Intersectional trauma: COVID-19, the psychosocial contract, and America’s racialized public health lineage.

Abstract

This comparative review explores how, during COVID-19 and recent American public health disasters, including the water crisis in Flint, Michigan, Hurricane Katrina, and Hurricane Maria, early failures in public health communications, porous epidemiologic oversight, and lax crisis management created significant gaps in outreach and treatment for historically disenfranchised racial/ethnic minorities. In consideration of each event’s broader specter in terms of population health inequities, a highly salient but underresearched dynamic emerges: the development of heightened psychological sequelae including depression, anxiety, and posttraumatic stress, factors linked to civic and health care system disengagement and poorer overall health. This excess mental illness morbidity can be said to fall under the umbrella of intersectional trauma, or psychological harm and psychosocial vulnerability produced through the accumulation of cultural, political, economic, and ecologic stressors tied to salient identity markers such as race or ethnicity. During COVID-19, reports have presaged race- and class-specific disparities in infections and mortality, with evidence highlighting adverse effects on the “psychosocial contract,” public trust and faith in government and health care systems which is borne from relational experiences tied to one’s identity markers. We discuss how COVID-19’s kinetic and fluid political dynamics may add to the burden of mental illness and trauma in racial/ethnic minority communities in the United States and further entrench said disparities, closing with potential strategies for mitigation.

The impact of COVID-19 on the mental health of Canadian children and youth

“…Cost et al ( 2021) also found the rates of deterioration were greatest for those with a pre-existing diagnosis and among children who perceived greater stress from being socially isolated. This is consistent with other cross-sectional studies examining COVID-19 in children and youth with pre-existing mental health problems as well as other pre-existing vulnerabilities like physical health problems (Hawke et al 2020), neurodevelopmental conditions (e.g., Asbury et al 2020;Sciberras et al 2020;Theis et al 2021), and those living in adverse socio-economic circumstances (Whitehead et al 2021) and in racialized communities (Ezell et al 2021). There is nothing new here, differential exposure and vulnerability have been reliably associated with differential outcomes (Cicchetti and Rogosch 1996).…”

COVID-19 Related Shifts in Social Interaction, Connection, and Cohesion Impact Psychosocial Health: Longitudinal Qualitative Findings from COVID-19 Treatment Trial Engaged Participants

“…The pandemic’s burden on mental health is associated with multiple intersecting factors, including economic decline resulting in increased job insecurity [ 3 , 4 ]; housing precarity [ 5 , 6 ]; childcare disruptions and school closures [ 7 , 8 , 9 ]; increased risk of interpersonal violence [ 10 , 11 ]; and general disruption to daily routines [ 12 ]. Furthermore, the burden of COVID-19 disease, and its psychosocial sequelae, has disproportionately impacted certain populations, such as children and youth [ 12 , 13 ], cisgender women [ 14 , 15 , 16 ], minoritized communities [ 17 , 18 ], people who use drugs [ 19 ], older adults [ 20 , 21 ], people with disabilities [ 22 , 23 ], and LGBTQIA+ individuals [ 24 , 25 , 26 , 27 ].…”

Black sickle cell patients’ lives matter: healthcare, long-term shielding and psychological distress during a racialised pandemic in England – a mixed-methods study

“…16 The galvanising of the Black Lives Matter (BLM) movement during the height of the pandemic with the tragic killing of the African-American George Floyd, due to police brutality on 25 May 2020, gave another layer of understanding the pandemic as 'racialised'. 17 These events redirected examination of the role of structural racism in society, including within healthcare services, an issue that particularly affects people with SCD. 18 It is against this background that we conducted our study.…”