COVID-19 as a social disease: qualitative analysis of COVID-19 prevention needs, impact of control measures and community responses among racialized/ethnic minorities in Antwerp, Belgium

Abstract

Background In high income countries, racialized/ethnic minorities are disproportionally affected by COVID-19. Despite the established importance of community involvement in epidemic preparedness, we lack in-depth understanding of these communities’ experiences with and responses to COVID-19. We explored information and prevention needs, coping mechanisms with COVID-19 control measures and their impact on lived experiences among selected racialized/ethnic minority communities. Methods This qualitative rapid assessment conducted in Antwerp/Belgium used an interpretative and participatory approach. We included migrant communities with geographic origins ranging from Sub-Saharan Africa, North-Africa to the Middle East, Orthodox Jewish communities and professional community workers. Data were collected between May 2020–May 2021 through key informant-, in-depth interviews and group discussions (N = 71). Transcripts were analyzed inductively, adopting a reflexive thematic approach. A community advisory board provided feedback throughout the research process. Results Participants indicated the need for tailored information in terms of language and timing. At the start of the epidemic, they perceived official public health messages as insufficient to reach all community members. Information sources included non-mainstream (social) media and media from home countries, hampering a nuanced understanding of virus transmission mechanisms and local and national protection measures. Participants felt the measures’ most negative impact on their livelihoods (e.g. loss of income, disruption of social and immigration support). Economic insecurity triggered chronic stress and fears at individual and family level. High degrees of distrust in authorities and anticipated stigma were grounded in previously experienced racial and ethnic discrimination. Community-based initiatives mitigated this impact, ranging from disseminating translated and tailored information, providing individual support, and successfully reaching community members with complex needs (e.g. the elderly, digitally illiterate people, those with small social networks or irregular legal status). Conclusion Study participants’ narratives showed how coping with and responding to COVID-19 was strongly intertwined with socio-economic and ethnic/racial characteristics. This justifies conceptualizing COVID-19 a social disease. At the same time, communities demonstrated resilience in responding to these structural vulnerabilities. From a health equity perspective, we provide concrete policy recommendations grounded in insights into communities’ structural vulnerabilities and resilience.

Sub-Saharan African communities’ experiences and engagement with COVID-19 and the related control strategies in Antwerp, Belgium

“…This qualitative study was part of a larger rapid assessment at the start of the COVID-19 outbreak in Antwerp among several racialised and ethnic minorities including SSA communities, Moroccan, Syrian, Turkish, and Orthodox Jewish communities. Detailed findings from the Orthodox Jewish communities [ 17 ] and issues cutting across the diverse communities [ 18 ] have been described elsewhere. Because we were interested in communities’ lived experiences, we chose an interpretative ethnographical approach [ 19 ], a method suitable to explore peoples’ perceptions of and attitudes towards COVID-19 and its control measures, and how they coped with these measures [ 20 ].…”

Impact of the COVID-19 pandemic on Muslim older immigrants in Edmonton, Alberta: A community-based participatory research project with a local mosque

“…Public health restrictions and policies shut down many essential services for extended periods of time. Although these measures were essential, barriers to accessing necessities were exacerbated for certain populations (D'cruz & Banerjee, 2020;Hearst et al, 2021;Nöstlinger et al, 2022). Older adults and stakeholders reported decreased social connectivity from lack of access to transportation before and during the pandemic and closure of mosques during the pandemic.…”

We hang on to social media to get information but we do not master it: Sub-Saharan African communities’ experiences and engagement with the COVID-19 pandemic and related control strategies in Antwerp, Belgium

“…We adopted an interpretative ethnographical approach (20) among several ethnic/racial minorities including SSA communities, Moroccan, Syrian, Turkish and Orthodox Jewish communities. Detailed ndings from the Orthodox Jewish communities (21) and issues cutting across the diverse communities (22) have been described elsewhere. We used iterative and participatory methodologies: We set up a community advisory board (CAB) to advise on recruitment of participants, data collection and interpretation of ndings.…”