Understanding the COVID-19, Racism, and Violence Syndemic and its Effects on COVID-19 Testing Disparities

项目摘要 美国黑人社区正在经历三场共同的公共卫生危机：新冠肺炎、系统性 种族主义、社区暴力和警察暴力。美国黑人明显不太可能得到需要的 新冠肺炎检测发现，新冠肺炎的感染率和死亡率都高于美国白人。另外， 黑人社区在2020年经历了枪支暴力的激增，并继续成为警察的受害者 骚扰和暴力，导致大规模的社会正义示威。这些因素的汇聚 流行病创造了一个共性，种族主义、暴力和新冠肺炎聚集在以黑人为主的地方 和低收入社区。这项拟议的研究旨在描述这种共性，以了解如何 黑人社区中的个人和系统的种族主义和暴力可能会影响新冠肺炎的测试决定。 这项对伊利诺伊州芝加哥黑人居民的混合方法研究将产生社区驱动的建议 加强新冠肺炎检测和预防战略，解决这一新兴合并症。我们将研究 医疗不信任、心理创伤和压力以及经济不公的潜在调解途径。 此外，我们将采取基于强度的方法来了解潜在的保护因素，包括 社区凝聚力、社会支持和获得医疗保健的机会。研究的具体目的是：1) 定性地考察种族歧视、社区暴力和警察暴力的经历 影响对医疗保健系统的信任和参与，并为围绕新冠肺炎的决策做出贡献 芝加哥黑人个人的测试和缓解策略(例如，社交距离)(N=50)；2) 定量评估芝加哥(N)黑人居民新冠肺炎测试的流行率及其相关因素 =500)，并将新冠肺炎、种族主义和暴力融为一体；以及3)与 社区咨询委员会，使用综合翻译研讨会方法和干预地图 开发社区和数据驱动的建议的技术，以及针对地方和地区的干预蓝图 卫生部门、研究人员和公共卫生组织改善黑人新冠肺炎检测 美国人。这项研究将产生政策和研究建议、社区资源和 “随时准备”的干预蓝图，以加强新冠肺炎测试，并解决这一新兴合并症。

Project Summary Black communities in the US are experiencing three converging public health crises: COVID-19, systemic racism, and community and police violence. Black Americans are significantly less likely to receive a needed COVID-19 test and have higher rates of COVID-19 infection and death than white Americans. Additionally, Black communities have experienced a surge in gun violence in 2020 and continue to be victims of police harassment and violence, resulting in large-scale social justice demonstrations. The convergence of these epidemics has created a syndemic, wherein racism, violence, and COVID-19 cluster in predominantly Black and low-income communities. The proposed study aims to characterize this syndemic to understand how personal and systemic racism and violence in Black communities may influence COVID-19 testing decisions. This mixed-method study with Black residents of Chicago, IL will result in community-driven recommendations to enhance COVID-19 testing and prevention strategies and address this emerging syndemic. We will examine the potential mediating pathways of medical mistrust, psychological trauma and stress, and economic injustice. Additionally, we will take a strengths-based approach to understand potential protective factors including neighborhood cohesion, social support, and access to health care. The specific aims of the study are to: 1) Qualitatively examine how experiences of racial discrimination, community violence, and police violence influence trust in and engagement with healthcare systems and contribute to decisions around COVID-19 testing and mitigation strategies (e.g. social distancing) among Black individuals in Chicago (N=50); 2) Quantitatively assess the prevalence and correlates of COVID-19 testing among Black residents in Chicago (N = 500) and characterize the COVID-19, racism, and violence syndemic; and 3) In partnership with a Community Advisory Council, use an integrative translational workshop approach and intervention mapping techniques to develop community and data-driven recommendations and an intervention blueprint for local health departments, researchers, and public health organizations to improve COVID-19 testing among Black Americans. This study will result in policy and research recommendations, community resources, and a ‘shovel-ready’ intervention blueprint to enhance COVID-19 testing and address this emerging syndemic.