Purpose of Review COVID-19 is a major concern for the health and wellbeing of individuals worldwide. As COVID-19 cases and deaths continue to increase in the USA, aging Black and Hispanic populations have emerged as especially at-risk for increased exposure to COVID-19 and susceptibility to severe health outcomes. The current review discusses the weathering hypothesis and the influence of social inequality on the identified health disparities. Recent Findings Aging minoritized populations have endured structural and social inequality over the lifecourse. Consequently, these populations experience weathering, a process that results in physiological dysregulation due to stress associated with persistent disadvantage. Through weathering and continued inequity, aging minoritized populations have an increased risk of exposure and poor health outcomes from COVID-19. Summary Current literature and available data suggests that aging minoritized persons experience high rates of COVID-19 morbidity and mortality. The current review hypothesizes and supports that observed disparities are the result of inequalities that especially affect Black and Hispanic populations over the lifecourse. Future efforts to address these disparities should emphasize research that supports governments in identifying at-risk groups, providing accessible COVID-19-related information to those groups, and implementing policy that addresses the structural and social inequities that perpetuate current COVID-19 disparities.
Background: Health care satisfaction is a key component of patient-centered care. Prior research on transgender populations has been based on convenience samples, and/or grouped all gender minorities into a single category. Objective: The objective of this study was to quantify differences in health care satisfaction among transgender men, transgender women, gender nonconforming, and cisgender adults in a diverse multistate sample. Research Design: Cross-sectional analysis of 2014–2018 Behavioral Risk Factor Surveillance System data from 20 states, using multivariable logistic models. Subjects: We identified 167,468 transgender men, transgender women, gender-nonconforming people, cisgender women, and cisgender men and compared past year health care satisfaction across these groups. Results: Transgender men and women had the highest prevalence of being “not at all satisfied” with the health care they received (14.6% and 8.6%, respectively), and gender-nonconforming people had the lowest prevalence of being “very satisfied” with their health care (55.7%). After adjustment for sociodemographic characteristics, transgender men were more likely to report being “not at all satisfied” with health care than cisgender men (odds ratio: 4.45, 95% confidence interval: 1.72–11.5) and cisgender women (odds ratio: 3.40, 95% confidence interval: 1.31–8.80). Conclusions: Findings indicate that transgender and gender-nonconforming adults report considerably less health care satisfaction relative to their cisgender peers. Interventions to address factors driving these differences are needed.
A disproportionate burden of the ongoing COVID-19 pandemic is being shouldered by members of racial and ethnic minorities and socially disadvantaged communities. Structural and social determinants of health have been recognized as key contributors to the inequalities observed. Racism, a major structural determinant of health that patterns related social determinants of health, in the USA, warrants further investigation. In this perspective piece we provide an overview of the historical context of racism, followed by preliminary findings from the ongoing COVIDStory study—a cross-sectional study addressing perceptions of COVID-19 and COVID-19 research—that highlights the experiences of non-Hispanic Black and Hispanic identifying adult participants, residing in Worcester Massachusetts, during the COVID-19 pandemic. We then discuss these findings in the context of current and past research considering racism and relevant social determinants of health. Our study results suggest that racism and its residuals (residential segregation, economic insecurity, discrimination, bias, and vigilance) are modern challenges for non-Hispanic Black and Hispanic participants, and these findings are supported by the existing literature. It is our hope that this perspective piece provides additional evidence for action on structural and social determinants affecting the health of minoritized people, especially those living in Massachusetts.
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