Bishop-Royse Jessica, Gutierrez-Kapheim Melissa, Silva Abigail, Lomahan Sarah, Jindal Monique, Krogen Michaela, Vu Milkie, Martin Molly
Department of Adult Health and Gerontological Nursing, Rush University College of Nursing, Chicago, USA.
Sinai Urban Health Institute, Chicago, USA.
J Community Health. 2025 Jun;50(3):395-405. doi: 10.1007/s10900-024-01424-8. Epub 2024 Dec 16.
Black Americans are disproportionately affected by COVID-19 related disease and mortality due to longstanding social, political, economic, and environmental injustices. Although structural determinants of health have clear links to both COVID-19 disease and vaccine uptake, many public health researchers focus on the contribution of individual level trust in vaccine uptake, obscuring how distrust develops and is reinforced through continued systemic injustice. While much is known about relationship between individual trust and receipt of the COVID-19 vaccine, less is known about how structural racism and exposure to discrimination influence that association. Using survey data collected in the Chicago metropolitan area, we examined associations between structural racism, discrimination, and trust on two measures of vaccine acceptance: self-report receipt of any vaccine and completion of the primary series. Multiple variable logistic regression results suggest that participants who trusted the federal government to ensure a safe pediatric COVID-19 vaccine had higher odds of being vaccinated and completing the primary series. NH Black and Hispanic participants' distrust of their doctor to provide COVID-19 information reduced their odds of vaccine uptake. Trust in medical professionals was linked to higher odds of vaccine receipt for Hispanic participants but not for NH Black participants. Education consistently influenced the likelihood of receiving any vaccine for both NH Black and Hispanic participants, but not completing the primary series. Conversely, employment was strongly related to completing the primary series but not initial vaccine receipt. Measures of structural racism and discrimination had minimal impact on vaccine uptake in this sample.
由于长期存在的社会、政治、经济和环境不公正现象，美国黑人在与新冠病毒相关的疾病和死亡率方面受到的影响尤为严重。尽管健康的结构性决定因素与新冠病毒疾病和疫苗接种率都有明确的联系，但许多公共卫生研究人员将重点放在个人层面的疫苗接种信任度上，从而掩盖了不信任是如何通过持续的系统性不公正而产生和强化的。虽然人们对个人信任与新冠疫苗接种之间的关系了解很多，但对于结构性种族主义和遭受歧视如何影响这种关联却知之甚少。利用在芝加哥大都市区收集的调查数据，我们研究了结构性种族主义、歧视与疫苗接受度的两项指标之间的关联：自我报告的任何疫苗接种情况和完成主要接种系列。多元变量逻辑回归结果表明，信任联邦政府能确保儿科新冠疫苗安全的参与者接种疫苗和完成主要接种系列的几率更高。非裔美国黑人和西班牙裔参与者对医生提供新冠病毒信息的不信任降低了他们接种疫苗的几率。对医疗专业人员的信任与西班牙裔参与者更高的疫苗接种几率相关，但与非裔美国黑人参与者无关。教育程度一直影响着非裔美国黑人和西班牙裔参与者接种任何疫苗的可能性，但与完成主要接种系列无关。相反，就业情况与完成主要接种系列密切相关，但与首次接种疫苗无关。在这个样本中，结构性种族主义和歧视的衡量指标对疫苗接种的影响微乎其微。
