COVID-19 research overlooks key perspectives from marginalized communities, study finds

During the pandemic, the Centers for Disease Control and Prevention (CDC) reported that people from historically marginalized racial and ethnic groups were more likely than non-Hispanic white people to be infected, be hospitalized and die from SARS-CoV-2, the virus that causes COVID-19.

However, the very communities that bear the brunt of those disparities are underrepresented in scientific efforts to understand them. A multidisciplinary team of researchers from Cornell conducted a pair of experiments that examined the consequences of such omissions.

The key finding: By prioritizing the perspectives of white Americans, studies of pandemic disparities likely missed important insights. They also found that members of underrepresented groups were the most willing to engage in both individual and collective efforts at solving health disparities.

“I’ve been studying collective-action problems, and how misperceptions about what different groups of people think makes it harder to actually bring them together to work on these issues,” said Neil Lewis Jr. ’13, associate professor of communication and a Nancy and Peter Meinig Family Investigator in the Life Sciences, in the College of Agriculture and Life Sciences (CALS) and at Weill Cornell Medicine.

“So by documenting where these different groups stand, it becomes more clear that there are a lot more people willing to work on this than you might have thought, and you can go out and mobilize those people to create change.”

Lewis is co-corresponding author of “Beyond Fear of Backlash: Effects of Messages About Structural Drivers of COVID-19 Disparities Among Large Samples of Asian, Black, Hispanic, and White Americans,” which is published in Social Science & Medicine. The other corresponding author is Norman Porticella, Ph.D. ’10, a research associate in the Department of Communication (CALS).

Other contributors included Colleen Barry, dean of the Cornell Jeb E. Brooks School of Public Policy; Jamila Michener, associate professor of government in the College of Arts and Sciences, and senior associate dean for public engagement (Brooks School); and Jeff Niederdeppe, the Liberty Hyde Bailey Professor of Communication (CALS) and senior associate dean for faculty development (Brooks School).

The team conducted two survey experiments to test the impact of messages about racial health disparities. Participants were from the four largest racial and ethnic groups in America—Asian, Black, Hispanic and white. The Hispanic group was further broken down into Hispanic white and Hispanic non-white.

In both studies, participants were randomly assigned to view either a message simply describing racial disparities in the health impacts of COVID, similar to past news coverage and studies (control group), or the same message that added context about the structural factors underlying the disparities (intervention group), such as: “These differences in COVID-19 infections and deaths are due to longstanding patterns of discrimination … that history continues to shape modern life.”

After reading their respective messages, participants responded to a series of questions or statements that revealed their beliefs about causes and accountability for the racial disparities, emotional responses, and their support and intentions to advocate for COVID mitigation policies. The second experiment sought to replicate the first with a larger sample of U.S. adults from the same four racial and ethnic groups.

The experiments also showed that the intervention message could bolster beliefs that COVID-19 racial disparities were driven by structural causes, as well as increase support for mitigation policies. In addition, regardless of which message they read, Black, Hispanic and Asian respondents were more willing than their white counterparts to engage in actions to address disparities.

The team has conducted similar research investigating attitudes related to the child tax credit, and is currently examining these attitudes in the contexts of Medicaid, opioid addiction and treatment, and the unequal effects of climate change. According to Niederdeppe, the key to shifting attitudes is by doing more than just saying, “There is a problem.”

“We invite people in through connecting on shared values,” he said. “We provide explanations that try to pull people out of stereotypical attributions of an issue. And I think, critically, we say, ‘Look, there are policies that we know can address these inequalities; this is not an insurmountable problem. We just have to choose to work on it together.'”

Porticella said this line of research is revealing “a lot of potential for change within those who are disproportionately affected—people who, as it turns out, are quite responsive to these messages.”

The researchers found that, contrary to frequent claims about the dangers of talking about racial inequality, they did not find evidence of a so-called “white backlash” when the discussion includes an explanation of why the disparity exists.

“There’s been a lot of research showing that when you discuss disparities without context, Americans end up having these individualized and stereotypical attributions—’There must be something wrong with those people; why are these bad things happening to them?'” said Lewis, who’s also co-director of the Action Research Collaborative.

“And so we wondered whether, if you provide more of the context around why these disparities are happening—the structural drivers of these disparities—might that mitigate some of these backlash effects?”

The team also included Teairah Taylor, M.S. ’22, doctoral student in the field of communication; and researchers from the University of Florida, the University of Minnesota and Wesleyan University.