Article Text
PDF
Abstract
Objectives Essential healthcare workers (HCW) uniquely serve as both COVID-19 healers and, potentially, as carriers of SARS-CoV-2. We assessed COVID-19-related stigma and bullying against HCW controlling for social, psychological, medical and community variables.
Design We nested an analytical cross-sectional study of COVID-19-related stigma and bullying among HCW within a larger mixed-methods effort assessing COVID-19-related lived experience and impact. Adjusted OR (aOR) and 95% CIs evaluated the association between working in healthcare settings and experience of COVID-19-related bullying and stigma, controlling for confounders. Thematic qualitative analysis provided insight into lived experience of COVID-19-related bullying.
Setting We recruited potential participants in four languages (English, Spanish, French, Italian) through Amazon Mechanical Turk’s online workforce and Facebook.
Participants Our sample included 7411 people from 173 countries who were aged 18 years or over.
Findings HCW significantly experienced more COVID-19-related bullying after controlling for the confounding effects of job-related, personal, geographic and sociocultural variables (aOR: 1.5; 95% CI 1.2 to 2.0). HCW more frequently believed that people gossip about others with COVID-19 (OR: 2.2; 95% CI 1.9 to 2.6) and that people with COVID-19 lose respect in the community (OR: 2.3; 95% CI 2.0 to 2.7), both which elevate bullying risk (OR: 2.7; 95% CI 2.3 to 3.2, and OR: 3.5; 95% CI 2.9 to 4.2, respectively). The lived experience of COVID-19-related bullying relates frequently to public identities as HCW traverse through the community, intersecting with other domains (eg, police, racism, violence).
Interpretation After controlling for a range of confounding factors, HCW are significantly more likely to experience COVID-19-related stigma and bullying, often in the intersectional context of racism, violence and police involvement in community settings.
- COVID-19
- public health
- epidemiology
Data availability statement
Data are available on reasonable request. Given the identifying and potentially stigmatising nature of the data in this study, analyses are provided in this paper to support its conclusions, although datasets are not publicly available. Interested investigators can request data from the corresponding author.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Statistics from Altmetric.com
Data availability statement
Data are available on reasonable request. Given the identifying and potentially stigmatising nature of the data in this study, analyses are provided in this paper to support its conclusions, although datasets are not publicly available. Interested investigators can request data from the corresponding author.
Supplementary materials
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Footnotes
Twitter @GlobalHealthNow
Correction notice This article has been corrected since it first published. The provenance and peer review statement has been included.
Contributors TDD directed the design, implementation and analysis of this study, and led the development and revision of this manuscript. LA conducted background research and contributed to writing and revision of this manuscript. SSi contributed to this study’s design, conducted background research and contributed to writing this manuscript. MB and SSh contributed to this study’s design, reviewed and coded qualitative data and reviewed and edited drafts. TP reviewed and edited drafts and participated in the design of the study. EP contributed to the design of this study and reviewed the final manuscript. All coauthors reviewed and approved the final manuscript.
Funding This work was funded by The Richard W. & Mae Stone Goode Foundation, Award # 057843-002. Drs SSh and LA are trainees in the University of Rochester’s Translational Biomedical Science PhD Program, which is supported by Grant 2TL1TR002000-05 from the National Center for Advancing Translational Sciences, National Institutes of Health. Dr LA is additionally supported by funds from BWF1014095 from the Burroughs Wellcome Fund. Drs SSi and TP are supported by the National Institute of General Medical Sciences of the National Institute of Health under Award Number K12GM106997. The authors also accessed the recruitment and REDCap resources of the University of Rochester CTSA, award number UL1 TR002001 from the National Center for Advancing Translational Sciences of the National Institutes of Health.
Conflict of interest statement The authors report no financial or other conflicts of interest with the content of this study. During the period of this study, Dr TDD was the Principal Investigator on unrelated grants and contracts from the US National Institutes of Health, Pfizer Global Medical Grants and the New York State AIDS Institute.
Map disclaimer The funders had no role in the study design, data collection and analysis, decision to publish or preparation of this manuscript.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.