ABSTRACT
BACKGROUND: Prior studies establish that Black neighborhoods and older persons experience higher rates of COVID-19 death than white neighborhoods and younger persons. However, such works point to the effect of age on COVID-19 mortality and the racial and ethnic inequalities present in COVID-19 deaths as independent vectors of inequality, neglecting to consider the multiplicative impact of structural conditions. METHODS: Using weekly ZIP code counts of deaths from March 2020 through July 2021 from the Chicago Department of Public Health (n = 4168) and measures of structural characteristics derived from the 5-year estimates of the 2019 American Community Survey, the current study examined how place, racial composition, and the age structure of communities act in tandem to shape the number of deaths due to COVID-19. We used STATA to estimate negative binomial models predictive of COVID-19 mortality. RESULTS: Findings from our statistical analysis revealed that in predominately Black neighborhoods, racial composition amplified the association of age structure (65 +) on COVID-19 mortality by 40%. Neighborhoods that were not predominately black did not show this multiplicative risk of death. Our findings underscore that the elevated risk of death in in older Black communities is attributed to historic and contemporary structural inequality. CONCLUSIONS: Although society typically frames pandemics as natural disasters, doing such undermines dimensions of marginalization that amplify vulnerability among select populations. To begin eliminating such inequalities, the USA must deal with the entrenched limitations of institutions that render unequal attention and care to sectors of its population.
ABSTRACT
RESEARCH SUMMARY: Despite growing national awareness that COVID-19 in jails and prisons constitutes a public health emergency in the United States, remarkably little attention has been paid to understanding how the virus affects people under community supervision. We used data from the National Survey on Drug Use and Health (NSDUH) to explore differences in the extent to which men under community supervision are vulnerable to COVID-19 and have access to care during the pandemic, relative to men who are not involved with the U.S. criminal legal system. Results from this study highlight the greater levels of risk for serious illness or death from COVID-19 and the disproportionate lack of health insurance among men under community supervision. POLICY IMPLICATIONS: Jurisdictions across the United States are currently relying on decarceration to contain the spread of COVID-19 in jails and prisons. Decarceration efforts alone, however, are insufficient for addressing the spread of COVID-19 among people involved with the U.S. criminal legal system. People released from jails and prisons or diverted from incarceration during the pandemic must be given the opportunity to receive the COVID-19 vaccination upon their transitions. Likewise, individuals under community supervision must be prioritized for immediate vaccination against COVID-19. People involved with the U.S. criminal legal system should also be eligible for emergency Medicaid during the COVID-19 crisis, and their health insurance coverage should remain available beyond the pandemic.