COVID-19: Race, Discrimination, Stigma and Impacts on Health

This piece was written by current Disability Studies’ student, Pauline Wangari.

Stigma and Discrimination

The Coronavirus is associated with racial stigma and discrimination. Stories and stereotypes have already had a major impact, specifically on Asian populations. Most countries, if not all, have imposed travel bans and restrictions on Chinese nationals and non-citizens to the area. Discrimination has manifested in the form of evictions, cutting off of business ties, bullying, as well asphysical and verbal altercations. 

The phrase “We’re all in this together” has become a rallying cry during this pandemic. Although the Coronavirus has affected most everyone in some way, regardless of race, gender, age and even socioeconomic status, the magnitude and nature of the impact has been anything but global. Instances of racism fuel the risk of perpetuating stereotypes and triggering health inequities. This is particularly true for female healthcare workers. Evidence now points out that Black and Latinx workers face much more economic and health insecurity from COVID-19 as compared to their Caucasian counterparts . 

The impact of the Coronavirus will leave a lasting mark on society for years to come. The disparate racial impact of COVID-19 comes as no surprise, given the ongoing legacy of racism that continues to produce inequities affecting nearly every aspect of life, particularly in the US.There is a notable racial impact of the virus in our social and economic aspects of life. Persistent racial differences in regard to health status, healthcare accessibility, wealth, employment, wages, housing, income, and poverty all contribute to increased susceptibility to the virus – both economically and physically.

Racialized healthcare workers face greater underlying pre- and post-pandemic health insecurities making them more vulnerable to COVID-19. Some of the challenges include a heightened risk of contracting the virus, increased workplace violence, underpayment, being under-valued, pre-existing health conditions, lack of health insurance, housing conditions, shame and stigma.

Increased  Risks

All frontline healthcare workers have an increased risk of contracting the virus. However, as women are predominantly  tasked with the role of providing care, they will be disproportionately affected. Gender and power dynamics  increase the likelihood that men will be prioritized over women, or male-dominated roles such as doctors prioritized over female-dominated roles such as nurses in distribution and decision-making around personal protective equipment (PPE). Given women’s additional gender roles as primary caregivers in their households, a ripple effect of increased risks will occur. 

From a recent incident in Ontario, Canada:

“Over 1675 troops have been deployed to five long-term care homes in Ontario and a further 25 in Quebec over the course of the COVID-19 pandemic. The Ontario officials were notified of the report by the federal government in a memo citing concerns on deficiencies in home care infrastructure for example PPE’s.” 

“Nurses/PSWs were often observed not changing PPE for several hours while moving between numerous patient rooms. Equipment is seldom ever observed to be disinfected but is used in between patients.” 

Wage Differences-Underpayment

Female workers are often paid less than their male counterparts. This inequity in pay can also be seen in healthcare workers. Additionally, racial inequities in pay also exist causing Black workers to face significant pay penalties., Black workers face significant pay gaps in the labor market, and research has shown these pay gaps have grown since 2000 and in the decades before (Gould 2020a; Wilson and Rodgers 2016). 

Safety

We have witnessed severe restrictions in day-to-day activities due to the  lockdown associated with the pandemic in hopes of  “flattening the curve”. These measures may lead to particular safety concerns for women going to and from their places of work, given that they are also constrained by part-time employment. Drastic changes have disrupted the normal protections afforded in typical daily life–such as the presence of other people, well-lit transport routes, variety of options for travel times, etc.— and leave women vulnerable to violence, including sexual violence. In some contexts, where workers regularly commute across national or state borders, take an example of Swiss healthcare workers commuting to northern Italy, more stringent restrictions on movement may also increase vulnerability and risk for women such as getting stuck on the opposite side of the border. Women frontline healthcare workers will need to continue to reach their jobs each day, despite the risks, and with fewer options available. 

Prior to the pandemic’s onset, research from northern Italy found 45% of healthcare professionals reported workplace violence. This research found that men were more likely to commit physical violence than women, and that assaulted professionals were more likely to be female.Already, there are reports of violence against healthcare workers during the COVID-19 outbreak in numerous countries, with the majority of  victims being women. 

As fright of the pandemic spreads, so does panic and panic behavior. Women frontline healthcare workers are at an increased risk of shame, discrimination and stigma from their community and family members for their perceived role in managing the pandemic. Additionally, there may be fears that these individuals are also spreading the virus within the community.. Examples of this were drawn from the Philippines and the Democratic Republic of Congo (DRC), where health workers were expelled from their homes because landlords feared they would transmit the virus. There may also be unintended consequences to sudden upswings in community health workers or volunteers, who may also face shame, discrimination and stigma based on their involvement with the response and/or bending of traditional gender roles.

Lack of Supports

In times of crisis, care and wellbeing for ourselves, staff, volunteers and others tends to get overlooked for the more ‘urgent’ work of ensuring lives are saved. This results in fast burn out, a decline in the quality of healthcare being provided, stress and can have long-term harmful effects for frontline workers.

We have already witnessed many equity and justice challenges that need to be looked into before further damage is caused. We mustrecognize and stand up against racial discrimination and stereotyping. Our federal, state and local governments have to ensure that necessary policies and practices are implemented, so that needed information, training, resources, and care are equitably available to all people and communities. As we think about the upcoming Census and elections, the COVID-19 pandemic underscores the ongoing need to push for affordable and quality healthcare coverage. Workers must be well-trained and have a diverse understanding of healthcare and medical research. Healthcare and healthcare resources must be accessible to all,regardless of race, gender, age or other differences.

What can be done?

To mitigate the risks  to healthcare workers with regards to the virus, certain measures need to be put in place:

• All health care workers need to be given adequate PPEs;
• The needs, risks and concerns of the healthcare workers must be heard and communicated up the chains of command;
• Gender and equity policies need to be put in place to ensure equity in the workplace;
• Female healthcare workers need to have representation in decision-making; 
• Supports in the form of  increased wages, promotions and leaves should be given to healthcare workers; and 
• Higher ups need to facilitate the movement of healthcare workers in contexts where movement restrictions have been imposed.

References

• China Labor Bulletin (5 March 2020). Women workers on the frontline in the battle against the coronavirus. Retrieved from https://clb.org.hk/content/women-workers-frontline-battle-againstcoronavirus.
• Gould, Elise. 2020b. “The Unemployment Rate Is Not the Right Measure to Make Economic Policy Decisions Around the Coronavirus-Driven Recession: Policymakers Should Use the Employment Rate to Continue or Stop Economic Assistance.” Working Economics Blog (Economic Policy Institute), March 20, 2020.
• Gould, Elise, and Heidi Shierholz. 2020. “Senate Coronavirus Bill Is Crucial—But It’s a Fraction of What’s Needed.” Working Economics Blog (Economic Policy Institute), March 18, 2020. Rho, Hye Jin, Haley Brown, and Shawn Fremstad. 2020. A Basic Demographic Profile of Workers in Frontline Industries. Center for Economic and Policy Research, April 2020 Meepagala, Shawn, and Carl Romer. 2020. “Mapping Racial and Ethnic Differences with COVID-19” (interactive data tool). Center for Global Data. Accessed May 29, 2020. 
• WHO. COVID-19: Operational guidance for maintaining essential health services during an outbreak [Internet]. Geneva; 2020. Available from: file:///C:/ Users/ebarasa/Downloads/WHO- 2019-nCoV-essential_health_services-2020.1-eng (2).pdf
• Wilson, Valerie, and William M. Rodgers III. 2016. Black–White Wage Gaps Expand with Rising Wage Inequality. Economic Policy Institute, September 2016.