Racial and Ethnic Differences in COVID-19 Outcomes, Stressors, Fear, and Prevention Behaviors among U.S. Women: Web-based Cross-sectional Study

This article was originally published here

J Med Internet Res. 2021 Apr 2. doi: 10.2196/26296. Online ahead of print.


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, higher prevalence of pre-existing conditions, increased stress and anxiety from loss of wages and caregiving, and domestic violence.

OBJECTIVE: The purpose of this study was 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 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/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 for the fear of COVID-19 scale, significant racial/ethnic differences were observed for some of the individual scale items (e.g., being afraid of getting COVID-19, sleep loss and heart racing due to worrying about COVID-19).

CONCLUSIONS: Low prevalence of COVID-19 testing and knowledge of where to get tested indicate a critical need to expand testing for women in the U.S., particularly among racial/ethnic minority women. Although overall prevalence of engagement in prevention behaviors was high, targeted education and promotion of prevention activities is warranted in communities of color, particularly with consideration for stressors and adverse mental health.

PMID:33819909 | DOI:10.2196/26296