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National Institute of Environmental Health Sciences

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Your Environment. Your Health.

Publication Detail

Title: Structural Racism and COVID-19 in the USA: a County-Level Empirical Analysis.

Authors: Tan, Shin Bin; deSouza, Priyanka; Raifman, Matthew

Published In J Racial Ethn Health Disparities, (2022 Feb)

Abstract: Substantial health disparities exist across race/ethnicity in the USA, with Black Americans often most affected. The current COVID-19 pandemic is no different. While there have been ample studies describing racial disparities in COVID-19 outcomes, relatively few have established an empirical link between these disparities and structural racism. Such empirical analyses are critically important to help defuse "victim-blaming" narratives about why minority communities have been badly hit by COVID-19. In this paper, we explore the empirical link between structural racism and disparities in county-level COVID-19 outcomes by county racial composition. Using negative binomial regression models, we examine how five measures of county-level residential segregation and racial disparities in socioeconomic outcomes as well as incarceration rates are associated with county-level COVID-19 outcomes. We find significant associations between higher levels of measured structural racism and higher rates of COVID-19 cases and deaths, even after adjusting for county-level population sociodemographic characteristics, measures of population health, access to healthcare, population density, and duration of the COVID-19 outbreak. One percentage point more Black residents predicted a 1.1% increase in county case rate. This association decreased to 0.4% when structural racism indicators were included in our model. Similarly, one percentage point more Black residents predicted a 1.8% increase in county death rates, which became non-significant after adjustment for structural racism. Our findings lend empirical support to the hypothesis that structural racism is an important driver of racial disparities in COVID-19 outcomes, and reinforce existing calls for action to address structural racism as a fundamental cause of health disparities.

PubMed ID: 33469868 Exiting the NIEHS site

MeSH Terms: COVID-19*; Health Status Disparities; Humans; Pandemics; Racism*; SARS-CoV-2; Systemic Racism; United States/epidemiology

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