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Perceptions of Racial/Ethnic Inequities in COVID-19 Healthcare and Willingness to Receive the COVID-19 Vaccine.

Epidemiology 2024 March 29
BACKGROUND: Perceptions of the U.S. healthcare system can impact individuals' healthcare utilization, including vaccination intentions. This study examined the association between perceived racial-ethnic inequities in COVID-19 healthcare and willingness to receive the COVID-19 vaccine.

METHODS: This study used data from the REACH-US study, a large, diverse study of U.S. adults (N=5,145 January-March 2021). Confirmatory factor and regression analyses examined a latent factor of perceived racial-ethnic inequities in COVID-19 healthcare, whether the factor was associated with willingness to receive the COVID-19 vaccine, and whether associations varied across racial-ethnic groups reported as probit estimates (B) and 95% confidence intervals (CIs).

RESULTS: Perceived racial-ethnic inequities in COVID-19 healthcare were highest among Black/African American adults (mean latent factor score: 0.65 +/- 0.43) and lowest among White adults (mean latent factor score: 0.04 +/-0.67). Black/African American (B = -0.08 [95% CI: -0.19, 0.03]) and Native Hawaiian/Pacific Islander (B = -0.08 [95% CI: -0.23, 0.07]) adults who perceived greater racial-ethnic inequities in COVID-19 healthcare were less willing than participants who perceived lower inequities. In contrast, American Indian/Alaska Native (B = 0.15 [95% CI: -0.01, 0.30]), Asian (B = 0.20 [95% CI: 0.08, 0.31]), Hispanic/Latino (English language preference) (B = 0.22 [95% CI: 0.01, 0.43]), Multiracial (B = 0.23 [95% CI: 0.09, 0.36]), and White (B = 0.31 [95% CI: 0.19, 0.43]) adults who perceived greater racial-ethnic inequities in COVID-19 healthcare were more willing to receive the COVID-19 vaccine than participants perceiving higher inequities.

CONCLUSIONS: Greater perceived racial-ethnic inequities in COVID-19 healthcare were associated with less willingness to receive the COVID-19 vaccine among Black/African American and Native Hawaiian/Pacific Islander adults.

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