New report details racial and ethnic differences in access to care, recovery, and social impacts of COVID-19
Q&A with Blair Whittington
Research Specialist, Michigan COVID-19 Recovery Surveillance Study
A new report from the Michigan COVID-19 Recovery Surveillance Study (MI CReSS) details differences in access to care, recovery, and the social impacts of COVID-19 by race and ethnicity among Michiganders who had COVID-19 between March 1, 2020 and May 31, 2022.
First established in 2020 with the Michigan Department of Health and Human Services (MDHHS), MI CReSS has surveyed thousands of individuals across the state to examine their experiences before, during, and after illness to better inform and document the influence of the virus among different populations. University of Michigan School of Public Health Associate Professor of Epidemiology Nancy Fleischer leads the MI CReSS team.
Previous reports have examined numerous angles from which the virus has impacted Michganders’ lives, including:
- Geographic differences in the impact of COVID-19
- Rural and urban disparities related to the pandemic
- COVID-19 stigma and mental health
- Sociodemographic and clinical characteristics of Long COVID
- Disability status before and after COVID-19 illness
- Non-Hispanic (NH) Black-NH White and Hispanic-NH White differences in the impact of COVID-19
Here, Blair Whittington, MPH ‘21, a research specialist on the MI CReSS team who led the report, highlights the latest report’s information and potential implications of the findings. Whittington joined the MI CReSS team in April 2020 as an interviewer and moved on to become a full-time researcher with the team after earning a Master of Public Health degree in Epidemiology at Michigan Public Health.
What makes this MI CReSS report unique?
This report stands out for two key reasons: Our use of an expanded race and ethnicity measure and the enhanced involvement of our Community Advisory Committee (CAC).
The study captured detailed information on race and ethnicity, allowing us to look beyond the usual categories of Hispanic, non-Hispanic Black, non-Hispanic white, and another race and ethnicity and to highlight groups often underrepresented in research, including Arab/Middle Eastern and North African and American Indian/Alaska Native.
Additionally, our CAC members, recruited from Michigan communities disproportionately impacted by the pandemic, provided invaluable context and interpretation to the data we presented. Specifically, they offered their perspective on findings, which helped to refine our reporting and gave a richer understanding of the data presented. These insights have been integrated into the report, in what we are calling “Community Insights,” showing a holistic view that combines quantitative data with qualitative, community-based knowledge.
What were some of the significant patterns observed in the report?
We found that racial and ethnic minoritized adults faced greater barriers to care, experienced more severe illness and persistent symptoms of COVID-19 (defined as long COVID), and endured poorer mental health outcomes and COVID-19-related stigma compared to non-Hispanic white adults. These patterns were consistent across different measures, emphasizing the disparate impact of the pandemic amongst these groups relative to non-Hispanic white adults.
Can you elaborate on the disparities revealed by the report?
The report digs deeper into various aspects of healthcare access and recovery, such as insurance coverage, which can drastically affect one's ability to seek care, as well as where and when one seeks care. Racial and ethnic minoritized adults were more likely to be uninsured at the time of their diagnosis compared to non-Hispanic white adults. Despite reporting more severe COVID-19 illness, adults within each racial and ethnic minoritized group were more likely to be turned away from needed care and delay seeking care during their illness due to cost or other barriers than non-Hispanic white adults. With the rollback of pandemic-era policies, it is important to consider how the loss of insurance and other social protections might affect care-seeking behaviors for future COVID-19 infections or persistent COVID-19 symptoms.
This report also explores differences in the social impacts of the pandemic. Overall, adults within each racial and ethnic minoritized group were more likely to experience stigma related to their COVID-19 illness and encounter economic stressors, such as loss of employment or reduction in hours worked, compared to non-Hispanic white adults. Racial and ethnic minoritized adults were generally also more likely to be exposed to the virus at work, have less access to adequate personal protective equipment like masks, and take unpaid sick leave than non-Hispanic white adults, which have further implications for disease severity and recovery.
What implications do the findings of the MI CReSS report have for the future of public health?
The findings in this report highlight the need to bolster social protections targeted at reducing racial and ethnic disparities in health. It reinforces the need for strategic public health interventions and preparedness efforts informed by communities to mitigate infectious disease transmission. Lastly, the report underscores the critical importance of investing in our public health infrastructure, learning from the COVID-19 pandemic, and preparing more effectively for the future.