Study shows psychological impact of perceived COVID-19 health threat among Black Americans

As the coronavirus pandemic continues to devastate communities worldwide, Black Americans who face racial discrimination in hospitals and doctor's offices weather additional stresses that can exacerbate threats from COVID-19. A new University of Georgia study examines the interplay between the perceptions of coronavirus threat and psychological distress among Black Americans.

The additional stresses arise from the prevalent belief among Black Americans worried that they might not recover from how hospitals treat them if they become infected with the coronavirus.

While the notion has been floated among commentators, this is the first study that uses nationally representative data to assess whether this threat, or feeling, is real among Black adults, and then assess how it how it impacts their health."

Ryon Cobb, Lead Author, Assistant Professor of Sociology, UGA Franklin College of Arts and Sciences

The study used data from the American Trends Panel survey by the Pew Research Center collected shortly after the initial outbreak in March 2020, a nationally representative sample of adults in the United States.

Using self-reports of perceived coronavirus threat and beliefs about racism in medical settings, researchers found that the perception that the coronavirus outbreak was a major threat to one's health and the belief that Black Americans face discrimination in medical settings were positively and significantly associated with higher psychological distress levels.

The research also establishes a relationship between these two factors that multiply the risk. Cobb said the data suggest people may take preventive measures more seriously though it could also cause Black adults to engage less with the health care system.

"What we find in the data is the more people think COVID-19 outbreak is a threat to their health, it increases the likelihood of adherence, with Blacks and Latinos more likely to adhere to COVID guidelines than their white counterparts," he said.

The study identifies the additional effect of the outbreak's psychological impacts on these groups, beyond the threat of contracting the virus. "Contracting COVID-19 makes interactions with the health care system inevitable. The fear held by many people of color is that medical institutions are biased against Blacks. The stress of the outbreak and potentially unfair treatment appears to induce psychological distress," said Christy L. Erving, assistant professor in the Department of Sociology at Vanderbilt University.

"Discussions about dealing with the fear of just getting it or not often come down to, if you don't get it, you're fine," Cobb said. "But the outbreak itself is stressful, and the increasing stress is part of people's health, regardless of whether they have COVID."

The study presents a snapshot of some underlying aspects of how structural bias in the American health care system contributes to the outbreak's stressfulness, which continues to have a disproportionate effect on Black Americans.

"These findings highlight the complexity of how a public health crisis can influence Black community members' navigation of an already unequal health care system in increasingly difficult circumstances," W. Carson Byrd, associate professor at the University of Michigan, added.

"We need to be mindful of these perceptions, especially as they blend with the reality that, in the United States, hospitals are businesses. As such, their profits track with the severity of illness in patients. While the stories are anecdotal, they are also backed up by the data: People being turned away from hospitals or unable to see a doctor can lead to worsening health," Cobb said.

"And by the time things are critical, at least for Black Americans, the perception is that there is little hope for recovery."