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医疗保健中的种族主义影响:芝加哥黑人母亲对 COVID-19 疫苗的犹豫。

The Influence of Racism in Healthcare: COVID-19 Vaccine Hesitancy Among Black Mothers in Chicago.

机构信息

Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA.

Sinai Health System, Sinai Urban Health Institute, Chicago, IL, USA.

出版信息

J Racial Ethn Health Disparities. 2024 Aug;11(4):2425-2434. doi: 10.1007/s40615-023-01708-0. Epub 2023 Aug 2.

Abstract

Black mothers and children experience significant health disparities in the USA. These health disparities have been attributed, in part, to experiencing racism in healthcare. This study aimed to explore how experiences of healthcare discrimination and mistreatment experienced by Black mothers may influence COVID-19 vaccine beliefs and decision-making for themselves and their families. From April 2021 to November 2021, we conducted 50 semi-structured interviews among Chicago residents. Ten participants self-identified as female and with reported children; these data were extracted from the larger sample for data analysis. Interview content included perceptions and experiences with the COVID-19 vaccine and experiences with healthcare discrimination, mistreatment, and medical mistrust. Interview transcripts were transcribed verbatim and coded using the MAXQDA 2022 qualitative software. Themes were identified using a team-based thematic analysis to understand how experiences of racism in healthcare may influence COVID-19 vaccine decision-making. Four themes were generated from the data: (1) experiences of healthcare discrimination and mistreatment, (2) distrust and fears of experimentation, (3) the influence of discrimination and distrust on COVID-19 vaccine decision-making, and (4) overcoming vaccine hesitancy. The results of this study highlight the current literature; Black mothers experience racism and discrimination in healthcare when seeking care for themselves and their children. It is evident in their stories that medical racism and historical medical abuse influence vaccine decision-making. Therefore, healthcare and public health initiatives should be intentional in addressing past and present racism in healthcare to improve vaccine distrust.

摘要

美国的黑人和儿童在健康方面存在显著的差异。这些差异部分归因于他们在医疗保健中经历的种族主义。本研究旨在探讨黑人生育经历中的医疗保健歧视和虐待经历如何影响他们自己和家人对 COVID-19 疫苗的信念和决策。2021 年 4 月至 2021 年 11 月,我们在芝加哥居民中进行了 50 次半结构化访谈。10 名参与者自认为是女性,并报告有孩子;这些数据是从更大的样本中提取出来进行数据分析的。访谈内容包括对 COVID-19 疫苗的看法和经验,以及对医疗保健歧视、虐待和医疗不信任的看法。访谈记录逐字转录,并使用 MAXQDA 2022 定性软件进行编码。使用基于团队的主题分析确定主题,以了解医疗保健中的种族主义经历如何影响 COVID-19 疫苗决策。从数据中生成了四个主题:(1)医疗保健歧视和虐待的经历,(2)不信任和对实验的恐惧,(3)歧视和不信任对 COVID-19 疫苗决策的影响,以及(4)克服疫苗犹豫。本研究的结果突出了当前的文献;黑人生育经历中的种族主义和歧视在他们寻求自己和孩子的医疗保健时就存在。从他们的故事中可以明显看出,医疗种族主义和历史上的医疗虐待影响了疫苗决策。因此,医疗保健和公共卫生计划应该有意解决过去和现在的医疗保健中的种族主义问题,以改善对疫苗的不信任。

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本文引用的文献

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COVID-19 Vaccine Hesitancy in the United States: A Systematic Review.美国的 COVID-19 疫苗犹豫:系统评价。
Front Public Health. 2021 Nov 23;9:770985. doi: 10.3389/fpubh.2021.770985. eCollection 2021.
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Discrimination and the Role of the Clinician.歧视与临床医生的角色
Pediatrics. 2021 Dec 1;148(6). doi: 10.1542/peds.2021-053619.

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