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Contextualizing the Racial Gradient in COVID-19 Outcomes: Narratives From HBCU Students

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Title: Contextualizing the Racial Gradient in COVID-19 Outcomes: Narratives From HBCU Students
Language: English
Authors: Anna K. Lee (ORCID 0000-0002-7420-2954), Jeannette Wade (ORCID 0000-0001-9126-5554), Stephanie Teixeira-Poit, Dextiny McCain, Christopher Doss, Smriti Shrestha, Adrienne T. Aiken-Morgan
Source: Journal of American College Health. 2024 72(6):1759-1767.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 9
Publication Date: 2024
Sponsoring Agency: National Science Foundation (NSF)
Contract Number: 2033926
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: COVID-19, Pandemics, Personal Narratives, Student Attitudes, College Students, Black Colleges, African American Students, Mental Health, Academic Persistence, Knowledge Level, Health Behavior, Barriers, Academic Achievement, Emotional Response, Racism, Access to Health Care, Trust (Psychology), Intervention, Health Services, Critical Race Theory, Health Conditions
DOI: 10.1080/07448481.2022.2089849
ISSN: 0744-8481
1940-3208
Abstract: COVID-19 spread across the nation with Black Americans experiencing twice of the prevalence of deaths than White Americans. Black American college students are facing a unique set of biopsychosocial costs including less retention and poorer mental health. Therefore, the purpose of this study was to examine how Historically Black College or University (HBCU) students contextualize COVID-19. Interviews were conducted with 19 participants and lasted 40-60 minutes. They discussed topics including: their COVID-19 knowledge, precautionary measures, and barriers and promoters of school success were covered. Data were coded through semi-open coding and discussed among the research team. Responses were summarized by eight themes: emotional responses, colorblind rhetoric, lack of healthcare, essential work, distrust for the medical field, barriers to precautions like supply shortages and environmental factors, and poor baseline health. These findings may be used to develop interventions that moderate the impact of COVID-19 and future pandemics on mental health.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1433382
Database: ERIC
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  Value: <anid>AN0178681383;acl01aug.24;2024Jul31.05:49;v2.2.500</anid> <title id="AN0178681383-1">Contextualizing the racial gradient in covid-19 outcomes: Narratives from HBCU students </title> <p>COVID-19 spread across the nation with Black Americans experiencing twice of the prevalence of deaths than White Americans. Black American college students are facing a unique set of biopsychosocial costs including less retention and poorer mental health. Therefore, the purpose of this study was to examine how Historically Black College or University (HBCU) students contextualize COVID-19. Interviews were conducted with 19 participants and lasted 40-60 minutes. They discussed topics including: their COVID-19 knowledge, precautionary measures, and barriers and promoters of school success were covered. Data were coded through semi-open coding and discussed among the research team. Responses were summarized by eight themes: emotional responses, colorblind rhetoric, lack of healthcare, essential work, distrust for the medical field, barriers to precautions like supply shortages and environmental factors, and poor baseline health. These findings may be used to develop interventions that moderate the impact of COVID-19 and future pandemics on mental health.</p> <p>Keywords: Black college students; COVID-19; health disparities; social determinants of health</p> <hd id="AN0178681383-2">Introduction</hd> <p>As Coronavirus Disease 2019 (COVID-19) spread quickly across the nation, the impact is not shared equally across racial groups.[<reflink idref="bib1" id="ref1">1</reflink>] The number of COVID-19 deaths in Black neighborhoods is disproportionately higher than the population of Blacks in the U.S.[<reflink idref="bib2" id="ref2">2</reflink>] Black Americans account for 12.14% of the U.S. population but are more than twice as likely as White Americans (60.32%) to die from COVID-19. [<reflink idref="bib3" id="ref3">3</reflink>] Furthermore, those on college campuses face major hurdles in terms of social distancing and avoiding groups larger than 10-15.[<reflink idref="bib1" id="ref4">1</reflink>]</p> <p>Current trends in COVID-19 diagnoses mean Black American college students are facing a unique set of biopsychosocial costs. One cost is retention. Black students are more likely to take leaves of absence or withdraw from school completely.[<reflink idref="bib4" id="ref5">4</reflink>],[<reflink idref="bib5" id="ref6">5</reflink>] Another notable cost is decreases in mental health. Most of the research on the mental impact of COVID-19 on Black college students have focused on students at Historically/Traditional White Institutions.[<reflink idref="bib6" id="ref7">6</reflink>],[<reflink idref="bib7" id="ref8">7</reflink>] These studies have found that dealing with racism during the pandemic has contributed to the mental health challenges Black students experience.[<reflink idref="bib4" id="ref9">4</reflink>],[<reflink idref="bib5" id="ref10">5</reflink>] Another notable cost is declines in mental health. To understand racial disparities in COVID-19, it is important to consider the ways in which Black Americans have experienced the pandemic. To date there are speculative reports based on established social determinants of health, but no study that focuses on the lived experiences of Black American college students. Instead, much of the research on the mental health impact of COVID-19 on Black college students has focused on students at Historically/Traditionally White Institutions.[<reflink idref="bib6" id="ref11">6</reflink>]</p> <p>Researchers have noted that mental health stigma among Black Americans may be related to the systemic racism and discrimination they face. Systemic racism drives the lack of exposure, awareness and access to care that contributes to the lack of understanding regarding mental health. For example, research has found that among Black American college students, it was found the more they perceive an ability to visibly identify those with mental illness the more likely they were to experience stigma.[<reflink idref="bib8" id="ref12">8</reflink>] Furthermore, research suggests that Black American college students are more likely to believe that having mental health problems means that your problem must be serious in nature and is significant enough to require hospitalization.[<reflink idref="bib9" id="ref13">9</reflink>] Greater stigma toward those who are mentally ill may be linked to individuals associating mental illness and psychological treatment to severe mental illness.[<reflink idref="bib10" id="ref14">10</reflink>] Due to the educational, physical and mental health costs caused by the pandemic it is critical to understand how college students have been affected. Therefore, the purpose of this paper is to examine the ways in which Historically Black College or University (HBCU) students contextualize COVID-19.[<reflink idref="bib4" id="ref15">4</reflink>],[<reflink idref="bib5" id="ref16">5</reflink>]</p> <hd id="AN0178681383-3">Established social determinants of Black American health</hd> <p>Several contextual factors have been shown to negatively impact Black American health, including residential segregation, essential work, preexisting health conditions, and racism in healthcare. Black Americans are more likely to reside in neighborhoods where residential segregation exists. There is evidence that both Black (about 65%) and White Americans (about 75%) live in racially homogenous neighborhoods, however this has different implications by race. [<reflink idref="bib11" id="ref17">11</reflink>] Before the COVID-19 pandemic, poverty rates for African Americans were 22% compared to 9% for whites.[<reflink idref="bib12" id="ref18">12</reflink>] As a result, Black families are subjected to densely populated living conditions as well as multigenerational households, both of which can make social distancing more challenging. [<reflink idref="bib2" id="ref19">2</reflink>]<sups>, </sups>[<reflink idref="bib12" id="ref20">12</reflink>] These living conditions can increase the risk for both COVID-19 infection and transmission. In addition to overcrowded living conditions, these communities often lack adequate plumbing facilities, requiring them to utilize communal accommodations, thus potentially creating higher risk to contract the virus.[<reflink idref="bib13" id="ref21">13</reflink>] Low-income homes are also more likely to house individuals who work in food preparation, health care, transportation, or grounds cleaning, and who are essential workers.[<reflink idref="bib2" id="ref22">2</reflink>] As such, lower income workers are less able to follow stay at home orders because their work must be done onsite. During a pandemic, having essential positions means low wage, essential workers are putting themselves at a higher risk for COVID-19 exposure, which could eventually become a risk that is shared by the household,[<reflink idref="bib3" id="ref23">3</reflink>] however this has different implications by race which makes disease management more difficult.[<reflink idref="bib1" id="ref24">1</reflink>]<sups>, </sups>[<reflink idref="bib3" id="ref25">3</reflink>]<sups>, </sups>[<reflink idref="bib11" id="ref26">11</reflink>],[<reflink idref="bib12" id="ref27">12</reflink>] Black Americans are less likely to visit hospitals for non-emergency needs, and many of the hospitals in their areas are not full-service establishments.[<reflink idref="bib13" id="ref28">13</reflink>],[<reflink idref="bib14" id="ref29">14</reflink>] Of note, it was found that Black Americans who visited the emergency room during COVID-19 experienced longer wait times, which further increases the risk for exposure to the virus. which makes disease management more difficult. In addition to the wait times, the quality of care is often poorer in these underserved neighborhoods, which also proliferates COVID-19 exposure.[<reflink idref="bib12" id="ref30">12</reflink>]</p> <p>Residential segregation also contributes to the higher rates of preexisting conditions in Black neighborhoods. Persons with diabetes, hypertension, cardiovascular disease, or chronic lung disease are at higher risk for severe COVID-19[<reflink idref="bib15" id="ref31">15</reflink>] and Black Americans have a disproportionately high prevalence of these diseases.[<reflink idref="bib12" id="ref32">12</reflink>] Segregated Black Americans face various health related barriers including increased exposure to air pollutants and higher rates of fast-food density.[<reflink idref="bib11" id="ref33">11</reflink>],[<reflink idref="bib12" id="ref34">12</reflink>] Fast food density (defined by Kwate 2008 as the number of fast-food restaurants per square mile) means Black Americans leaves Black Americans with limited health related autonomy and forces them to have diets centered on fried and processed food. Studies show that blacks living in racially homogenous neighborhoods are more vulnerable to these chronic health conditions,[<reflink idref="bib1" id="ref35">1</reflink>] therefore making them more susceptible to COVID-19 and increasing the need for health care. Black Americans have a disproportionately high prevalence of these diseases.[<reflink idref="bib12" id="ref36">12</reflink>]</p> <p>A final concern is medical racism. Healthcare occurs in a society that is structured by race so medical experiences are guided by racist practices and plagued with historical violations against Black neighborhoods.[<reflink idref="bib16" id="ref37">16</reflink>] One cost of the racial divide in healthcare is a lack of access to health care in predominately Black neighborhoods which makes disease management more difficult.[<reflink idref="bib1" id="ref38">1</reflink>]<sups>, </sups>[<reflink idref="bib11" id="ref39">11</reflink>],[<reflink idref="bib12" id="ref40">12</reflink>] Black Americans are less likely to visit hospitals for non-emergency needs, and many of the hospitals in their areas are not full-service establishments.[<reflink idref="bib13" id="ref41">13</reflink>],[<reflink idref="bib14" id="ref42">14</reflink>] Of note, it was found that Black Americans who visited the emergency room during COVID-19 experienced longer wait times, which further increases the risk for exposure to the virus. In addition to the wait times, the quality of care is often poorer in these underserved neighborhoods, which also proliferates COVID-19 exposure[<reflink idref="bib12" id="ref43">12</reflink>]<sups>, </sups>[<reflink idref="bib15" id="ref44">15</reflink>],[<reflink idref="bib16" id="ref45">16</reflink>] healthcare occurs in a society that is structured by race so medical experiences are guided by racist practices and plagued with historical violations against Black neighborhoods. One cost of the racial divide in healthcare is a lack of access to health care in predominately Black neighborhoods, which makes disease management more difficult.[<reflink idref="bib1" id="ref46">1</reflink>]<sups>, </sups>[<reflink idref="bib11" id="ref47">11</reflink>],[<reflink idref="bib12" id="ref48">12</reflink>] Black Americans are less likely to visit hospitals for non-emergency needs, and many of the hospitals in their areas are not full-service establishments.[<reflink idref="bib13" id="ref49">13</reflink>],[<reflink idref="bib14" id="ref50">14</reflink>] It has been found that Black Americans who visited the emergency room during COVID-19 experienced longer wait times, which further increases the risk for exposure to the virus.[<reflink idref="bib15" id="ref51">15</reflink>] In addition to the wait times, the quality of care is often poorer in these underserved neighborhoods, which also proliferates COVID-19 exposure.[<reflink idref="bib12" id="ref52">12</reflink>]<sups>, </sups>[<reflink idref="bib16" id="ref53">16</reflink>]</p> <hd id="AN0178681383-4">Theoretical framework</hd> <p>This work is grounded in Critical Race Theory (CRT) because this theoretical approach suggests that to understand the lived experiences of a group of people; their voices should be centered within the systems of oppression under which they live.[<reflink idref="bib17" id="ref54">17</reflink>] This theory was first introduced to describe Black Americans experiences within the context of the law but has since been applied to understand their experiences within other systems, such as education and health. In this case, we center the voices of Black college students as they navigate a particular health crisis, the COVID-19 pandemic. This theory highlights how false notions of objectivity, colorblindness, and meritocracy have historically blocked centering of Black Americans experiences. Therefore, a race-conscious approach is needed to acknowledge and redress the pervasiveness of racism across various social systems (e.g., health, education, legal).[<reflink idref="bib18" id="ref55">18</reflink>] The CRT framework allows marginalized students' voices to be integrated into the conversation about factors impacting their health outcomes while also accounting for racism and other systems of oppression.[<reflink idref="bib19" id="ref56">19</reflink>],[<reflink idref="bib20" id="ref57">20</reflink>] In this study, CRT is used to ascertain Black students' perspectives on COVID-19 when situating racism and other forms of structural oppression. [<reflink idref="bib21" id="ref58">21</reflink>] This study is necessary because it provides voice to thoseoften underrepresented in scholarly literature Black college students at HBCUS and provides a context for how Black Americans understand COVID-19 risk. [<reflink idref="bib17" id="ref59">17</reflink>]</p> <hd id="AN0178681383-5">Methods</hd> <p></p> <hd id="AN0178681383-6">Procedure</hd> <p>The current study uses data from a larger mixed methods study of psychosocial determinants of school success during the COVID-19 pandemic. The larger study, known as the Promoting Readiness Online by Maximizing Opportunities in Technology and Education (PROMOTE) Study sought to identify and understand barriers to remote learning faced by college students at a HBCU and to develop effective interventions to mitigate the disruptions caused by COVID-19. The research team conducted interviews from June 2020 to January 2021. Participants were recruited as part of a two-pronged process. First, the research team advertised the quantitative study using flyer distribution, email blasts, news reports on the university website and social media. Second, upon survey completion students were given the opportunity to share their contact information to participate in the interviews. Students received a $50.00 visa gift card as an incentive for their participation. The study was approved by the Institutional Review Board (IRB) at The HBCU under study. Interviews lasted 40-60 minutes and covered topics ranging from COVID-19 knowledge, to related precautions, to barriers and promoters of school success. Due to CDC and campus COVID-19 guidelines, the research team conducted and recorded interviews using Zoom software. Data were coded through semi-open coding by three primary investigators and two graduate research assistants. Data were subsequently discussed for consensus and analyzed for emergent themes[<reflink idref="bib22" id="ref60">22</reflink>]</p> <p>Our team used an explanatory research design whereby qualitative interviews were used to explain quantitative survey results.[<reflink idref="bib23" id="ref61">23</reflink>] The greatest benefit to this approach is that one set of data builds on another. Additionally, in depth interviews as a preferred method of collecting data on new topics that need a depth of information and for issue identification.[<reflink idref="bib24" id="ref62">24</reflink>] Given the growing evidence that Black Americans are at disproportionate risk for contracting and suffering from Covid-19, collecting rich data on why and how that is the case, is vital for the improvement of public and personal health. The findings reported here come from 19 of 21 in depth interviews from students who ranged in age from 18-27 (M = 21.3, SD = 1.4) attending a large southern HBCU. Two interviews were excluded because the respondents were not Black American. Basic demographic information is available in Table 1.[<reflink idref="bib23" id="ref63">23</reflink>]</p> <p>Table 1. Descriptive statistics for interview participants - AA sample (N = 19).</p> <p> <ephtml> <table><thead><tr><td /><td>Number</td></tr></thead><tbody valign="top"><tr><td><bold>Age</bold></td><td char=".">18-27 (M = 21.3, SD = 1.4)</td></tr><tr><td><bold>Sex</bold></td><td /></tr><tr><td>M</td><td char=".">2</td></tr><tr><td>F</td><td char=".">17</td></tr><tr><td><bold>K-12 Urbanicity</bold></td><td /></tr><tr><td>Urban</td><td char=".">4</td></tr><tr><td>Suburban</td><td char=".">11</td></tr><tr><td>Rural</td><td char=".">4</td></tr><tr><td><bold>Virtual Learning Location</bold></td><td /></tr><tr><td>On Campus</td><td char=".">3</td></tr><tr><td>Off Campus Housing</td><td char=".">9</td></tr><tr><td>Non traditional Student - Stayed Home</td><td char=".">3</td></tr><tr><td>Return Home</td><td char=".">4</td></tr></tbody></table> </ephtml> </p> <hd id="AN0178681383-7">Results</hd> <p>Interviewees were read the following prompt: According to the Centers for Disease Control, Black Americans are more likely to be hospitalized due to Covid-19 and most likely to die from Covid-19. What do you think when you hear those trends? Why do you think that is the case?" Themes and codes are listed in Table 2 below.</p> <p>Table 2. Race and covid-19 outcomes codes and themes.</p> <p> <ephtml> <table><thead><tr><td>Question</td><td>Codes</td><td>Example Quotes</td></tr></thead><tbody valign="top"><tr><td><bold><italic>What do you think when you hear those trends? Why do you think that is the case?</italic></bold></td><td><list list-type="Bullet"><list-item><p>Emotional Response</p></list-item><list-item><p>Lack of Healthcare</p></list-item><list-item><p>Essential Work</p></list-item><list-item><p>Distrust Medical Field</p></list-item><list-item><p>Barriers to Precautions: Supply Shortage</p></list-item><list-item><p>Barriers to Precautions: Environmental Factors</p></list-item><list-item><p>Poor baseline health/ Race specific health conditions</p></list-item><list-item><p>Time constraints</p></list-item></list></td><td>"Like historically we never trust the medical system, especially like from the Tuskegee, so of course they're not going to go to the doctor to get checked up about other things." "I'm angry because it's like I don't want to hear things like that, especially constantly being thrown at me, but at the same time. So I know I need to know."</td></tr><tr><td><bold><italic>Can you tell me how you feel about the items on the list and if they impact you and your loved ones? Black Americans...</italic></bold></td></tr><tr><td><bold>Prompts</bold></td><td><bold>Codes for all Prompts</bold></td><td><bold>Example Quotes</bold></td></tr><tr><td><list list-type="Bullet"><list-item><p><bold><italic>live in areas with many neighbors (like apartments and duplex homes)</italic></bold></p></list-item><list-item><p><bold><italic>more likely to be essential workers</italic></bold></p></list-item><list-item><p><bold><italic>feelings/fears/attitudes - working and avoiding COVID-19</italic></bold></p></list-item><list-item><p><bold><italic>have more preexisting health conditions</italic></bold></p></list-item><list-item><p><bold><italic>live far away from hospitals</italic></bold></p></list-item><list-item><p><bold><italic>have less faith in hospitals and thus do not go for non-emergency issues</italic></bold></p></list-item></list></td><td>• Disagree • No Clear Stance • Firsthand Account • Speculation / Other Evidence</td><td>"A lot of African Americans are more prone to heart failure and heart disease. So I feel like that definitely takes a toll on them when it some to whether or not they contract Covid and how they deal with it." "Um, and then also African Americans have to go to work, they're not able to virtually, you know, work telework."</td></tr></tbody></table> </ephtml> </p> <hd id="AN0178681383-8">Responses from participants</hd> <p>Participants' responses to statistics on racial disparities in COVID-19 outcomes were summarized by eight themes: 1) some had emotional responses; 2) some distanced themselves from the numbers using colorblind rhetoric; and 3) others attributed the numbers to a lack of healthcare, essential work, distrust for the medical field, barriers to precautions like supply shortages and environmental factors, and poor baseline health.</p> <hd id="AN0178681383-9">Emotional response</hd> <p>Participants expressed feelings of anger and sadness when asked to reflect on trends regarding Black Americans rates of COVID-19. This emotional response shows a group's specific empathy that comes from taking historical and present-day instances of race-based health disparities together and seeing a broader pattern. This demonstrates students acknowledging the social construction of race and racism and their impact on everyday life.</p> <p>I don't even know how to feel because it's just like a lot of emotions at once, because it's like I'm part of it. I'm angry because it's like I don't want to hear things like that, especially constantly being thrown at me, but at the same time I know I need to know. So, I know how to carry myself when I go out in public. So, it's just a lot.</p> <p>When I think of that type of data, I think that it's no different than any other disease that plagues our society. The reason why I feel that way is because with issues in regard to not only our health, but when it comes to doctors or people in the pharmaceutical industry, how they treat you know treat us as well as the treatments that they have, you know, I just, it makes sense to me. But I'm still kind of sad about it now.</p> <hd id="AN0178681383-10">Lack of healthcare</hd> <p>Several students highlighted a lack of access to healthcare as a reason that Black Americans have a higher likelihood of contracting COVID-19. Perhaps, their status as both Black Americans and HBCU students, who are more likely to center blackness and related social implications of belonging to that race group, makes it easier for them to connect larger social issues, like lack of healthcare, to COVID-19 related outcomes.</p> <p>It isn't surprising to hear. It goes back in history when African Americans haven't received the same health care as other races. And when you think about that, and then in a pandemic that comes out of nowhere, you have to think about all the factors that play into why these people are dying before other races. So, it's like I said it's not surprising because they came out of nowhere. That means we have to find health care that we really haven't had over the years, or maybe we've had but haven't given to this special group just because they say it's a pandemic. So, I could definitely agree.</p> <p>A lot of Black Americans don't have health care. So last time they went to a doctor, I hate to be this extreme, but the last time they went to the doctor was probably when they were born. A lot of Black people just don't go to the doctor, especially older relatives in my family. So, you're not getting active healthcare, you're not getting your immune system, you know, checked on and looked on, so I'm not surprised that it's wiping out Black Americans like that. When we were in the Obama era, a lot of Black Americans were depending on his health care program and when Trump got in office, they lost those health care benefits. So, I think that's a number one reason is access to health care.</p> <hd id="AN0178681383-11">Essential work</hd> <p>Another social implication of minority racial status is economic disadvantage and barriers to ideal employment. Several respondents indicated that Black Americans are more likely to be essential workers and unable to adhere to stay at home orders or work remotely. They also suggested that socioeconomic factors contribute to their need to keep working despite the dangers of the pandemic.</p> <p>African Americans have to go to work, they're not able to virtually, you know, work, telework. So, we're having to a lot of African Americans work in retail, health care, whether it's like nursing homes, or just jobs that they cannot work virtually and why our cases are going up higher.</p> <p>When I first heard that I think about it a little bit but I think it has a lot to do with where you are like your socioeconomic status (SES) as well as where you are like what communities you are in because I'm thinking about black people that maybe can't afford to work from home, so they're more likely to go out when they're essential workers. They go out and they're more likely to catch it because they can't afford to work from home.</p> <hd id="AN0178681383-12">Distrust medical field</hd> <p>Centering blackness means considering this group's long-term health related outcomes and medical care. As a group that has been used as involuntary study participants for over 200 years, it should be expected that Black Americans express fear and distrust when it comes to seeking medical advice or trusting CDC orders around COVID-19. Respondents from our study cited historical issues that drive mistrust of the medical field as well as racism embedded within the healthcare system as reasons for higher death rates and higher likelihood to contract the virus.</p> <p>Like historically we never trust the medical system, especially like from the Tuskegee, so of course they're not going to go to the doctor to get checked up about other things. So, if they don't know about those, then it affects them even more since this virus, you know it preys on that.</p> <p>I think because it's our problem with African Americans going to doctors and doctors not catching their symptoms for other things, so I feel like it is higher for us to die from it because most doctors don't pay us more attention. So, it's not equal across the board.</p> <p>I believe the part where they said that the blacks are more likely to die, simply because whites are treated differently in health care. They don't care. They don't care as much for us than they do white people and that's proven.</p> <hd id="AN0178681383-13">Barriers to precautions: Supply shortage</hd> <p>Another concern that emerged from our interviews was the supply shortage. During the early stages of the pandemic, many stores had no cleaning supplies which made it difficult to slow the spread of the virus. This concern is especially pronounced in predominately Black communities which are less likely to have supermarkets, major shopping centers or other outlets.</p> <p>Lack of resources like hand sanitizer, cleaning supplies is rare to find those in this area. So, I know a lot of people have been doing drives over here. But it's not, you know, having the money to buy the cleaning supplies, especially because you're limited to the certain amount of you can get and then it's a shortage on supplies. So, and then there's not a lot of grocery stores over here in my area so pretty much a lot of people take the bus.</p> <hd id="AN0178681383-14">Barriers to precautions: Environmental factors</hd> <p>Several respondents connected racial disparities in COVID-19 outcomes to environmental factors. In a study of disparities, environmental factors can also be understood as products of environmental racism, or any environmental policy, practice, or directive that disproportionately disadvantages nonwhite communities.</p> <p>Well, I know one of the things that I've talked about or learned about over the summer is like food deserts and especially my black psychology class... they don't have access to good food that may be somewhere else.</p> <p>But also, it just reminds me of so many intersections of racially related issues that stem from systemic racism and so it's not just COVID, it's access to health care. It's healthcare affordability it's the income gap its housing inequity. It's all these things that show up and COVID is just amplifying the impact of those issues.</p> <hd id="AN0178681383-15">Poor baseline health/race specific health conditions</hd> <p>Poor baseline health and race specific health conditions came up in several interviews. Students discussed how preexisting conditions, higher rates of conditions like diabetes, and poor health behaviors leave black Americans vulnerable to the effects of COVID-19. This is also attributable to social aspects of race stemming from mechanisms like medical distrust, food access, safe places to exercise, demands of work and exposure to environmental waste.</p> <p>And then along with that a lot of African Americans are more prone to heart failure and heart disease. So, I feel like that definitely takes a toll on them when it comes to whether or not they contract COVID and how they deal with it.</p> <p>And then we as black Americans do suffer from just being susceptible to other different diseases, like for example (female relative). She already had breathing issues due to ... she used to be a chain smoker. So, people are already having preexisting conditions and they're not going to the doctor and then you have this weird virus. It's not surprising that we're dying.</p> <hd id="AN0178681383-16">Colorblind rhetoric</hd> <p>Some students chose to avoid processing the statistics by using colorblind rhetoric. Colorblind means not "seeing" color. Individuals who use a colorblind approach to racial issues believe there is no stigma, inequality, or discrimination, based on race.</p> <p>Well, I think I understand what they feel like that the Black American community may die from the COVID, but I've seen a lot of our white and Asian people are dying as well with this virus and some have very good insurance, and some don't. And they still dying from this disease. Viruses don't attack by color. They just attack people; it just attacks your system. So, if people say that there are more blacks than whites, I think it's even across the board.</p> <p>I don't feel like it's necessarily just black people. I just feel like it's just for anyone who is nonchalant to what's going on, and what's happening. But I wouldn't just say them. I would you know I feel like it's a fair spread of other racial people that's doing it. I would believe black people because maybe they aren't really believing it or just not taking the necessary steps to not do it. But yeah, that's how I would kind of look at that.</p> <hd id="AN0178681383-17">Reactions to social scientific theories</hd> <p>Participants' responses to social determinants of COVID-19 outcomes established by the Centers for Disease control are presented in Table 3. They were coded as disagree, no clear stance (neither agree nor disagree), agree with firsthand experience, or agree with speculative evidence.</p> <p>Table 3. Social determinant of COVID-19 disparities data count.</p> <p> <ephtml> <table><thead><tr><td>Can you tell me how you felt about the items on the list and if they impact you and your loved one? Black Americans...</td></tr></thead><tbody valign="top"><tr><td>Live in areas with many neighbors (Like apartments and duplex homes)</td><td>Disagree =2 No clear Stance = 2 Firsthand Account = 2 Speculation/ Other Evidence = 13<list list-type="Bullet"><list-item><p>Historical Evidence = 2</p></list-item><list-item><p>Societal Structure = 4</p></list-item><list-item><p>Secondhand Account = 3</p></list-item><list-item><p>Agree/No Reason Provided = 4</p></list-item></list></td></tr><tr><td>More likely to be essential workers</td><td>Disagree =2 No clear Stance = 3 Firsthand Account = 5 Speculation/ Other Evidence = 9<list list-type="Bullet"><list-item><p>Historical Evidence = 1</p></list-item><list-item><p>Societal Structure = 1</p></list-item><list-item><p>Secondhand Account = 2</p></list-item><list-item><p>Agree/No Reason Provided = 5</p></list-item></list></td></tr><tr><td>Feelings/ fears/ attitudes – working and avoiding COVID-19</td><td>Disagree =8 No clear Stance = 3 Firsthand Account = 0 Speculation/ Other Evidence = 8<list list-type="Bullet"><list-item><p>Historical Evidence = 0</p></list-item><list-item><p>Societal Structure = 0</p></list-item><list-item><p>Secondhand Account = 3</p></list-item><list-item><p>Agree/No Reason Provided = 5</p></list-item></list></td></tr><tr><td>Have more preexisting health conditions</td><td>Disagree =1 No clear Stance = 2 Firsthand Account = 2 Speculation/ Other Evidence = 14<list list-type="Bullet"><list-item><p>Historical Evidence = 2</p></list-item><list-item><p>Societal Structure = 4</p></list-item><list-item><p>Secondhand Account = 3</p></list-item><list-item><p>Agree/No Reason Provided = 5</p></list-item></list></td></tr><tr><td>Live far away from hospitals</td><td>Disagree =8 No clear Stance = 3 Firsthand Account = 0 Speculation/ Other Evidence = 8<list list-type="Bullet"><list-item><p>Historical Evidence = 1</p></list-item><list-item><p>Societal Structure = 2</p></list-item><list-item><p>Secondhand Account = 1</p></list-item><list-item><p>Agree/No Reason Provided = 4</p></list-item></list></td></tr><tr><td>Have less faith in hospitals and thus do not go for non-emergency issues</td><td>Disagree =0 No clear Stance = 0 Firsthand Account = 0 Speculation/ Other Evidence = 19<list list-type="Bullet"><list-item><p>Historical Evidence = 3</p></list-item><list-item><p>Societal Structure = 7</p></list-item><list-item><p>Secondhand Account = 0</p></list-item><list-item><p>Agree/No Reason Provided = 9</p></list-item></list></td></tr></tbody></table> </ephtml> </p> <hd id="AN0178681383-18">Live in areas with many neighbors (like apartments and duplex homes)</hd> <p>An overwhelming majority of our interviewees agreed that Black Americans are more likely to live in overpopulated areas. The two passages below include firsthand accounts from students who live in off-campus housing.</p> <p>I agree. I think you're more likely to contract it [covid-19] from someone in your house because they bring a lot of things in. For me, I stay in a house with three roommates, and those people have partners, bringing our total to eight. And then those eight people, they go to work in high population places, and you have to still make sure that you're protected, but it's difficult.</p> <p>It's like you're already exposed to it. It's like how you are saying I'm supposed to stay feet from people when that's not even possible. I already stay in a space where we have to be within six feet of one another because of the space or because this is their situation and how they live.</p> <p>In addition, interviewees referred to speculative evidence for example a secondhand account is below.</p> <p>I think you're more likely to contract if somebody in in your house. You know, because they bring a lot of different things in. For me, I stayed in the US, I stayed in the house. My last roommate moved out yesterday. But for other people I know, everyone has partners. So that brings the total to eight and then those people, they go to work, and they work in high population places. And so, you have to kind of still make sure you are protected, but it's difficult.</p> <hd id="AN0178681383-19">More likely to be essential workers</hd> <p>Again, many students agreed that Black Americans are more likely to be essential workers. This may be more prevalent in their demographic as 25% told firsthand stories. The stories below show more speculative accounts.</p> <p>It makes sense because a lot of the times we are put in positions where we have to provide for our families and we have to make sure that we are doing what we have to do and that means that we have to take on the job and the roles that other people don't want to take on, so we end up putting our lives out on the forefront not only for ourselves, but for our loved ones. We have to do essential work just to get the essentials, basically.</p> <p>Yes. Maybe not toward the high-end paying jobs, but more so cleaning up, maintenance, food service jobs, CNAs, jobs like that.</p> <p>Interviewees also reported speculative evidence that included the sub-themes of historical evidence and social structure as noted below.</p> <p>I think it's great that black people are doing awesome things and supporting us [as essential workers]. But then I also question: Why does it have to be Black people doing it? And it just so happens there's probably more research behind why Black folks is in these roles, but it just comes down to why Black people have to suffer first.</p> <p>Now, I feel like Black people are more prone to be essential workers because we realized this is a job that's always going to be needed. We need that income that consistency. For example, during the pandemic there were many people that lost their jobs because they were not essential workers. Being essential gives you that extra stress reliever to make you feel like "Okay I don't have to worry about anything because they need me." It's like they have more job security.</p> <hd id="AN0178681383-20">Feelings/fears/attitudes - working and avoiding COVID-19</hd> <p>Several interviewees agreed that Black Americans had expressed more feelings, fears and negative attitudes about working and avoiding COVID-19.</p> <p>I agree because there are a lot of people who don't trust the medical field or believe what they say because they feel like they are just saying stuff, so that runs them away from the facts that are out there.</p> <p>I think anytime you're in fear of your safety then you're going to have general concerns.</p> <p>In addition, an interviewee provided a speculative secondhand account.</p> <p>When I was still taking classes, we talked about how it was a really huge outbreak in *Grocery Store* nationally among a lot of their workers. Yeah, the Costco outbreak. So that's just the main example of that, like, yes, I have to work, but then I'm putting myself at risk with all these people getting their items so It's kind of a lose, lose situation. You either work and you put yourself at risk or don't work.</p> <hd id="AN0178681383-21">Have more preexisting health conditions</hd> <p>Interviewees who agreed that Black Americans have more preexisting health conditions referenced access, inequity and having higher rates of certain conditions.</p> <p>It's extremely aggravating because it's about access to housing and income inequity. Where you're housed is what's around you. So, if you live in an area that doesn't have a lot of resources in terms of healthy food options and accessibility then it's going to be harder to maintaining a healthy diet that's well-balanced, so then you get health problems that are, yes genetic, but then also environmental.</p> <p>I do feel that is true considering that in class we have discussed African Americans having obesity. I do feel like that is into play especially since they tell you that if you have preexisting conditions then you are high risk, so I do feel that could affect COVID-19 and death rates.</p> <p>Interviewees also mentioned speculative societal structure and secondhand account evidence.</p> <p>But then, where your house is what's around you. And so, if you live in an area that doesn't have a lot of resources in terms of healthy food options and accessibility. Then it's going to be harder to maintain a healthy diet that's well balanced and so then you get health problems that yes genetic but then also environmental.</p> <p>So, I've heard that argument a lot where it's like, well, I mean, people are getting it and they recover more people are going to live. But it's like okay well what about the people with preexisting conditions?</p> <hd id="AN0178681383-22">Live far away from hospitals</hd> <p>Interestingly, our interviewees had opposite responses to the prompt that Black Americans are more likely to live in communities with limited access to hospitals. It is likely that are highly suburban sample (11/19) do not relate to the disparities that rural and urban Black Americans experience.</p> <p>I could see that, or if they don't live far away, the one that they have that is close to them isn't a good one or they don't have good doctors.</p> <p>I think that is true. In all the cities that I'm familiar with black people do pretty much stay far. Hospitals are usually in the wealthy areas, the very wealthy areas.</p> <p>Interviewees' responses that fell within the speculative theme included thoughts related to historical evidence and secondhand account.</p> <p>Um, yeah. I mean, I would say that's always been the case. I feel like if you look statistically, in apartments, typically, those are located, you know, like outside of downtown area and typically hospitals are in downtown</p> <p>The inability to control, have control over your life, or whatever the treatment is. So, like, even with it being broader, it's been broadcasted even more that ventilators, we're really helping and at least you know we can agree on that, mainly because that's what the mainstream media started to stay.</p> <hd id="AN0178681383-23">Have less faith in hospitals and thus do not go for non-emergency issues</hd> <p>According to our sample, experiences with medical racism and fear of contracting COVID-19 appear to be the greatest barriers to care. Every interviewee agreed that little faith in hospitals stops Black Americans from getting regular health care. Upon further examination of their responses, they were not definitive but generalized perspective on perceptions of Black Americans' feeling.</p> <p>I believe that's very valid because we don't have trust in the medical care system. Not all of us, but I feel like most of us don't have trust in the medical care system.</p> <p>People don't really trust the hospitals now especially with COVID-19 being in the hospitals. They say go to the hospital to treat COVID-19, but people don't want to go to the hospital because COVID-19 is there.</p> <p>Interviewees also speculated that Black Americans have less faith in hospitals because of historical occurrences and societal structure.</p> <p>Yes, I agree with that. I'm not gonna say we don't go. But I will say we have selected hospitals that we do go to because of previous things that have happened to us.</p> <p>Apparently, there's this idea that Black women don't feel, or Black people don't feel pain. The same way other races do so when we, when we tell them, 'Hey, we're dealing with this.' You know, they might think we're over exaggerating, and not treat us the full extent or their full capability to treat us and then that results in death.</p> <hd id="AN0178681383-24">Discussion</hd> <p>This paper sought to examine the ways in which Black American students from a Historically Black College or University (HBCU) contextualize COVID-19. Findings indicate that HBCU students had various reactions to data on racial disparities in COVID-19 outcomes. Some students highlighted those racial disparities in COVID-19 reflected larger patterns of inequality in society. This was evidenced by students describing inequalities in access to health care, the ability to work remotely, receipt of high-quality health care, access to supplies to prevent the spread of COVID-19, and other social determinants such as living in food deserts. These findings affirm that HBCU students are acutely aware of the interrelatedness of oppressions and the notions of systematic racism and cumulative disadvantage. It is well-established that systematic racism has influenced the "social, economic, political, and educational resources and opportunities available to Black Americans for over fifteen generations."[<reflink idref="bib25" id="ref64">25</reflink>] Over time, cumulative effects of discrimination and a complex of social relations result in racial disparities in outcomes.[[<reflink idref="bib26" id="ref65">26</reflink>], [<reflink idref="bib28" id="ref66">28</reflink>]] Research has demonstrated that social determinants contribute to racial disparities in many different health outcomes such as stroke,[<reflink idref="bib29" id="ref67">29</reflink>] diabetes,[<reflink idref="bib30" id="ref68">30</reflink>] and COVID-19.[<reflink idref="bib31" id="ref69">31</reflink>]</p> <p>Some students acknowledged this cumulative disadvantage, while simultaneously expressing an intense emotional response. This is consistent with scholarly literature that found racial discrimination can be a significant, traumatic factor impacting psychological well-being.[[<reflink idref="bib32" id="ref70">32</reflink>], [<reflink idref="bib34" id="ref71">34</reflink>]] As researchers begin to examine the collective trauma and mental health impacts created by COVID-19, they should pay special attention to how COVID-19 related trauma exposures may differ between population sub-groups, including subpopulations at the intersections of multiple axes of inequality and subpopulations experiencing multiple social determinants of health. COVID-19 may exacerbate inequalities;[<reflink idref="bib35" id="ref72">35</reflink>] the impact of COVID-19 on mental well-being may vary across subpopulations depending on their "pre-pandemic circumstances and resources – prior exposures to adversity, physical and mental health vulnerabilities, and economic and social supports" and pandemic exposures such as having family members who experience COVID-19 and immersing oneself in social media and news sources reporting bad news.[<reflink idref="bib36" id="ref73">36</reflink>] Researchers have already demonstrated the deleterious impact of COVID-19 on Black college students.[<reflink idref="bib6" id="ref74">6</reflink>],[<reflink idref="bib7" id="ref75">7</reflink>] Researchers have also begun to explore whether the impacts of COVID-19 on mental well-being are moderated by resilience, which may point to interventions that could mitigate the impacts of COVID-19.[<reflink idref="bib37" id="ref76">37</reflink>]</p> <p>Although Friedman (2021) found that colorblind rhetoric is common among white individuals, some HBCU students in our sample also used colorblind rhetoric to distance themselves from racial disparities in COVID-19.[<reflink idref="bib38" id="ref77">38</reflink>] In our sample, students used two different types of colorblind frames when interpreting COVID-19 trends. The discourse of "viruses not attacking by color" was consistent with naturalization, a colorblind frame that "explains away racial phenomena by suggesting they are natural occurrences".[<reflink idref="bib39" id="ref78">39</reflink>] Additionally, the discourse blaming Black people for not "believing it" or "not taking the necessary steps" was consistent with cultural racism, which relies on culturally based arguments to explain racial disparities in outcomes.[<reflink idref="bib39" id="ref79">39</reflink>] Yet, in our color-conscious world, colorblind approaches are not beneficial to understanding the persistence of racial and ethnic inequalities.[<reflink idref="bib26" id="ref80">26</reflink>]<sups>, </sups>[<reflink idref="bib40" id="ref81">40</reflink>] Accepting colorblind approaches have been critiqued for (<reflink idref="bib1" id="ref82">1</reflink>) viewing race as a biological holdover lacking political or social meaning; (<reflink idref="bib2" id="ref83">2</reflink>) locating both the problem of racism and the solution to racism in the individual; and (<reflink idref="bib3" id="ref84">3</reflink>) problematizing discussing race at all and blaming Black individuals for their condition.[<reflink idref="bib26" id="ref85">26</reflink>] Following Critical Race Theory, we contend that a race-conscious approach is needed to acknowledge and address racial disparities in health outcomes exacerbated by COVID-19.</p> <p>Other COVID-19 studies guided by CRT have examined the prison system, bioethical concerns, and vaccine adherence. Like our findings, researchers found racial disparities in prison release during the pandemic, such that incarcerated Black individuals were underrepresented and White inmates were overrepresented.[<reflink idref="bib38" id="ref86">38</reflink>] Other scholars have argued that as a field, bioethics should promote alternative narratives or "counter storytelling" as defined by CRT to fulfill a moral obligation for equity.[<reflink idref="bib41" id="ref87">41</reflink>] A study in the United Kingdom guided by CRT, found that higher vaccine hesitancy among racial and ethnic minority groups were a consequence of mistrust therefore historical and contemporary abuses of power must be acknowledged.[<reflink idref="bib42" id="ref88">42</reflink>]</p> <hd id="AN0178681383-25">Limitations</hd> <p>This study has limitations that should be noted. The overarching concern, as with all qualitative research, is the greater likelihood of bias. According to Anderson (2010) study design and implementation are subject to positionality bias and analytical bias and the data collected are subject to social desirability bias.[<reflink idref="bib43" id="ref89">43</reflink>] To minimize these concerns, we used a team of diverse scholars (in terms of race, ethnicity, and academic training) to create checks and balances for concerns around positionality. Analytical bias becomes a concern when the researcher(s) have limited training in qualitative methods. Our team included three experienced qualitative researchers and two graduate student assistants. Social desirability bias, however, is unavoidable in studies of controversial topics that involve face-to-face interactions. We mitigated the impact of social desirability bias by assuring our respondents their responses would be de-identified and by allowing them to provide outside evidence of their views, not just personal experiences.</p> <hd id="AN0178681383-26">Conclusion</hd> <p>Despite these limitations, our study helps to understand how HBCU students contextualize COVID-19. Some students identified how COVID-19 exacerbated racial disparities through mechanisms related to systematic racism and cumulative disadvantage. Less commonly, some students attempted to distance themselves from these concepts by employing colorblind rhetoric. Additionally, our research highlighted the negative impact COVID-19 may have on mental well-being among HBCU students. Future researchers should further explore these impacts and develop interventions to moderate the impact of COVID-19 on mental health. Given students' robust discussions of psychosocial determinants, our study points to the need to develop interventions to address psychosocial risks that have been exacerbated by COVID-19; mitigating these risk factors may help promote academic persistence and retention among HBCU students.</p> <hd id="AN0178681383-27">Conflict of interest disclosure</hd> <p>The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States of America and received approval from the Institutional Review Board of North Carolina A&T State University.</p> <ref id="AN0178681383-28"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Berkowitz RL, Gao X, Michaels EK, Mujahid MS. Structurally vulnerable neighbourhood environments and racial/ethnic COVID-19 inequities. 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Presenting and evaluating qualitative research. Am J Pharm Educ. 2010; 74 (8):1–7.</bibtext> </blist> </ref> <aug> <p>By Anna K. Lee; Jeannette Wade; Stephanie Teixeira-Poit; Dextiny McCain; Christopher Doss; Smriti Shrestha and Adrienne T. Aiken-Morgan</p> <p>Reported by Author; Author; Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib10" firstref="ref14"></nolink> <nolink nlid="nl2" bibid="bib11" firstref="ref17"></nolink> <nolink nlid="nl3" bibid="bib12" firstref="ref18"></nolink> <nolink nlid="nl4" bibid="bib13" firstref="ref21"></nolink> <nolink nlid="nl5" bibid="bib14" firstref="ref29"></nolink> <nolink nlid="nl6" bibid="bib15" firstref="ref31"></nolink> <nolink nlid="nl7" bibid="bib16" firstref="ref37"></nolink> <nolink nlid="nl8" bibid="bib17" firstref="ref54"></nolink> <nolink nlid="nl9" bibid="bib18" firstref="ref55"></nolink> <nolink nlid="nl10" bibid="bib19" firstref="ref56"></nolink> <nolink nlid="nl11" bibid="bib20" firstref="ref57"></nolink> <nolink nlid="nl12" bibid="bib21" firstref="ref58"></nolink> <nolink nlid="nl13" bibid="bib22" firstref="ref60"></nolink> <nolink nlid="nl14" bibid="bib23" firstref="ref61"></nolink> <nolink nlid="nl15" bibid="bib24" firstref="ref62"></nolink> <nolink nlid="nl16" bibid="bib25" firstref="ref64"></nolink> <nolink nlid="nl17" bibid="bib26" firstref="ref65"></nolink> <nolink nlid="nl18" bibid="bib28" firstref="ref66"></nolink> <nolink nlid="nl19" bibid="bib29" firstref="ref67"></nolink> <nolink nlid="nl20" bibid="bib30" firstref="ref68"></nolink> <nolink nlid="nl21" bibid="bib31" firstref="ref69"></nolink> <nolink nlid="nl22" bibid="bib32" firstref="ref70"></nolink> <nolink nlid="nl23" bibid="bib34" firstref="ref71"></nolink> <nolink nlid="nl24" bibid="bib35" firstref="ref72"></nolink> <nolink nlid="nl25" bibid="bib36" firstref="ref73"></nolink> <nolink nlid="nl26" bibid="bib37" firstref="ref76"></nolink> <nolink nlid="nl27" bibid="bib38" firstref="ref77"></nolink> <nolink nlid="nl28" bibid="bib39" firstref="ref78"></nolink> <nolink nlid="nl29" bibid="bib40" firstref="ref81"></nolink> <nolink nlid="nl30" bibid="bib41" firstref="ref87"></nolink> <nolink nlid="nl31" bibid="bib42" firstref="ref88"></nolink> <nolink nlid="nl32" bibid="bib43" firstref="ref89"></nolink>
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  Data: Contextualizing the Racial Gradient in COVID-19 Outcomes: Narratives From HBCU Students
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Anna+K%2E+Lee%22">Anna K. Lee</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-7420-2954">0000-0002-7420-2954</externalLink>)<br /><searchLink fieldCode="AR" term="%22Jeannette+Wade%22">Jeannette Wade</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-9126-5554">0000-0001-9126-5554</externalLink>)<br /><searchLink fieldCode="AR" term="%22Stephanie+Teixeira-Poit%22">Stephanie Teixeira-Poit</searchLink><br /><searchLink fieldCode="AR" term="%22Dextiny+McCain%22">Dextiny McCain</searchLink><br /><searchLink fieldCode="AR" term="%22Christopher+Doss%22">Christopher Doss</searchLink><br /><searchLink fieldCode="AR" term="%22Smriti+Shrestha%22">Smriti Shrestha</searchLink><br /><searchLink fieldCode="AR" term="%22Adrienne+T%2E+Aiken-Morgan%22">Adrienne T. Aiken-Morgan</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+American+College+Health%22"><i>Journal of American College Health</i></searchLink>. 2024 72(6):1759-1767.
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  Data: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
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  Label: Peer Reviewed
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  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 9
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2024
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  Label: Sponsoring Agency
  Group: SrcSuprt
  Data: National Science Foundation (NSF)
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  Label: Contract Number
  Group: NumCntrct
  Data: 2033926
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
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  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
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  Label: Descriptors
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  Data: <searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink><br /><searchLink fieldCode="DE" term="%22Pandemics%22">Pandemics</searchLink><br /><searchLink fieldCode="DE" term="%22Personal+Narratives%22">Personal Narratives</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink><br /><searchLink fieldCode="DE" term="%22Black+Colleges%22">Black Colleges</searchLink><br /><searchLink fieldCode="DE" term="%22African+American+Students%22">African American Students</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Health%22">Mental Health</searchLink><br /><searchLink fieldCode="DE" term="%22Academic+Persistence%22">Academic Persistence</searchLink><br /><searchLink fieldCode="DE" term="%22Knowledge+Level%22">Knowledge Level</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Behavior%22">Health Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Barriers%22">Barriers</searchLink><br /><searchLink fieldCode="DE" term="%22Academic+Achievement%22">Academic Achievement</searchLink><br /><searchLink fieldCode="DE" term="%22Emotional+Response%22">Emotional Response</searchLink><br /><searchLink fieldCode="DE" term="%22Racism%22">Racism</searchLink><br /><searchLink fieldCode="DE" term="%22Access+to+Health+Care%22">Access to Health Care</searchLink><br /><searchLink fieldCode="DE" term="%22Trust+%28Psychology%29%22">Trust (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Services%22">Health Services</searchLink><br /><searchLink fieldCode="DE" term="%22Critical+Race+Theory%22">Critical Race Theory</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Conditions%22">Health Conditions</searchLink>
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  Label: DOI
  Group: ID
  Data: 10.1080/07448481.2022.2089849
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0744-8481<br />1940-3208
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: COVID-19 spread across the nation with Black Americans experiencing twice of the prevalence of deaths than White Americans. Black American college students are facing a unique set of biopsychosocial costs including less retention and poorer mental health. Therefore, the purpose of this study was to examine how Historically Black College or University (HBCU) students contextualize COVID-19. Interviews were conducted with 19 participants and lasted 40-60 minutes. They discussed topics including: their COVID-19 knowledge, precautionary measures, and barriers and promoters of school success were covered. Data were coded through semi-open coding and discussed among the research team. Responses were summarized by eight themes: emotional responses, colorblind rhetoric, lack of healthcare, essential work, distrust for the medical field, barriers to precautions like supply shortages and environmental factors, and poor baseline health. These findings may be used to develop interventions that moderate the impact of COVID-19 and future pandemics on mental health.
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  Data: 2024
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  Data: EJ1433382
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      – SubjectFull: COVID-19
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