COVID-19 and vulnerable populations.

At the time of this special issue, coronavirus disease 2019 (COVID-19) is the leading cause of death in the United States and has contributed to millions of deaths worldwide. The world had no idea how the pandemic was going to impact our lives. COVID-19 exposed the inequities in our world and the individuals that were most impacted by it: vulnerable populations. Vulnerable populations may be defined as those living in poverty, living with disability, and racial, ethnic, sexual, and gender minorities. Additionally, as community psychologists we understand that the impact of inequities do not appear singlehandedly since as human beings we do not exist in a vacuum and there are multiple factors that create our level of health and well-being. Therefore, the idea of examining COVID-19 in a syndemic framework allows us to explore how a synergistic epidemic (i.e., the aggregation of two or more concurrent or sequential epidemics or disease clusters in a population with biological interactions) exacerbates the prognosis and burden of disease, which can impact vulnerable populations simultaneously. The main goal of this special issue concentrates on how COVID-19 had a synergistic impact on vulnerable populations and how these populations reacted and coped with these events.

As Community Psychologists, we have several guiding principles such as prevention, empowerment, the ecological perspective, respect for human diversity, social justice, sense of community, active citizen participation, and empirical grounding, as well as the of use our 18 community psychology practice competencies to make the lives of vulnerable populations better, and in this case especially those affected by coronavirus disease 2019 (COVID‐19). When as community psychologists we saw that we faced the most challenging pandemic of our lives and saw its impact, the birth of the special issue was born to highlight how the synergistic connections occurred between houselessness, access  inequities, domestic violence, hunger, and racism exacerbated the impact of COVID‐19. The response to the call for papers was overwhelming as many community psychologists, social scientists, and public health experts around the world wanted to share what they had learned about the synergistic nature of COVID‐19 and vulnerable populations. Therefore, we invite you to read the articles in this double issue and explore how synergistic connections between COVID‐19 and many health and well‐being variables unfolded across the world with different vulnerable populations. These include survivors of sexual assault, people with disabilities, college students, Black Americans, caregivers, survivors of domestic violence, pregnant women, and people living in low‐income neighborhoods.

The first paper is written by Cokley et al. (2022) and is titled “The COVID‐19/Racial Injustice Syndemic and Mental Health among Black Americans: The Roles of General and Race‐Related COVID Worry, Cultural Mistrust and Perceived Discrimination.” The article concisely explicates COVID‐19 and the racial injustice syndemic among Black Americans, specifically focusing on cultural mistrust, perceived discrimination, vaccination status, and mental health. The results from this multistate study indicated that racist and discriminatory systems place Black Americans in perilous situations regarding trust in systems, such as medical or criminal justice, which are supposed to be supportive institutions. Surprisingly, the findings revealed an unsupported relationship between police brutality and mental health (i.e., anxiety and depressive symptoms). The authors suggested that public health practitioners and mental health providers need to understand the complex history of Black Americans in accessing health care and develop culturally responsive prevention programming in Black communities.

The next article by Sakiz (2022), “Delayed Educational Services during COVID‐19 and Their Relationships with the Mental Health of Individuals with Disabilities,” is a paper that highlights the devastating impact of COVID‐19 on the disruption of educational services for individuals with disabilities. The authors collected the views of individuals with disabilities and the delays of educational services in Turkey. The themes that emerged were mental health, special and rehabilitation services, inclusive services, and distance education. The author outlined the devastating impact COVID‐19 had on the sample in Turkey.

Fishere & Bartoli's (2022) article titled “COVID‐19 and Risk of Retraumatization in Adults with a Past Exposure to Potentially Traumatic Events: A Cross‐cultural Exploration across Egypt, Germany, and Italy” explored the links between past exposure to potentially traumatic events, fear of contracting COVID‐19, and perceived stress that impacted a sample of adults in Egypt, Germany, and Italy. The authors also explored how exposure to traumagenic experiences affected locus of control over the health of the sample. Finally, the authors compared whether fear, stress reactions, and differences in health locus of control differed across the three targeted countries. The authors conclude that there is a relationship between past exposure to trauma and fear of contracting COVID‐19 dependent on the country of residence. These findings highlight the point that COVID‐19 might be particularly disruptive for people who survived potentially traumatic experiences. Nevertheless, the mass mental health impact of the COVID‐19 pandemic varies across different sociocultural contexts related to country of residence. These results provide insight into how tailored interventions are necessary based on previous traumatic events experienced, the level of locus of control individuals have, and the countries in which they reside.

The next article, written by Ashby et al. (2022), entitled “The Relationship of COVID‐19 Traumatic Stress, Cumulative Trauma, and Race to Post Traumatic Stress Disorder Symptoms.” The overall goal of this manuscript was to explore if COVID‐19 traumatic stress predicted posttraumatic stress disorder (PTSD) symptoms after cumulative trauma across three domains: COVID‐19, cumulative trauma, and race. The authors conducted a survey with a diverse sample who completed the cumulative stressors and traumas scale, COVID‐19 traumatic stress scale, and the posttraumatic stress disorders scale. The authors conclude that COVID‐19 had an additive effect on PTSD symptoms beyond cumulative trauma for all groups, except for Asians. The authors state that with the ongoing wave of aggression towards Asians that perhaps COVID‐19 specific trauma was not related to the PSTD symptoms they experienced.

Siegal et al. (2022) article, “Using Geographic Information Systems to Inform the Public Health Response to COVID‐19 and Structural Racism: The Role of Place‐Based Initiatives,” outlined the disproportionate impact of COVID‐19 on Black communities by focusing on two racially segregated communities in the Southeastern part of the United States. The study used Geographic Information System and community responses, to gather information to examine COVID‐19's impact and structural racism. A social determinants of health index was also used to measure resource accessibility in the two communities. The results showed there were multiple inequities between the communities (one White and one Black). Before COVID‐19 and following the onset of COVID‐19, the devastating rates of unemployment and food insecurity were higher in the predominately Black community compared with the White community and to the United States as a whole. The authors note the pandemic made the inequities worse for the Black community.

The sixth article by Redmond et al. (2022), titled “Learning from Maternal Voices on COVID‐19 Vaccine Uptake: Perspectives from Pregnant Women Living in the Midwest on the COVID‐19 Pandemic and Vaccine,” explored COVID‐19 vaccine perceptions and decision‐making among African American, Non‐Hispanic White, and Hispanic pregnant and lactating women. In this mixed‐method study, results revealed little differences in perceptions of COVID‐19 and low vaccine hesitancy among the participants. The qualitative analysis revealed four themes as follows: (1) concern about vaccine safety, (2) general anxiety from the pandemic, (3) limited vaccine hesitancy, and (4) seeking knowledge. The authors contend that community psychologists and health care practitioners should utilize a socio‐ecological framework focusing on the individual level interpersonal level and organizational level, to affect change on COVID‐19 vaccine hesitancy and decision‐making among ethnically/racially pregnant and lactating women residing in the United States.

Engleton et al.'s (2022) article, “Sexual Assault Survivors' Engagement with Advocacy Services During the COVID‐19 Pandemic,” sought to understand sexual assault survivors' experiences during the COVID‐19 pandemic in an effort to develop strategies to support survivors in a future public health emergency. In this qualitative study, semistructured interviews were conducted in a community‐based advocacy organization in Detroit, Michigan. The themes that emerged from these interviews were that sexual assault survivors experienced a disruption of advocacy services, had difficulty obtaining tangible resources, and had a desire for COVID‐related support, information, and resources. This study highlights the challenges sexual assault survivors face during the COVID‐19 pandemic and explores how public health emergencies have the potential to exacerbate the needs of this vulnerable population.

Chiaramonte et al. (2022) article titled “The impact of COVID‐19 on Safety, Housing Stability, Mental Health of Unstably Housed Domestic Violence Survivors” focuses on domestic violence survivors' safety, housing stability, and well‐being and the impact COVID‐19 had on their lives. The impact the stay‐at‐home order had on housing stability and mental health has been devastating. People lost their jobs, social support, and incomes. Approximately 300 participants were interviewed initially before COVID‐19 and then interviewed over a 2‐year period. The findings from this study revealed that safety, housing stability, and mental health had been improving before the pandemic and then remained steady. The authors suggested that the domestic survivors did not get worse however the results leveled off, meaning they stopped going in a positive direction. The authors conclude that services and access to resources are critical during and after a global health crisis (i.e., pandemic).

Urizar et al.'s (2022) article, “Mental Health Outcomes and Experiences of Family Caregivers of Children with Disabilities during the COVID‐19 Pandemic in Bolivia,” explored the mental health status and perceived strain experienced by family caregivers of children with disabilities in Bolivia during the COVID‐19 pandemic. Additionally, the authors explored how demographic characteristics, caregiver strain, impact of the pandemic, coping strategies used were associated with mental health outcomes for the caregivers. The authors conclude that a large portion of the caregivers experienced poor mental health outcomes, specifically stress, anxiety, and depression, especially among those caregivers experiencing poor health, high caregiver strain, and those using maladaptive coping strategies. These findings highlight the need to infuse culturally tailored prevention treatment interventions to assist caregivers in navigating their own mental health care.

This article by Huang et al. (2022) titled “Coping Knowledge, Communication and HBCU Student's Emotional Well‐being: Mediating Role of Perceived Control and Social Connectedness.” Given that initial coronavirus infectious rates were higher in communities of color, especially among Black Americans, the purpose of this study investigated the impact of COVID‐19 among students attending an Historically Black Colleges and University (HBCU), specifically proactive coping strategies, access to accurate COVID‐19 information, and self‐care practices. The present study examined whether perceived control and social connectedness mediated the link between proactive coping strategies, COVID‐19 knowledge, communication, and emotional well‐being. The authors reported that a strong sense of control in life represented a key factor in supporting HBCU students' emotional health and strong sense of control during the pandemic. Although there are scant collaborations among community psychologists and HBCUs, the authors provide several strategies in which community psychologists can partner with HBCUs to promote psychological well‐being among students. For instance, the authors argue that both parties should develop culturally competent mental health programming using either face‐to‐face or online sessions.

Glantsman et al.'s (2022) article titled “Risk of food and Housing Insecurity Among College Students During the COVID‐19 Pandemic” addressed how students in a public institution in the United States are considered vulnerable populations and, as such, have been disproportionately affected by the COVID‐19 pandemic. The main purpose of the work was to identify how food and housing insecurity impacted these students. The authors make a convincing case that students, both graduate and undergraduate, completing a higher education degree are indeed an especially vulnerable population and that students of color and/or students with multiple identities might be at greater risk for food and housing insecurity.

The last article by Benson and Whitson (2022) titled “The Protective Role of Sense of Community and Access to Resources and Access to Resources on College Student Stress and COVID‐19 Related Daily Life Disruptions” suggests that having a sense of community can be a protective factor among college students during the pandemic. Sense of community has been studied and shown to be a protective factor for psychological well‐being, particularly for college students. The findings from this study supported the idea that female students were more at risk for negative consequences during the COVID‐19 pandemic. The authors noted that sense of community and access to resources were found to be protective factors in mitigating stress and COVID‐19 among college students, especially for female students.

In closing, over the past 2‐years, research has shown the devasting impact COVID‐19 had on vulnerable populations. The purpose of this special issue addresses the devasting impact that COVID‐19 has had on disenfranchised communities from a domestic and international perspective. Globally, research has undeniably made it clear that the worldwide indigenous communities, immigrants, refugee, and other displaced communities have disproportionally experienced sickness and death related to COVID‐19 (Clark et al., 2020). Importantly, this special issue highlighted the syndemic nature of COVID‐19 and diverse communities navigating coronavirus in their daily lived experiences. The articles in Volume 1 shed light on how the virus also had a horrific impact on the economic and mental health status of the targeted populations. Many of the authors in this volume described lack of resources and how that lack had disproportionately affected vulnerable populations in terms of unemployment, lost wages, and contributed to houselessness. In addition, the articles related to education strongly support how students of color and women have experienced a devasting effect of COVID‐19 (e.g., stress and trauma, psychological well‐being, and housing and food insecurity), which can potentially make obtaining higher education unreachable for vulnerable populations. This issue shares innovative approaches that community psychologists and those from allied fields can utilize to push the field forward in solving problems to combat the social determinants of health that COVID‐19 exposed. As the world continues to experience the effects of this synergistic explosion of COVID‐19 and racial injustices, this volume allows the readers to expand their knowledge of how community psychology and allied fields are making a historical impact on highlighting the important topics covered in this issue.