 COVID-19 负担。
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