Racial and ethnic differences in COVID-19 outcomes, stressors, fear, and prevention behaviors among US women: Web-based cross-sectional study

• Type of Material: Article
• Authors: Jamila K Stockman, University of California, San Diego; Brittany A Wood, University of California, San Diego; Katherine M Anderson, Emory University
• Language: English
• Date: 2021-07-01
• Publisher: JMIR Publication
• Publication Version: Final Published Version
• Copyright Statement: ©Jamila K Stockman, Brittany A Wood, Katherine M Anderson. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 12.07.2021.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.2196/26296
• Title of Journal or Parent Work: Journal of Medical Internet Research
• Volume: 23
• Issue: 7
• Start Page: e26296
• End Page: e26296
• Grant/Funding Information: All authors acknowledge support from NIH/NIAID grant P30 AI036214 and the University of California, San Diego Office of Research Affairs; the Office for Equity, Diversity, and Inclusion; and the Office of the Chancellor. JKS and KMA are also supported by NIH/NIDA grant R01 AI128803. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.
• Keywords: SARS-CoV-2; Ethnicity; Native Hawaiian or Other Pacific Islander; Prevalence; Cross-Sectional Studies; Minority Groups; Pandemics; prevention behaviors; Whites; prevalence; Internet; United States; Fear; race; fear; American Indians or Alaska Natives; Racial Groups; ethnicity; Health Education; COVID-19; Hispanic or Latino; COVID-19 Testing; Health Behavior; Adult; African Americans; stress; women; Humans; Female; cross-sectional; demographics
• Research Categories: Education, Health

Abstract

Background: In the United States, racial and ethnic minorities are disproportionately affected by COVID-19, with persistent social and structural factors contributing to these disparities. At the intersection of race/ethnicity and gender, women of color may be disadvantaged in terms of COVID-19 outcomes due to their role as essential workers, their higher prevalence of pre-existing conditions, their increased stress and anxiety from the loss of wages and caregiving, and domestic violence. Objective: The purpose of this study is to examine racial and ethnic differences in the prevalence of COVID-19 outcomes, stressors, fear, and prevention behaviors among adult women residing in the United States. Methods: Between May and June 2020, women were recruited into the Capturing Women’s Experiences in Outbreak and Pandemic Environments (COPE) Study, a web-based cross-sectional study, using advertisements on Facebook; 491 eligible women completed a self-administered internet-based cross-sectional survey. Descriptive statistics were used to examine racial and ethnic differences (White; Asian; Native Hawaiian or other Pacific Islander; Black; Hispanic, Latina, or Spanish Origin; American Indian or Alaskan Native; multiracial or some other race, ethnicity, or origin) on COVID-19 outcomes, stressors, fear, and prevention behaviors. Results: Among our sample of women, 16% (73/470) reported COVID-19 symptoms, 22% (18/82) were concerned about possible exposure from the people they knew who tested positive for COVID-19, and 51.4% (227/442) knew where to get tested; yet, only 5.8% (27/469) had been tested. Racial/ethnic differences were observed, with racial/ethnic minority women being less likely to know where to get tested. Significant differences in race/ethnicity were observed for select stressors (food insecurity, not enough money, homeschooling children, unable to have a doctor or telemedicine appointment) and prevention behaviors (handwashing with soap, self-isolation if sick, public glove use, not leaving home for any activities). Although no racial/ethnic differences emerged from the Fear of COVID-19 Scale, significant racial/ethnic differences were observed for some of the individual scale items (eg, being afraid of getting COVID-19, sleep loss, and heart racing due to worrying about COVID-19). Conclusions: The low prevalence of COVID-19 testing and knowledge of where to get tested indicate a critical need to expand testing for women in the United States, particularly among racial/ethnic minority women. Although the overall prevalence of engagement in prevention behaviors was high, targeted education and promotion of prevention activities are warranted in communities of color, particularly with consideration for stressors and adverse mental health.