Black, Latinx, and Sexual and Gender Minorities in Chicago Experience Significant COVID-19 Disparities
A team of Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH) faculty, staff, and interns from the institute’s EDIT Program recently authored the paper “Evidence of social and structural COVID-19 disparities by sexual orientation, gender identity, and race/ethnicity in an urban environment” in the Journal of Urban Health.
Lead author Megan Ruprecht, a research study coordinator with the EDIT Program, describes the main focus of the article as “examining disparities regarding different COVID-19 related outcomes in Chicago by race/ethnicity, sexual orientation, and gender modality.” The paper’s findings demonstrate that Black, Latinx, sexual minority, and gender minority groups in Chicago experienced significant disparities in COVID-19 exposure, susceptibility, treatment access, and in psychosocial effects of the pandemic.
These data were part of a survey conducted in the spring of 2020 by the City of Chicago called the COVID-19 Resiliency Survey. Measures in the survey evaluated the impact of COVID-19 on city residents in the wake of Chicago’s initial lockdown, with particular focus on the experiences of minority populations.
Gregory Phillips II, Ph.D., an ISGMH faculty member who directs the EDIT Program and is senior author on this article, clarifies that “although the survey was initially designed as a resiliency survey, most measures assessed how the most impacted communities in Chicago were getting information, how they were accessing services, and other experiences with COVID-19 testing or prevention in the city.”
In order to assess potential disparities faced by marginalized populations, analyses compared COVID-19-related outcomes on heterosexual vs. sexual minority populations, cisgender vs. gender minority populations, and white vs. racial/ethnic minority subgroups. Results of these analyses concluded that Black and Latinx populations experienced significant difficulties accessing food and supplies. Black and Latinx participants also reported significantly lower levels of access to a healthcare provider to assess the need for a COVID-19 test, medical services, and use of telehealth for mental health services.
“Racial and ethnic minority populations reported lower rates of certain prevention behaviors, such as physical distancing and washing hands,” Ruprecht further explains. “We wanted to look at that from a structural lens. What is preventing these populations from engaging in these prevention behaviors? What changes does the city need to implement to make sure that all groups are able to engage in preventative behaviors?”
Sexual and gender minority individuals also experienced disparities related to COVID-19. Gender minority participants reported significantly lower levels of access to a primary care provider. Sexual minority participants reported significantly lower rates of using telehealth for mental health services, but were significantly more likely to have a mental health provider. “This was something we were not expecting to see,” Ruprecht says. “We thought it might have something to do with higher rates of mental illness in this population. Maybe they were already accessing mental healthcare to begin with.”
The authors conclude the article with four recommendations for a greater focus on health equity:
- Invest increased resources and supplies directly into marginalized communities.
- Revise the city’s emergency preparedness plan to include marginalized populations. “The next time there is an emergency, make sure we are serving these populations first so they do not experience the brunt of the negative effects,” Ruprecht explains.
- Prioritizing structural level changes rather than focusing on individual prevention behaviors. And finally,
- Systematically collect data on sexual orientation and gender identity. “This was one of the first COVID-19 surveys to capture sexual orientation and gender identity. We really don’t have a lot of information on how COVID-19 impacts sexual and gender minority populations because the data are not collected,” says Ruprecht.
Phillips echoes this call for data, adding that “it was really telling that even with the small sample sizes we had for gender modality we were still able to see these associations. That means that these disparities are likely much more pronounced than we expected. We would really love to do something that focuses on these populations in a follow up survey.”
Xinzi Wang, Amy Johnson, Jiayi Xu, Dylan Felt, Siobhan Ihenacho, Patrick Stonehouse, Caleb Curry, Caty DeBroux, and Diogo Costa also contributed to this paper.