Racial and Ethnic Disparities in Health-Related Socioeconomic Risks During the Early COVID-19 Pandemic: A National Survey of U.S. Women

Abstract

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.

Examining Health Disparities in Orthopedic Care During COVID-19

“…These risks include food insecurity, housing instability, transportation difficulties, and utility difficulties. 8 These findings are consistent with other studies during the COVID-19 pandemic. Preventative healthcare and screening, such as breast cancer screening, declined during the COVID-19 pandemic, and this decline was even more pronounced among patients of underserved racial/ethnic groups and lower socioeconomic status.…”

“…These risks include food insecurity, housing instability, transportation difficulties, and utility difficulties. 8…”

“…7 In addition, many people experienced increased socioeconomic risks during the COVID-19 pandemic, including food insecurity, housing instability, transportation difficulties, and utilities difficulties. 8 Similar to the multifactorial nature of disparities related to COVID-19, multifactorial healthcare disparities in orthopedic care also exist. In addition to disparities due to race/ethnicity and sex, differences in a patient's insurance status affect their ability to schedule appointments with an orthopedic provider and access to elective surgery.…”

“…7 In addition, many people experienced increased socioeconomic risks during the COVID-19 pandemic, including food insecurity, housing instability, transportation difficulties, and utilities difficulties. 8…”

Ethnic disparities in mortality and group-specific risk factors in the UK Biobank

“…While the mortality gap between race and ethnicity groups have narrowed, the decreasing trend has leveled off in recent years: mortality disparity continues to exist and is variously complex across different populations, geographies, and mortality causes [2,3]. In particular, the ongoing pandemic of Coronavirus disease 2019 (COVID-19) exemplifies the profound adverse effects of disparity, demonstrated by the disproportionate burden and number of deaths among highrisk and medically underserved racial and ethnic minority groups [4,5].…”