Similarities and Differences in COVID-19 Awareness, Concern, and Symptoms by Race and Ethnicity in the United States: Cross-Sectional Survey

• Authors: Jeb Jones, Emory University; Patrick Sullivan, Emory University; Travis Sanchez, Emory University; Jodie Guest, Emory University; Eric W. Hall, Emory University; Nicole Luisi, Emory University; Maria Zlotorzynska, Emory University; Gretchen Wilde, Emory University; Heather Bradley, Georgia State University; Aaron Siegler, Emory University
• Journal Title: Journal of Medical Internet Research
• Volume: Volume 22, Number 7
• Publisher: JMIR Publications, Inc. | 2020-07-10, Pages e20001-e20001
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.2196/20001
• Subjects: Health Sciences, Health Care Management; Health Sciences, Epidemiology; Biology, Biostatistics; Health Sciences, Public Health
• Keywords: Science & Technology; Life Sciences & Biomedicine; Health Care Sciences & Services; Medical Informatics; COVID-19; SARS-CoV-2; race; ethnicity; awareness; concern; symptom; cross-sectional; knowledge; health disparity; inequality

Abstract

Background Existing health disparities based on race and ethnicity in the United States are contributing to disparities in morbidity and mortality during the coronavirus disease (COVID-19) pandemic. We conducted an online survey of American adults to assess similarities and differences by race and ethnicity with respect to COVID-19 symptoms, estimates of the extent of the pandemic, knowledge of control measures, and stigma. Objective The aim of this study was to describe similarities and differences in COVID-19 symptoms, knowledge, and beliefs by race and ethnicity among adults in the United States. Methods We conducted a cross-sectional survey from March 27, 2020 through April 1, 2020. Participants were recruited on social media platforms and completed the survey on a secure web-based survey platform. We used chi-square tests to compare characteristics related to COVID-19 by race and ethnicity. Statistical tests were corrected using the Holm Bonferroni correction to account for multiple comparisons. Results A total of 1435 participants completed the survey; 52 (3.6%) were Asian, 158 (11.0%) were non-Hispanic Black, 548 (38.2%) were Hispanic, 587 (40.9%) were non-Hispanic White, and 90 (6.3%) identified as other or multiple races. Only one symptom (sore throat) was found to be different based on race and ethnicity (P=.003); this symptom was less frequently reported by Asian (3/52, 5.8%), non-Hispanic Black (9/158, 5.7%), and other/multiple race (8/90, 8.9%) participants compared to those who were Hispanic (99/548, 18.1%) or non-Hispanic White (95/587, 16.2%). Non-Hispanic White and Asian participants were more likely to estimate that the number of current cases was at least 100,000 (P=.004) and were more likely to answer all 14 COVID-19 knowledge scale questions correctly (Asian participants, 13/52, 25.0%; non-Hispanic White participants, 180/587, 30.7%) compared to Hispanic (108/548, 19.7%) and non-Hispanic Black (25/158, 15.8%) participants. Conclusions We observed differences with respect to knowledge of appropriate methods to prevent infection by the novel coronavirus that causes COVID-19. Deficits in knowledge of proper control methods may further exacerbate existing race/ethnicity disparities. Additional research is needed to identify trusted sources of information in Hispanic and non-Hispanic Black communities and create effective messaging to disseminate correct COVID-19 prevention and treatment information.