Perceptions of Healthcare Access and Racial Inequity Among Racial/Ethnic Groups During the COVID-19 Pandemic

• In Event: Intersecting Inequities: Discrimination, Policy, and Health in Underrepresented Communities

Abstract

Social equity, one of the pillars of public administration, along with economy, effectiveness, and efficiency, has increasingly centered on the talk and walk of racial equity, given its deep historical and emotional roots in the social system of the United States. Racism, the cause of racial inequity, has brought harm to communities of Color’s health and well-being, leading to health inequities. Since the beginning of the COVID-19 pandemic, the acknowledgement of racial inequity in the United States (US) has exposed stark disparities in healthcare impact among people of Color; structural racism, economic inequalities, and systemic barriers that limit access to healthcare for underrepresented groups exacerbated COVID-19 outcomes. These factors emphasize the urgent need to dismantle structural barriers to equitable healthcare access, thereby improving the well-being of communities of Color. 

The present study aimed to understand how perceptions of access to healthcare relate to perceptions of racism and injustice, and how these relationships differ among racial and ethnic groups through the lens of critical race theory (CRT). This study employed structural equation modelling (SEM), utilizing data from a larger longitudinal study conducted by the RAND Corporation and the Robert Wood Johnson Foundation, which examined experiences related to COVID-19. The data in the present study come from 3,588 completed surveys from the 4th wave of the study, given that the last wave of the survey was fielded after many subsidies and policies had been designed and distributed to reduce the impact of COVID-19.  The predictors were hypothesized to be the four variables of perception of access to healthcare for African Americans, rural Americans, low-income Americans, and Latinx Americans, treated as manifest variables. The outcome is hypothesized to be a latent variable of racial inequity consisting of 1) perceptions of systemic racism, 2) perceptions of racial injustice, and 3) perceptions of racism as a public health crisis. Results indicate that perceptions of access to care for African Americans, Latinxs, and low-income Americans significantly predict stronger perceptions of racial inequity. Black and Hispanic participants had stronger perceptions of racial inequity than white participants. The relationships between perceptions of access to healthcare and racial inequities differed between racial/ethnic groups. 

These results provide crucial evidence for public administrators and policymakers to understand how structural racism influences individuals’ perceptions of access to healthcare and, thus, their perceptions of racial inequity and injustice. Furthermore, it urges the government to take on the responsibility to address structural racism and the public health crisis and mitigate their effects on racial and health inequities through more equitable public health policies, practices, programs, and workforce.

Authors

• Yunru Lu, University of Delaware
  Presenting Author

• Lauren M Strickland, University of Delaware
  Non-Presenting Co-Author

• Benedicta Agyare-Aggrey, University of Delaware
  Non-Presenting Co-Author