Disparities and intersectionality in social support networks: addressing social inequalities during the COVID-19 pandemic and beyond

The coronavirus disease 2019 (COVID-19) pandemic posed disproportionate threats to marginalized communities (e.g., racial/ethnic and sexual minorities, persons with disabilities) worldwide. Various detrimental outcomes emerged from the psychosocial burden of isolation, economic uncertainty, and social unrest over the course of the pandemic. As a result of highly contagious SARS-CoV-2 and its variants, COVID-19 has disproportionately placed many marginalized groups at higher risk for infection and death. Aside from disparities in COVID-19 morbidity and mortality, marginalized populations are at increased risk for poor mental and physical well-being due to deleterious effects on biopsychosocial and political dimensions. Socioeconomic inequalities have disproportionately affected marginalized populations, exacerbating health disparities. These groups are more likely to struggle with mental health and/or economic insecurity and face additional barriers to engaging in prevention measures (e.g., lockdowns, social distancing), which can lead to overcrowded housing, weakened social networks, and increased isolation. Individuals in these groups have experienced increased distress and mental burden, straining family and social relationships. Little is known about disparities in specific sources of social support between marginalized populations and their counterparts, and few studies examine intersections of race/ethnicity, sexual orientation, and disability status on social support during the pandemic. It is critical to articulate and characterize such intersectional differences to address social inequalities during a time of global crisis.

The paper situates the study within evidence that COVID-19 disproportionately affected marginalized communities in infection, mortality, and psychosocial outcomes. Prior work documents socioeconomic disadvantages, barriers to prevention adherence, and increased isolation among racial/ethnic minorities, sexual minorities (LGBTQ+), and persons with disabilities. Literature also highlights the protective role of social support in health and wellness, pre-pandemic differences in social network size and religious affiliation across racial/ethnic groups, and unique stressors faced by sexual minorities (e.g., concealment, familial rejection) as well as access and digital literacy barriers among persons with disabilities. These strands motivate examining disparities by specific support sources (family, friends, significant other) and the intersectionality of identities during the pandemic.

Study approval: Office for Research Protections at The Pennsylvania State University (STUDY00016378); informed consent obtained. Power analysis using G*Power 3.1 indicated a minimum sample size of 128 for 80% power at α = 0.05 with medium effect sizes (d = 0.5, f = 0.25) for dependent t-tests and factorial ANOVA. Sample and recruitment: U.S. adults (N = 1499) from 45 states recruited via Qualtrics. Measures: Perceived social support assessed with the 12-item Multidimensional Scale of Perceived Social Support (MSPSS) comprising three subscales: family, friends, significant other; Cronbach’s α = 0.91 in this sample. Analytic strategy: Independent samples t-tests compared perceived support from family, friends, and significant other between marginalized groups (racial/ethnic minorities, sexual minorities, persons with disabilities) and their counterparts (White, straight, non-disabled). Factorial ANOVAs examined interactive effects among demographic factors on each support source. Software: IBM SPSS v27. Two-sided p < 0.05 considered statistically significant.

- Family support: Racial/ethnic minorities (M = 19.74, SD = 6.47) reported significantly less family support than White individuals (M = 21.03, SD = 5.77), t(517.39) = 3.10, p < 0.01. Sexual minorities (M = 18.80, SD = 6.56) reported significantly less family support than straight individuals (M = 21.29, SD = 5.70), t(354.51) = 5.40, p < 0.001. Persons with disabilities (M = 18.94, SD = 6.75) reported significantly less family support than non-disabled individuals (M = 21.00, SD = 5.81), t(215.28) = 3.74, p < 0.001. Factorial ANOVA indicated a significant interaction between race/ethnicity and sexual orientation for family support (details depicted in Fig. 2), and a main effect of disability status (non-disabled > disabled); no significant interaction between race/ethnicity and disability status for family support. - Friend support: Racial/ethnic minorities (M = 21.63, SD = 5.28) reported significantly less friend support than White individuals (M = 22.67, SD = 4.68), t(113) = 3.26, p < 0.01. No significant difference in friend support between sexual minorities and straight individuals. Persons with disabilities reported significantly less friend support than non-disabled individuals (p < 0.05). Factorial ANOVA showed no significant race × sexual orientation interaction for friend support, F(1, 1106) = 0.13, p = 0.72; a significant main effect emerged for race/ethnicity (racial/ethnic minorities < White), controlling for sexual orientation. Among straight individuals, racial/ethnic minorities reported less friend support than Whites; no significant differences among LGBTQ+ across racial/ethnic groups, nor between White LGBTQ+ and straight racial/ethnic minorities. - Significant other support: Independent t-tests indicated no significant differences between sexual minorities and straight individuals. A t-test reported persons with disabilities (M = 21.69, SD = 6.00) had lower support from a significant other than non-disabled individuals (M = 22.34, SD = 4.90), t(106) = 2.18, p < 0.05; however, factorial ANOVA found no significant interaction between race/ethnicity and sexual orientation, F(1, 1108) = 0.18, p = 0.67, and no significant main effects for race/ethnicity or sexual orientation on support from a significant other. - Intersectional comparison noted in the abstract: White individuals with a marginalized identity received less social support than White counterparts but similar levels to racial/ethnic minorities without additional marginalized identities.

The study addresses the research question by demonstrating that marginalized identities are associated with lower perceived social support during the COVID-19 pandemic, particularly from family and friends. Racial/ethnic minorities experienced reduced support, likely exacerbated by pandemic restrictions that curtailed in-person communal and religious activities, disproportionately impacting groups with more collectivist networks. Sexual minorities reported lower family support, consistent with potential familial strain, concealment, and rejection, although friend and partner networks may buffer these effects. Persons with disabilities reported reduced support, reflecting barriers to forming and maintaining social connections and potential limitations in digital access and literacy that hindered online social support during lockdowns. Intersectional analyses clarified that race/ethnicity exerted a main effect on friend support while interactions for significant other support were not significant, suggesting partner support remained relatively stable across groups during the pandemic. The findings underscore the importance of targeted strategies to mitigate social isolation among marginalized populations, including improving digital inclusion and access, and tailoring public health messaging and community support to address structural inequities in social capital.

This study contributes evidence that the COVID-19 pandemic exacerbated disparities in perceived social support across specific sources (family, friends, significant other) among racial/ethnic minorities, sexual minorities, and persons with disabilities, with intersectional patterns most evident for family and friend support. Results highlight the need to address social capital inequalities through initiatives that bolster familial and peer support for marginalized groups, remove access barriers, and enhance digital literacy and accessibility. The authors recommend coordinated actions by mental health professionals, public health officials, and community stakeholders to develop and promote inclusive, accessible support systems—both online and offline—during ongoing public health crises and in the post-pandemic era. Future work should continue to examine intersectional dynamics of support and evaluate interventions aimed at reducing social support disparities.