“I can’t breathe”: The effect of intersectionality on access to COVID-19 diagnostic tests in Brazil
This research aimed to analyze the effect of intersectionality on patients’ access to COVID-19 diagnostic tests during the outbreak of severe acute respiratory syndrome (SARS) in Brazil. A cross-sectional study was conducted, utilizing a secondary analysis of Brazilian patient records from March to June 2020. The first 4 months of the COVID-19 epidemic were selected as this was the period during which countries organized themselves to provide care for COVID-19 patients. Crude and adjusted odds ratios (OR) were calculated using logistic regression. Interactions with education were tested, considering it a proxy for social class. Statistical analysis was performed using Stata SE 15 software. Out of the 179,295 records examined, 6,326 (3.53%) patients were not tested, and 4,512 (71.32%) of the untested patients were black. The odds of not being tested were higher for black males (OR: 2.30) and black females (OR: 2.58) compared to other racial and gender groups. Black males exhibited a higher likelihood of non-testing than black females, while black females had a higher likelihood than both white males and females. Race, when modulated by social class, showed significant effects on failure to perform diagnostic testing in patients with SARS. The results suggest that structural racism, gender, and social class inequalities significantly impact access to diagnostic testing. Therefore, it is necessary for public policies to consider these findings to address not only the symptoms but also the underlying causes of racism within the social structure.
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