Evidence of Social and Structural COVID-19 Disparities by Sexual Orientation, Gender Identity, and Race/Ethnicity in an Urban Environment

Abstract

The ongoing COVID-19 pandemic has had widespread social, psychological, and economic impacts. However, these impacts are not distributed equally: already marginalized populations, specifically racial/ ethnic minority groups and sexual and gender minority populations, may be more likely to suffer the effects of COVID-19. The COVID-19 Resiliency Survey was conducted by the city of Chicago to assess the impact of COVID-19 on city residents in the wake of Chicago's initial lockdown, with particular focus on the experiences of minority populations. Chi-square tests of independence were performed to compare COVID-19related outcomes and impacts on heterosexual vs. sexual minority populations, cisgender vs. gender minority populations, and White vs. racial/ethnic minority subgroups. Marginalized populations experienced significant disparities in COVID-19 exposure, susceptibility, and treatment access, as well as in psychosocial effects of the pandemic. Notably, Black and Latinx populations reported significant difficulties accessing food and supplies (p = 0.002). Healthcare access disparities were also visible, with Black and Latinx respondents reporting significantly lower levels of access to a provider to see if COVID-19 testing would be appropriate (p = 0.013), medical services (p = 0.001), and use of telehealth for mental health services (p = 0.001). Sexual minority respondents reported significantly lower rates of using telehealth for mental health services (p = 0.011), and gender minority respondents reported significantly lower levels of primary care provider access (p = 0.016). There are evident COVID-19 disparities experienced in Chicago especially for Black, Latinx, sexual minority, and gender minority groups. A greater focus must be paid to health equity, including providing increased resources and supplies for affected groups, adapting to inequities in the built environment, and ensuring adequate access to healthcare services to ameliorate the burden of COVID-19 on these marginalized populations.

Impact of COVID-19 on Pediatric Primary Care Visits at Four Academic Institutions in the Carolinas

“…Due to the social and economic impact of COVID-19, however, the pandemic has led to numerous indirect effects in children and adolescents, including missed days of school, worse diet-related behaviors, and increasing rates of anxiety and depression [ 2 , 3 , 4 ]. Furthermore, recent research indicates these impacts have disproportionately affected racial/ethnic minorities in the U.S. [ 5 , 6 , 7 ].…”

A Nationwide Survey of COVID-19 Testing in LGBTQ+ Populations in the United States

“…105,106 Although we did not find significant differences in COVID-19 PCR and antibody testing results by race/ethnicity or gender identity, future research is warranted to better understand the effects of COVID-19 on Black and/or transgender LGBTQ+ people, who face disparities in health conditions, health care access, and economic stability. 56,[107][108][109] Our null finding may be due to our convenience sampling method or because the effects of race, ethnicity, or social class are not always evident at the onset of a pandemic, as was true for the 1918 influenza pandemic 110 or the HIV epidemic in the United States. 111 However, the negative effect of COVID-19 on the Black population is evidenced in the general population, 112 and as the disease has progressed, disparities have become more evident, especially among Black men.…”

COVID-19 Vaccine Acceptance among an Online Sample of Sexual and Gender Minority Men and Transgender Women

“…Thus, COVID-19 related vulnerability likely varies across intersectional racial/ethnic, sexual, and gender minority identities. COVID-19 restrictions have been associated with decreased access to healthcare and decreased perceived social support, which may weaken resilience to minority stressors [ 13 , 16 , 17 , 18 ]. The confluence of disproportionate psychosocial and economic burdens with increased vulnerability to minority stressors among SGM may decrease COVID-19 vaccine uptake and further deepen health inequities.…”