ABSTRACT
Background The COVID-19 pandemic has had a disproportionate effect on the Black/African American population. In addition to the higher infection rates and the worse outcomes, there were other unintended consequences of the pandemic. The study objective was to determine the impact of COVID-19 on the Black/African American community. Methods A needs assessment was conducted using a mixed-methods approach. To address this specific study objective, an item included in the survey questionnaire asked respondents (n = 183) about their greatest worry related to CODID-19. Interviews and focus group discussions were conducted to further explore individual and community perceptions. Results The areas of greatest concern were Health (41.0%), Family (25.1%), Finances (8.2%), and Education (4.9%). The needs assessment revealed that the COVID-19 pandemic had a profound impact on the mental health and wellness, healthcare access and utilization, and social aspects of life the Black community. Emerging themes revealed that there was worsening mental health for many, limited healthcare access and under-utilization, and profound disruption of the social cohesive identity of the Black/African American community. Conclusion Pre-existing structural inequities are implicated in the mental health impact, as well as the under-utilization of and limited access to healthcare services in the Black/African American population. The impact on social well-being emphasizes the important role of culture in the population health of communities of color, further supporting the need for culturally-responsive public health interventions when targeting these communities.
ABSTRACT
BACKGROUND: The COVID-19 pandemic has had a disproportionate effect on the Black/African American population. In addition to the higher infection rates and the worse outcomes, there were other unintended consequences of the pandemic. The study objective was to determine the impact of COVID-19 on the Black/African American community. METHODS: A needs assessment was conducted using a mixed-methods approach. To address this specific study objective, an item included in the survey questionnaire asked respondents (n = 183) about their greatest worry related to CODID-19. Interviews and focus group discussions were conducted to further explore individual and community perceptions. RESULTS: The areas of greatest concern were Health (41.0%), Family (25.1%), Finances (8.2%), and Education (4.9%). The needs assessment revealed that the COVID-19 pandemic had a profound impact on the mental health and wellness, healthcare access and utilization, and social aspects of life the Black community. Emerging themes revealed that there was worsening mental health for many, limited healthcare access and under-utilization, and profound disruption of the social cohesive identity of the Black/African American community. CONCLUSION: Pre-existing structural inequities are implicated in the mental health impact, as well as the under-utilization of and limited access to healthcare services in the Black/African American population. The impact on social well-being emphasizes the important role of culture in the population health of communities of color, further supporting the need for culturally-responsive public health interventions when targeting these communities.
Subject(s)
COVID-19 , Health Services Accessibility , Humans , Mental Health , Needs Assessment , PandemicsABSTRACT
BACKGROUND: The long history of distrust that characterizes the relationship between the Black/African-American population and the US Medical community makes COVID-19 vaccine hesitancy of great concern. A needs assessment of the Black/African-American community assessed willingness and explored the perceptions of community members regarding COVID-19 vaccination. METHODS: The study used a mixed-methods approach. Respondents (n = 183) were surveyed with a web-based questionnaire. They were asked whether there would get vaccinated for COVID-19 barring any access or cost-related challenges. Perceptions of community members regarding vaccination were explored through one-on-one interviews (n = 30) and eight focus groups (n = 49), with participants drawn from across various demographic characteristics. Survey responses were summarized using frequencies and proportions. A thematic analysis was conducted on the qualitative data. RESULTS: Thirty-four percent of respondents indicated "Yes" (willing to get vaccinated); 26.8% indicated "No", while 37.1% expressed hesitancy ("Maybe" or "I don't know"). Themes emerging from the qualitative data are grouped into three broad categories: vaccine accessibility (transportation, information, navigating healthcare system); vaccine hesitancy (with sub-categories of compliance, complacency and confidence); and vaccine "resistance" (conspiracy theories, conflicting beliefs, distrust of Government, trustworthiness of Health care). CONCLUSION: Findings demonstrate a nuanced expansion of "vaccine hesitancy" to delineate groups with varying issues and perspectives. Interventions to enhance vaccination rates in Black/African-American communities should incorporate components that assure accessibility at the minimum, but also address non-access-related issues. Priority should be given to enhancing vaccine literacy, information-sharing as efficacy and safety data emerge, and addressing specific concerns identified through community-engaged outreach efforts.