Open AccessRacial and Ethnic Disparities in Health-Related Socioeconomic Risks During the Early COVID-19 Pandemic: A National Survey of U.S. Women
Author(s) -
Milkie Vu,
Jennifer A. Makelarski,
Victoria Winslow,
Monica Christmas,
Sadia Haider,
Nita K. Lee,
Elizabeth Pinkerton,
Kristen Wroblewski,
Stacy Tessler Lindau
Publication year - 2021
Publication title -
journal of women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.195
H-Index - 98
eISSN - 1931-843X
pISSN - 1540-9996
DOI - 10.1089/jwh.2021.0230
Subject(s) - medicine , socioeconomic status , ethnic group , odds ratio , demography , pandemic , odds , confidence interval , health equity , cross sectional study , logistic regression , gerontology , public health , environmental health , covid-19 , disease , population , nursing , pathology , sociology , anthropology , infectious disease (medical specialty)
Background: Nearly half of U.S. women experienced new or worsening health-related socioeconomic risks (HRSRs) (food, housing, utilities and transportation difficulties, and interpersonal violence) early in the COVID-19 pandemic. We sought to examine racial/ethnic disparities in pandemic-related changes in HRSRs among women. Materials and Methods: We conducted a cross-sectional survey (04/2020) of 3200 women. Pre- and early pandemic HRSRs were described by race/ethnicity. Weighted, multivariable logistic regression models generated odds of incident and worsening HRSRs by race/ethnicity. Results: The majority of Black, East or Southeast (E/SE) Asian, and Hispanic women reported ≥1 prepandemic HRSR (51%-56% vs. 38% of White women, p < 0.001). By April 2020, 68% of Black, E/SE Asian, and Hispanic women and 55% of White women had ≥1 HRSR ( p < 0.001). For most HRSRs, the odds of an incident or worsening condition were similar across racial/ethnic groups, except Black, E/SE Asian and Hispanic women had 2-3.6 times the odds of incident transportation difficulties compared with White women. E/SE Asian women also had higher odds of worsening transportation difficulties compared with White women (adjusted odds ratios = 2.5, 95% confidence interval 1.1-5.6). In the early pandemic, 1/19 Hispanic, 1/28 E/SE Asian, 1/36 Black and 1/100 White women had all 5 HRSRs (extreme health-related socioeconomic vulnerability). Conclusions: Prepandemic racial/ethnic disparities in HRSRs persisted and prevalence rates increased for all groups early in the pandemic. Disparities in transportation difficulties widened. White women were much less likely than others to experience extreme health-related socioeconomic vulnerability. An equitable COVID-19 response requires attention to persistent and widening racial/ethnic disparities in HRSRs among women.