Disparities in access to COVID-19 testing in Los Angeles County

Abstract

COVID-19 has disparately impacted low-income persons and racial and ethnic minorities-primarily Black and Hispanic populations. Our objective is to quantify disparities in access to COVID-19 testing and identify barriers to testing during the winter 2020-2021 surge in COVID-19 infections in Los Angeles County. An online survey was administered between December 2020 and January 2021 through which respondents were asked about their use of COVID testing and the barriers to testing they experienced. Our sample of 1,984 was reweighted to match the demographics of Los Angeles County. Despite similar testing rates to White residents, Hispanic residents were more likely to report testing positive. Persons with an annual income of $20,000 or less were less likely to receive a test than those with an income of $100,000 or more. Barriers to testing were more prevalent among racial/ethnic minorities and low-income persons. White respondents and high-income persons were more likely to report the ability to take time off work to await test results. Rates of testing were not commensurate with the rates of infection across racial/ethnic groups, which may be explained by higher rates of reported barriers to testing among Black and Hispanic residents. These findings may inform policies that address structural barriers to testing that disproportionately impact racial/ethnic minorities and low-income populations.

Keywords: Access; COVID-19; Health disparity; Racial and ethnic disparity; Testing.

Fig. 1

Ability to Take Time Off Work While Waiting for Test Results by Race/Ethnicity and Income: Los Angeles County, December 2020 - January 2021. Note. Weighted by race/ethnicity, income, and sex. Survey results were excluded due to unemployment, not working, and retirement. *Statistically different (p value < 0.05) from reference group (Non-Hispanic white for differences in race/ethnicity, $100,000+ for difference across income groups).