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Dorri AA, Loza O, Bond MA, Ciszek E, Elias-Curry Y, Aguilar S, Fliedner P, Norwood A, Stone AL, Cooper MB, Schick V, Wilkerson JM, Wermuth PP, Yockey RA, Schnarrs P. Understanding the Experiences of Latinx LGBTQ Texans at the Beginning of the COVID-19 Pandemic. JOURNAL OF HOMOSEXUALITY 2024; 71:2424-2448. [PMID: 37552613 DOI: 10.1080/00918369.2023.2241597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Marginalized communities have been disproportionately affected by COVID-19, including both racial/ethnic minority and sexual minority populations. To date, there has been little research examining the impact of the COVID-19 pandemic at the intersections of marginalized identities. Furthermore, available national data on COVID-19 outcomes may obscure our understanding of region-specific outcomes, particularly in the U.S. South. Using an intersectional approach, we explore differences in worries over COVID-19, preventative behaviors, and COVID-19 outcomes in the early months of the pandemic in a diverse sample of LGBTQ people (N = 1076) living in Texas. Our findings indicated that LGBTQ Latinx people in Texas reported more COVID-19 related worries and adverse outcomes than non-Latinx LGBTQ people. These findings are in line with previous research that found that the increased risk to Latinx and LGBTQ populations in public health crises is often overlooked and can be attributed to many factors such as socioeconomic status, occupational propensity, disparities in physical health, and barriers to healthcare access. Furthermore, our findings suggest the necessity of utilizing an intersectional approach when examining the disproportionate burden marginalized communities face in public health crises.
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Affiliation(s)
- Armin A Dorri
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Oralia Loza
- Department of Public Health Sciences, University of Texas at El Paso, El Paso, Texas, USA
| | - Mark A Bond
- New Meridian Corporation, Austin, Texas, USA
| | - Erica Ciszek
- Stan Richards School of Advertising & Public Relations, University of Texas at Austin, Texas, USA
| | - Yona Elias-Curry
- Department of Population Health, University of Texas at Austin, Austin, Texas, USA
| | - Sheridan Aguilar
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| | - Paul Fliedner
- Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Aliza Norwood
- Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Amy L Stone
- Department of Sociology & Anthropology, Trinity University, San Antonio, Texas, USA
| | - M Brett Cooper
- Department of Pediatrics, University of Texas Southwestern, Dallas, Texas, USA
| | - Vanessa Schick
- School of Public Health, University of Texas Health at Houston, Houston, Texas, USA
| | - J Michael Wilkerson
- School of Public Health, University of Texas Health at Houston, Houston, Texas, USA
| | - Paige P Wermuth
- School of Public Health, University of Texas Health at Houston, Houston, Texas, USA
| | - Robert A Yockey
- School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas, USA
| | - Phillip Schnarrs
- Department of Population Health, University of Texas at Austin, Austin, Texas, USA
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2
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Yao A, Huhn AS, Ellis JD. COVID-19-Related Financial Hardship Is Associated With Depression and Anxiety in Substance Use Treatment Across Gender and Racial Groups. J Nerv Ment Dis 2024; 212:295-299. [PMID: 38598730 PMCID: PMC11008766 DOI: 10.1097/nmd.0000000000001753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
ABSTRACT Many individuals lost their employment during the COVID-19 pandemic and experienced financial hardship. These experiences may increase risk for co-occurring conditions, including substance use disorders (SUDs) and related symptoms of depression and anxiety. This study aimed to examine the associations between COVID-19-related financial hardship and/or job loss and co-occurring symptoms, across gender and racial groups. Respondents (N = 3493) included individuals entering SUD treatment in the United States in March-October of 2020. Results demonstrated that COVID-19-related financial hardship and unemployment in the household was associated with greater depression and anxiety severity among people in SUD treatment (p's < 0.05). Our findings highlight financial hardship and loss of employment as risk factors for co-occurring depression and anxiety. However, additive effects between marginalized identity status and COVID-19 economic hardship on co-occurring symptoms were not observed.
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Affiliation(s)
- Aijia Yao
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, United States
| | - Andrew S. Huhn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, United States
| | - Jennifer D. Ellis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, United States
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3
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Beccia AL, Zubizarreta D, Austin SB, Raifman JR, Chavarro JE, Charlton BM. Trajectories of Mental Distress Among US Women by Sexual Orientation and Racialized Group During the First Year of the COVID-19 Pandemic. Am J Public Health 2024; 114:511-522. [PMID: 38598758 PMCID: PMC11008304 DOI: 10.2105/ajph.2024.307601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Objectives. To describe longitudinal trends in the prevalence of mental distress across the first year of the COVID-19 pandemic (April 2020‒April 2021) among US women at the intersection of sexual orientation and racialized group. Methods. Participants included 49 805 cisgender women and female-identified people from the COVID-19 Sub-Study, a cohort of US adults embedded within the Nurses' Health Studies 2 and 3 and the Growing Up Today Study. We fit generalized estimating equation Poisson models to estimate trends in depressive and anxiety symptoms by sexual orientation (gay or lesbian, bisexual, mostly heterosexual, completely heterosexual); subsequent models explored further differences by racialized group (Asian, Black, Latine, White, other or unlisted). Results. Relative to completely heterosexual peers, gay or lesbian, bisexual, and mostly heterosexual women had a higher prevalence of depressive and anxiety symptoms at each study wave and experienced widening inequities over time. Inequities were largest for sexual minority women of color, although confidence intervals were wide. Conclusions. The COVID-19 pandemic may have exacerbated already-glaring mental health inequities affecting sexual minority women, especially those belonging to marginalized racialized groups. Future research should investigate structural drivers of these patterns to inform policy-oriented interventions. (Am J Public Health. 2024;114(5):511-522. https://doi.org/10.2105/AJPH.2024.307601).
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Affiliation(s)
- Ariel L Beccia
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
| | - Dougie Zubizarreta
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
| | - S Bryn Austin
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
| | - Julia R Raifman
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
| | - Jorge E Chavarro
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
| | - Brittany M Charlton
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
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4
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Gonzalez-Jaramillo N, Abbühl D, Roa-Díaz ZM, Kobler-Betancourt C, Frahsa A. COVID-19 vaccine acceptance in the general population and under-resourced communities from high-income countries: realist review. BMJ Open 2024; 14:e084560. [PMID: 38631831 PMCID: PMC11029206 DOI: 10.1136/bmjopen-2024-084560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To compare vaccination willingness before rollout and 1 year post-rollout uptake among the general population and under-resourced communities in high-income countries. DESIGN A realist review. DATA SOURCES Embase, PubMed, Dimensions ai and Google Scholar. SETTING High-income countries. DEFINITIONS We defined vaccination willingness as the proportion of participants willing or intending to receive vaccines prior to availability. We defined vaccine uptake as the real proportion of the population with complete vaccination as reported by each country until November 2021. RESULTS We included data from 62 studies and 18 high-income countries. For studies conducted among general populations, the proportion of vaccination willingness was 67% (95% CI 62% to 72%). In real-world settings, the overall proportion of vaccine uptake among those countries was 73% (95% CI 69% to 76%). 17 studies reported pre-rollout willingness for under-resourced communities. The summary proportion of vaccination willingness from studies reporting results among people from under-resourced communities was 52% (95% CI 0.46% to 0.57%). Real-world evidence about vaccine uptake after rollout among under-resourced communities was limited. CONCLUSION Our review emphasises the importance of realist reviews for assessing vaccine acceptance. Limited real-world evidence about vaccine uptake among under-resourced communities in high-income countries is a call to context-specific actions and reporting.
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Affiliation(s)
| | - Dominik Abbühl
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Zayne Milena Roa-Díaz
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
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5
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Marshall J, Zhang X, Green BB. Adults' willingness to report sexual orientation and gender identity when registering for a digital health application: A cross-sectional quantitative study. PLoS One 2023; 18:e0292739. [PMID: 37983232 PMCID: PMC10659155 DOI: 10.1371/journal.pone.0292739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/27/2023] [Indexed: 11/22/2023] Open
Abstract
The collection of patient sexual orientation and gender identity information is crucial in identifying and addressing disparities in healthcare access, quality, and outcomes for sexual and gender minority individuals. While some studies have explored patients' willingness to disclose this information in specific settings, little is known about response rates in digital health applications. In light of the growing use of digital health, including virtual care, we sought to determine whether adults would respond to optional sexual orientation and gender identity fields during registration for a digital health application offered through their employer-provided benefits. We analyzed response rates for sexual orientation and gender identity by age, race and ethnicity, and region among individuals over age 17 between September 9th and December 31, 2022. Our study, which included over 41,000 commercially-insured adults from all 50 states, found that nearly 80% were willing to report their sexual orientation and gender identity. However, we observed higher nonresponse rates among older adults and individuals living in central and southern regions, with no consistent pattern by race and ethnicity. Our findings indicate that digital health applications could be a valuable resource for collecting this data from a diverse group of adults. Nevertheless, digital health companies must ensure that they use the data responsibly, identifying quality improvement initiatives and contributing to research that can inform health policies for sexual and gender minority individuals.
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Affiliation(s)
- Jaclyn Marshall
- Included Health, San Francisco, CA, United States of America
| | - Xinyu Zhang
- Included Health, San Francisco, CA, United States of America
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6
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Pajek J, Mancini K, Murray M. COVID-19 and children's behavioral health: An overview. Curr Probl Pediatr Adolesc Health Care 2023; 53:101491. [PMID: 38040607 DOI: 10.1016/j.cppeds.2023.101491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
The paper reviews the impact of the COVID-19 pandemic on children's and adolescents' well-being. A trauma-informed framework is employed to discuss the emerging evidence of notable changes in youth's psychological, developmental, academic, and social well-being since the start of the COVID-19 pandemic. Children and adolescents have been uniquely affected based on their age at the start of the pandemic. Despite multiple resiliency factors, COVID-19 and its ramifications have had an adverse effect on youth in general and have exacerbated preexisting racial and socioeconomic disparities. This review concludes with recommendations for child health clinicians.
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Affiliation(s)
- Julie Pajek
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
| | - Kathryn Mancini
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Marsheena Murray
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
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7
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Levandowski BA, Miller SB, Ran D, Pressman EA, Van der Dye T. Piling it on: Perceived stress and lack of access to resources among US-based LGBTQ+ community members during the COVID-19 pandemic. PLoS One 2022; 17:e0271162. [PMID: 35802684 PMCID: PMC9269365 DOI: 10.1371/journal.pone.0271162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES While the LGBTQ+ community has been disproportionally impacted by COVID-19 medical complications, little research has considered non-medical impact. METHODS We conducted a secondary analyses of USA-based respondents from a global cross-sectional online mixed-methods survey collecting sexual orientation, gender identity, and the perceived stress scale (PSS). Bivariate and multivariate ordinal regression statistics were performed. RESULTS Fourteen percent (n = 193,14.2%) identified as LGBTQ+. Variables significantly associated with LGBTQ+ included: COVID testing/treatment affordability, canceled activities, stocking food/medications, quitting job, lost income, and inability to procure groceries/cleaning supplies/medications. Adjusting for Hispanic ethnicity and income, BIPOC LGBTQ+ individuals had twice the odds (OR:2.02;95%CI:1.16-3.53) of moderate compared to low PSS scores, and high compared to moderate PSS scores, compared to white non-LGBTQ+ individuals. Adjusting for Hispanic ethnicity, income, age, and education, deaf LGBTQ+ individuals had twice the odds (OR:2.00;95%CI:1.12-3.61) of moderate compared to low PSS scores, and high compared to moderate PSS scores, compared to hearing non-LGBTQ+ individuals. CONCLUSION The LBGTQ+ community has increased stress due to COVID-19. Public health interventions must mitigate stress in BIPOC and deaf LGBTQ+ communities, addressing their intersectional experiences.
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Affiliation(s)
- Brooke A. Levandowski
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Susan B. Miller
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Davy Ran
- Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Eva A. Pressman
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Timothy Van der Dye
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, United States of America
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8
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Harawa NT, Amani B, Abotsi-Kowu C, Nwankwo E, Ford CL. Using COVID-19 Surveillance Systems to Identify and Monitor Disparities: Best Practices and Recommendations. Ethn Dis 2022; 32:151-164. [PMID: 35497401 DOI: 10.18865/ed.32.2.151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Inadequate attention to racial health equity is a common challenge to effective, reliable monitoring and mitigation of COVID-19 disparities. Efforts to monitor and mitigate COVID-19 disparities continue to be hampered by inadequacies in how surveillance systems collect, tabulate, and report COVID-19-related outcomes. We conducted environmental scans of existing public health surveillance systems and reporting standards, literature reviews, focus groups with surveillance experts, and consultations with the Centers for Disease Control and Prevention (CDC) and an expert panel on surveillance to identify and explore strengths, weaknesses, and gaps in how existing systems monitor COVID-19 and their implications for addressing disparities in related outcomes. We present recommendations based on these reviews and propose a core minimum set of health indicators and best-practice standards for reporting these indicators by COVID-19 surveillance systems to monitor racial/ethnic and other disparities in the pandemic. These recommendations are relevant to monitoring disparities in the ongoing COVID-19 pandemic and may inform monitoring of future epidemics. This discussion is part of an effort by Project REFOCUS to develop syndemic surveillance systems for monitoring the intersecting pandemics of COVID-19 and racism.
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Affiliation(s)
- Nina T Harawa
- David Geffen School of Medicine, UCLA, Los Angeles, CA.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA
| | - Bita Amani
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA.,Center for the Study of Racism, Social Justice & Health, Fielding School of Public Health, UCLA, Los Angeles, CA
| | - Consuela Abotsi-Kowu
- Center for the Study of Racism, Social Justice & Health, Fielding School of Public Health, UCLA, Los Angeles, CA
| | - Ezinne Nwankwo
- Center for the Study of Racism, Social Justice & Health, Fielding School of Public Health, UCLA, Los Angeles, CA.,Department of Community Health Sciences, Fielding School of Public Health, UCLA, Los Angeles, CA
| | - Chandra L Ford
- Center for the Study of Racism, Social Justice & Health, Fielding School of Public Health, UCLA, Los Angeles, CA.,Department of Community Health Sciences, Fielding School of Public Health, UCLA, Los Angeles, CA
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9
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Tucker JS, Dunbar MS, Perez LG, Seelam R, Troxel WM, Davis JP, D’Amico EJ. Young Adults' Perceived Impact of COVID-19 Pandemic on Sleep and Other Functioning: Does It Differ for Sexual/Gender and Racial/Ethnic Minorities? Behav Sleep Med 2022; 20:294-303. [PMID: 35642294 PMCID: PMC9162434 DOI: 10.1080/15402002.2022.2075366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Since the beginning of the COVID-19 pandemic, there has been concern that the pandemic and associated mitigation efforts would have a particularly adverse effect on communities that are marginalized. This study examined disparities in the perceived impacts of the pandemic on sleep, mental and physical health, social functioning, and substance use among young adults based on sexual/gender minority (SGM) status and race/ethnicity. METHOD Participants were 2,411 young adults (mean age = 23.6) surveyed between July 2020-July 2021. A linear regression analysis tested SGM and racial/ethnic group differences on 17 outcomes. RESULTS Most young adults reported little-to-no effect of the pandemic on sleep or other indicators of health and functioning. However, SGM young adults reported more adverse effects than non-SGM young adults on their sleep and most other outcomes. Hispanic young adults reported shorter sleep duration - but less pandemic-related depression, loneliness, and relationship problems - compared to non-Hispanic white young adults. We found no evidence that young adults with multiple minority statuses had especially poor pandemic-related outcomes. CONCLUSIONS While most young adults did not perceive much impact of the pandemic, results highlight disparities across certain demographic subgroups that may need to be addressed through targeted interventions and close monitoring for long-term effects.
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Affiliation(s)
| | - Michael S. Dunbar
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA
| | | | | | - Wendy M. Troxel
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA
| | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute for Addiction Science, University of Southern California
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10
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Clark KD, Lunn MR, Sherman ADF, Bosley HG, Lubensky ME, Obedin-Maliver J, Dastur Z, Flentje A. COVID-19 News and Its Association with the Mental Health of Sexual and Gender Minority Adults: A Cross-Sectional Study. JMIR Public Health Surveill 2022; 8:e34710. [PMID: 35486805 PMCID: PMC9153913 DOI: 10.2196/34710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/14/2022] [Accepted: 04/27/2022] [Indexed: 11/14/2022] Open
Abstract
Background Sexual and gender minority (SGM; people whose sexual orientation is not heterosexual or whose gender identity varies from what is traditionally associated with the sex assigned to them at birth) people experience high rates of trauma and substantial disparities in anxiety and posttraumatic stress disorder (PTSD). Exposure to traumatic stressors such as news related to COVID-19 may be associated with symptoms of anxiety and PTSD. Objective This study aims to evaluate the relationship of COVID-19 news exposure with anxiety and PTSD symptoms in a sample of SGM adults in the United States. Methods Data were collected between March 23 and August 2, 2020, from The PRIDE Study, a national longitudinal cohort study of SGM people. Regression analyses were used to analyze the relationship between self-reported news exposure and symptoms of anxiety using the Generalized Anxiety Disorder-7 and symptoms of COVID-19–related PTSD using the Impact of Events Scale-Revised. Results Our sample included a total of 3079 SGM participants. Each unit increase in COVID-19–related news exposure was associated with greater anxiety symptoms (odds ratio 1.77, 95% CI 1.63-1.93; P<.001) and 1.93 greater odds of PTSD (95% CI 1.74-2.14; P<.001). Conclusions Our study found that COVID-19 news exposure was positively associated with greater symptoms of anxiety and PTSD among SGM people. This supports previous literature in other populations where greater news exposure was associated with poorer mental health. Further research is needed to determine the direction of this relationship and to evaluate for differences among SGM subgroups with multiple marginalized identities.
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Affiliation(s)
- Kristen D Clark
- Department of Nursing, University of New Hampshire, 4 Library Way, Durham, US
| | - Mitchel R Lunn
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, US.,The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, US.,Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, US
| | | | - Hannah G Bosley
- Department of Psychiatry, University of California San Francisco, San Francisco, US
| | - Micah E Lubensky
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, US.,Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, US
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, US.,Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, US.,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, US
| | - Zubin Dastur
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, US.,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, US
| | - Annesa Flentje
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, US.,Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, US
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11
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Swendeman D, Norwood P, Saleska J, Lewis K, Ramos W, SantaBarbara N, Sumstine S, Comulada WS, Jimenez S, Ocasio MA, Arnold EM, Nielsen-Saines K, Fernandez MI, Rotheram-Borus MJ. Vaccine Attitudes and COVID-19 Vaccine Intentions and Prevention Behaviors among Young People At-Risk for and Living with HIV in Los Angeles and New Orleans. Vaccines (Basel) 2022; 10:413. [PMID: 35335045 PMCID: PMC8954448 DOI: 10.3390/vaccines10030413] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 01/07/2023] Open
Abstract
Sexual and gender minority (SGM) and racial or ethnic minority youth at-risk for or living with HIV may have higher risk of SARS-CoV-2 infection. However, there are few data on vaccine hesitancy/acceptance and COVID-19 self-protective behaviors among this population. Youth aged 15-24 years (n = 440), predominantly African American and Latine (73%, n = 320) SGM, from Los Angeles and New Orleans reported their vaccine attitudes and COVID-19 and HIV preventive behaviors in October 2020. Latent class analyses categorized individuals into groups based on their vaccine attitudes and preventive behaviors. Relationships between these groups and other factors were analyzed using Fisher's exact tests, ANOVA, and logistic regression. Most youth had accepting vaccine attitudes (70.2%, n = 309), with 20.7% hesitant (n = 91), and 9.1% resistant (n = 40). SGM and African Americans were significantly less accepting than their cis-gender and heterosexual peers. About two-thirds (63.2%, n = 278) of the respondents reported consistent COVID-19 self-protective behaviors. Youth with pro-vaccine attitudes were most consistently self-protective; however, only 54.4% (n= 168/309) intended to take a COVID-19 vaccine. Homelessness history, race, and sexual orientation were associated with vaccine attitudes. Accepting vaccine attitudes and consistent COVID-19 self-protective behaviors were closely related. COVID-19 attitudes/behaviors were not associated with HIV risk and only loosely associated with SARS-CoV-2 vaccine intentions.
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Affiliation(s)
- Dallas Swendeman
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Peter Norwood
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Jessica Saleska
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Katherine Lewis
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Wilson Ramos
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | | | - Stephanie Sumstine
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Warren Scott Comulada
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Sergio Jimenez
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
| | - Manuel A. Ocasio
- Section of Adolescent Medicine, Department of Pediatrics, School of Medicine, Tulane University, New Orleans, LA 70112, USA;
| | - Elizabeth M. Arnold
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Karin Nielsen-Saines
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Maria Isabel Fernandez
- Department of Public Health, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33328, USA;
| | - Mary Jane Rotheram-Borus
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (P.N.); (J.S.); (K.L.); (W.R.); (S.S.); (W.S.C.); (S.J.); (M.J.R.-B.)
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Harner V, Munion AK, Shelton J. Trans Adults Amidst the COVID-19 Pandemic: Quality of Life, Pandemic Impact, and Vaccine Preferences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12536. [PMID: 34886263 PMCID: PMC8657091 DOI: 10.3390/ijerph182312536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 02/03/2023]
Abstract
The ongoing COVID-19 pandemic is disproportionately impacting marginalized communities, such as Black, Indigenous, and people of color (BIPOC), disabled individuals, and transgender/nonbinary (i.e., trans) individuals. As trans individuals may be multiply marginalized, it is necessary to examine within group differences among trans individuals of different genders, races, socioeconomic statuses, and abilities. This study examines the following research questions: (1) What is the quality of life of trans adults during the COVID-19 pandemic? (2) How does the self-reported impact of the pandemic vary across groups within the trans community? (3) What preferences do trans adults have regarding receiving a COVID-19 vaccine? Survey data were collected in August/September of 2020. Among a sample of 449 trans adults, findings suggest that the profound impact of the pandemic was not consistent across all community members. Being a woman predicted a higher self-reported impact of the pandemic while being a masc(uline) white respondent tended to predict a lower impact of the pandemic. Higher income was associated with a higher quality of life and being a disabled white respondent predicted a lower quality of life. The majority (99%) of the sample reported wanting to receive a COVID-19 vaccine should one become available. Implications for practice include the importance of considering the holistic experiences of clients and community members, as opposed to having homogenized perspectives of even subsets of the trans community. Future research related to barriers faced when attempting to access a vaccine is needed to inform future public health responses to epidemics/pandemics impacting this community.
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Affiliation(s)
- Vern Harner
- School of Social Work, University of Washington, Seattle, WA 98105, USA
| | - Ascher K. Munion
- Department of Psychology, East Carolina University, Greenville, NC 27858, USA;
| | - Jama Shelton
- Silberman School of Social Work, City University of New York, New York, NY 10065, USA;
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13
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Lynch KE, Shipherd JC, Gatsby E, Viernes B, DuVall SL, Blosnich JR. Sexual orientation-related disparities in health conditions that elevate COVID-19 severity. Ann Epidemiol 2021; 66:5-12. [PMID: 34785397 PMCID: PMC8601164 DOI: 10.1016/j.annepidem.2021.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/18/2021] [Accepted: 11/04/2021] [Indexed: 01/19/2023]
Abstract
Purpose The Veterans Health Administration (VA) is the largest single integrated healthcare system in the US and is likely the largest healthcare provider for people with minoritized sexual orientations (e.g., gay, lesbian, bisexual). The purpose of this study was to use electronic health record (EHR) data to replicate self-reported survey findings from the general US population and assess whether sexual orientation is associated with diagnosed physical health conditions that may elevate risk of COVID-19 severity among veterans who utilize the VA. Methods A retrospective analysis of VA EHR data from January 10, 1999–January 07, 2019 analyzed in 2021. Veterans with minoritized sexual orientations were included if they had documentation of a minoritized sexual orientation within clinical notes identified via natural language processing. Veterans without minoritized sexual orientation documentation comprised the comparison group. Adjusted prevalence and prevalence ratios (aPR) were calculated overall and by race/ethnicity while accounting for differences in distributions of sex assigned at birth, age, calendar year of first VA visit, volumes of healthcare utilization, and VA priority group. Results Data from 108,401 veterans with minoritized sexual orientation and 6,511,698 controls were analyzed. After adjustment, veterans with minoritized sexual orientations had a statistically significant elevated prevalence of 10 of the 11 conditions. Amongst the highest disparities observed were COPD (aPR:1.24 [95% confidence interval:1.23–1.26]), asthma (1.22 [1.20–1.24]), and stroke (1.26 [1.24–1.28]). Conclusions Findings largely corroborated patterns among the general US population. Further research is needed to determine if these disparities translate to poorer COVID-19 outcomes for individuals with minoritized sexual orientation.
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Affiliation(s)
- Kristine E Lynch
- VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT, USA; University of Utah School of Medicine, Department of Internal Medicine, Division of Epidemiology, Salt Lake City, UT, USA.
| | - Jillian C Shipherd
- Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) Health Program, Veterans Health Administration, Washington, DC, USA; National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Elise Gatsby
- VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT, USA
| | - Benjamin Viernes
- VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT, USA; University of Utah School of Medicine, Department of Internal Medicine, Division of Epidemiology, Salt Lake City, UT, USA
| | - Scott L DuVall
- VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT, USA; University of Utah School of Medicine, Department of Internal Medicine, Division of Epidemiology, Salt Lake City, UT, USA
| | - John R Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA; Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
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