MMWR Morb Mortal Wkly Rep. 2023 Apr 21;72(16):437-444. doi: 10.15585/mmwr.mm7216a5.
In 2021, the CDC Director declared that racism is a serious threat to public health,* reflecting a growing awareness of racism as a cause of health inequities, health disparities, and disease. Racial and ethnic disparities in COVID-19-related hospitalization and death (1,2) illustrate the need to examine root causes, including experiences of discrimination. This report describes the association between reported experiences of discrimination in U.S. health care settings and COVID-19 vaccination status and intent to be vaccinated by race and ethnicity during April 22, 2021-November 26, 2022, based on the analysis of interview data collected from 1,154,347 respondents to the National Immunization Survey-Adult COVID Module (NIS-ACM). Overall, 3.5% of adults aged ≥18 years reported having worse health care experiences compared with persons of other races and ethnicities (i.e., they experienced discrimination), with significantly higher percentages reported by persons who identified as non-Hispanic Black or African American (Black) (10.7%), non-Hispanic American Indian or Alaska Native (AI/AN) (7.2%), non-Hispanic multiple or other race (multiple or other race) (6.7%), Hispanic or Latino (Hispanic) (4.5%), non-Hispanic Native Hawaiian or other Pacific Islander (NHOPI) (3.9%), and non-Hispanic Asian (Asian) (2.8%) than by non-Hispanic White (White) persons (1.6%). Unadjusted differences in prevalence of being unvaccinated against COVID-19 among respondents reporting worse health care experiences than persons of other races and ethnicities compared with those who reported that their health care experiences were the same as those of persons of other races and ethnicities were statistically significant overall (5.3) and for NHOPI (19.2), White (10.5), multiple or other race (5.7), Black (4.6), Asian (4.3), and Hispanic (2.6) adults. Findings were similar for vaccination intent. Eliminating inequitable experiences in health care settings might help reduce some disparities in receipt of a COVID-19 vaccine.
2021 年,疾病预防控制中心主任宣布,种族主义是对公共健康的严重威胁,*这反映出人们越来越认识到种族主义是造成健康不平等、健康差距和疾病的原因。COVID-19 相关住院和死亡的种族和族裔差异(1,2)表明需要检查根本原因,包括歧视经历。本报告描述了在 2021 年 4 月 22 日至 2022 年 11 月 26 日期间,根据对国家免疫调查-成人 COVID 模块(NIS-ACM)1,154,347 名受访者收集的访谈数据进行的分析,报告的在美国医疗保健环境中经历歧视与 COVID-19 疫苗接种状况和接种意愿之间的关联,按种族和族裔划分。总体而言,3.5%的 18 岁及以上成年人表示与其他种族和族裔相比,他们的医疗体验较差(即他们经历了歧视),非西班牙裔黑人或非裔美国人(黑人)(10.7%)、非西班牙裔美洲印第安人或阿拉斯加原住民(AI/AN)(7.2%)、非西班牙裔多种族或其他种族(多种族或其他种族)(6.7%)、西班牙裔或拉丁裔(西班牙裔)(4.5%)、非西班牙裔夏威夷原住民或其他太平洋岛民(NHOPI)(3.9%)和非西班牙裔亚洲人(亚洲人)(2.8%)的报告比例明显高于非西班牙裔白人(白人)(1.6%)。与报告医疗体验与其他种族和族裔相同的受访者相比,报告医疗体验较差的受访者中,未接种 COVID-19 疫苗的比例在总体上(5.3)和 NHOPI(19.2)、白人(10.5)、多种族或其他种族(5.7)、黑人(4.6)、亚洲人(4.3)和西班牙裔(2.6)成年人中存在统计学意义。接种意愿的结果相似。消除医疗保健环境中的不平等体验可能有助于减少 COVID-19 疫苗接种方面的一些差异。