Alhomsi Alia, Quintero Stephanie M, Ponce Stephanie, Mendez Izabelle, Stewart Anita L, Napoles Anna Maria, Strassle Paula D
Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA.
Center for Aging in Diverse Communities, Institute for Health & Aging, University of California San Francisco, San Francisco, California, USA.
Health Equity. 2023 Aug 30;7(1):453-461. doi: 10.1089/heq.2022.0196. eCollection 2023.
The economic impact of the COVID-19 pandemic has been substantial, yet little is known about the financial effects resulting from lost employment or financial hardship racial-ethnic disparities.
We conducted a nationally representative, online survey of 5500 English- and Spanish-speaking American Indian/Alaska Native, Asian, Black/African American, Native Hawaiian/Pacific Islander, Latino, White, and multiracial adults, from December 2020 to February 2021. Six financial hardship domains were measured (lost income, debt, unmet expenses, unmet health care expenses, housing insecurity, and food insecurity). Prevalence of financial hardship among each racial-ethnic group was estimated using multivariable Poisson regression.
Overall, 70.3% reported experiencing financial hardship; debt (57.6%), lost income (44.5%), and unmet expenses (33.7%) were most common. American Indian/Alaska Native (adjusted prevalence ratio [aPR]=1.19, 95% confidence interval [CI]=1.04 to 1.35), Black/African American (aPR=1.18, 95% CI=1.06 to 1.32), Latino (English-speaking: aPR=1.15, 95% CI=1.01 to 1.31; Spanish-speaking: aPR=1.27, 95% CI=1.12 to 1.45), and Native Hawaiian/Pacific Islander (aPR=1.21, 95% CI=1.06 to 1.38) adults were more likely to experience financial hardship, compared with White adults. American Indian/Alaska Native, Black/African American, Spanish-speaking Latino, and Native Hawaiian/Pacific Islander adults were also more likely to report hardship in almost all hardship domains (e.g., housing insecurity: aPRs=1.37-1.91).
Racial/ethnic minorities were more likely to experience financial hardship during the pandemic. The prevalence of lost income was similar across most racial/ethnic groups, suggesting that preexisting wealth disparities led to some groups being less able to handle the economic shocks caused by the COVID-19 pandemic. Financial hardship may be underestimated for communities without English or Spanish fluency. Without intervention, financial hardship will likely exacerbate wealth disparities in the United States.
2019年冠状病毒病(COVID-19)大流行产生了巨大的经济影响,但对于失业或经济困难导致的种族差异所造成的财务影响,人们了解甚少。
2020年12月至2021年2月,我们对5500名讲英语和西班牙语的美洲印第安人/阿拉斯加原住民、亚裔、黑人/非裔美国人、夏威夷原住民/太平洋岛民、拉丁裔、白人及多族裔成年人进行了一项具有全国代表性的在线调查。对六个经济困难领域进行了测量(收入损失、债务、未满足的支出、未满足的医疗保健支出、住房不安全和粮食不安全)。使用多变量泊松回归估计每个种族/族裔群体中经济困难的患病率。
总体而言,70.3%的人报告经历了经济困难;债务(57.6%)、收入损失(44.5%)和未满足的支出(33.7%)最为常见。与白人成年人相比,美洲印第安人/阿拉斯加原住民(调整患病率比[aPR]=1.19,95%置信区间[CI]=1.04至1.35)、黑人/非裔美国人(aPR=1.18,95%CI=1.06至1.32)、拉丁裔(讲英语的:aPR=1.15,95%CI=1.01至1.31;讲西班牙语的:aPR=1.27,95%CI=1.12至1.45)和夏威夷原住民/太平洋岛民(aPR=1.21,95%CI=1.06至1.38)成年人更有可能经历经济困难。美洲印第安人/阿拉斯加原住民、黑人/非裔美国人、讲西班牙语的拉丁裔和夏威夷原住民/太平洋岛民成年人在几乎所有困难领域也更有可能报告困难(例如,住房不安全:aPRs=1.37 - 1.91)。
在大流行期间,少数种族/族裔更有可能经历经济困难。大多数种族/族裔群体的收入损失患病率相似,这表明先前存在的财富差距导致一些群体更难以应对COVID-19大流行造成的经济冲击。对于不精通英语或西班牙语的社区,经济困难可能被低估。如果不进行干预,经济困难可能会加剧美国的财富差距。