Health-insurance, diagnoses, and intersectionality: One couple’s experience with COVID-19

COVID-19 has wreaked havoc across the globe, infecting millions of individuals and altering our daily lives, but it has also uncovered the deeper systemic inequalities which make marginalized communities more vulnerable. 

The LGBTQ community faces unique challenges amidst COVID-19 and even more so coupled with the challenges that racial and ethnic groups face, such as Black, Native American, and Latinx individuals. 

The pandemic and its detrimental effects on marginalized communities has sparked a discussion surrounding intersectionality, and how various identities, when layered together, bring about unique challenges. Photographers Tierney Pierce and Autumn Johnson have been married for a year and each came down with COVID-19 symptoms in early April. Pierce identifies as Black American Mixed and Johnson is Caucasian, both female. They discussed how social and cultural differences have the potential to make some communities more vulnerable to COVID-19. 

“I mean we were being safe, we were wearing masks, we had hand sanitizer in the car. So we were doing all the precautions and still end up getting sick,” says Pierce. 

For a while, Johnson says it was difficult to pinpoint what was happening. Pierce has asthma and had a recently injured back, so for a while they couldn’t tell if her symptoms were related to COVID-19 or her injury. 

“I had a video call with my doctor,” says Pierce. “I went to x-ray my back and that came up nothing was broken or anything. And then she's like, ‘well, you know, just for kicks and giggles, let's just order you a test and you know, hope that it's negative.’ And it came back positive.”

Around the same time, Johnson began to lose her sense of smell, and then she says things happened really fast. 

“We also did not have health insurance when we were sick,” says Johnson. “We were, like, terrified to go to the hospital.” 

Since Johnson didn’t have health insurance at the time, she went to Rite Aid to get a COVID-19 test, but she didn’t know that she would have to administer it herself. The test came back negative, but she says she was certain that she had the disease. She later got another test, which made her realize that she didn’t put the swab far enough into her nose. 

The couple ended up moving their mattress into the living room to limit the distance they had to walk from where they were sleeping to the bathroom.

“Weirdly, Tierney having asthma saved us because without her having an inhaler already, we would have had to probably go to the hospital and then we would have been slammed with this super bill that we can’t pay because we’re in a pandemic and nobody’s working,” says Johnson. 

On June 11, however, Johnson did end up in the emergency room. Luckily, her health insurance began on the first of the month. She had all of the symptoms that would prompt a visit to the ER, but they sent her home telling her that everything seemed fine. 

There are nearly 14 million LGBTQ adults in the U.S. and more than five million work in industries that are more likely to be impacted by COVID-19, according to a brief from the Human Rights Campaign Foundation. The top five industries are food services and restaurants (15%), hospitals (7.5%), K-12 education (7%), colleges and universities (7%) and retail (4%), making up 40% of all industries where LGBTQ individuals work, versus only 22% of the industries where non-LGBTQ individuals work. 

Furthermore, the poverty rate for LGBTQ adults is nearly 22%, compared to only 16% for cisgender straight people, according to the Williams Institute, and 17% of LGBTQ adults don’t have health insurance, compared to 12% of non-LGBTQ individuals, according to the HRC Foundation’s analysis of the CDC’s Behavioral Risk Factor Surveillance System. The percentages are even higher for people of color and those that are transgender. 

With an increased likelihood of working in professions that put the community at risk, coupled with the added barriers to affordable health care, many may be hesitant to seek medical attention due to discrimination, which was expressed in an open letter to local media and health professionals discussing COVID-19 and the LGBTQ community. The first letter was initiated by six organizations and signed by over 100 additional organizations and the second letter was signed by over 170. The population also has a 50% higher likelihood of using tobacco and has a higher rate of HIV and cancer, which further puts the group at risk. 

Pierce’s mother ended up in the emergency room just days after Johnson and with the same symptoms, but since she had a stronger cough, she ended up getting an MRI, which found blood clots in her lungs. Johnson could have had the same thing. 

“You know now we have Medicaid,” says Pierce. “If it wasn't Medicaid, would she have gotten better treatment?" 

A friend of Johnson's is a nurse at a hospital in Big Rapids and when she told her about her ER experience, her friend said that it didn’t make any sense. “She said that anyone that comes in with breathing problems, they will try and give them a breathing treatment or something to help,” Johnson says about their conversation ...“So that even just shows the difference between different counties … and then who's to say the different hospitals, so even Spectrum or Mercy that have different systems or the hospital room next door? Who knows?”

The couple has a close relationship with Pierce’s family, who lives nearby and would visit often. 

“And that was actually very difficult for them and for us and even now, when we see people, we have to keep distance from them. And so I think seeing each other, like having the sense of community makes it easier and makes it more susceptible to getting sick,” says Johnson. 

“Whereas my family were, like taboo, they're like, go away, stay away, don't even come near me anything, you know, but your [Pierce’s] family's like I want to see you still. I don't care if you're sick.” 

“...But not really understanding the true consequences of being sick,” says Pierce. 

For many, the sense of community isn’t individualistic, such as in the Latino community, according to Johnson.

“You want to greet people, you want to hug them, you want to kiss them and attend parties when you're supposed to and then I think that's a lot of where some of the issues arise,” says Johnson, “because all the love. All of the love, that's what it is.” 

The road to recovery has been long and the couple is slowly gaining their strength back. Before contracting COVID-19, Pierce had started a running regimen with her dog. Now, in July, she has a difficult time running without asthma problems. 

“Like randomly I wake up, we'll both wake up and feel like somebody just kicked us in the chest immediately,” says Johnson. Even walking up the stairs can still be exhausting. 

“The last couple months...the meaning of ‘only time will tell’ has literally never been so prominent.” 

Images courtesy Tierney Pierce and Autumn Johnson.
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