Racism, xenophobia, discrimination, and the determination of health.

This Series shows how racism, xenophobia, discrimination, and the structures that support them are detrimental to health. In this first Series paper, we describe the conceptual model used throughout the Series and the underlying principles and definitions. We explore concepts of epistemic injustice, biological experimentation, and misconceptions about race using a historical lens. We focus on the core structural factors of separation and hierarchical power that permeate society and result in the negative health consequences we see. We are at a crucial moment in history, as populist leaders pushing the politics of hate have become more powerful in several countries. These leaders exploit racism, xenophobia, and other forms of discrimination to divide and control populations, with immediate and long-term consequences for both individual and population health. The COVID-19 pandemic and transnational racial justice movements have brought renewed attention to persisting structural racial injustice.

Xenophobia, prejudice, and blame in pandemic times

The authors take particular care to sketch out how blaming certain populations for spreading or causing the emergence of COVID-19 hardens enmities between groups already defined as different by social distinctions of race, class, sexuality, ethnicity, religion, nationality, or political affiliation. Xun and Gilman's analysis of the US Supreme Court debates over whether public health limits can be set on the right to religious congregation is instructive. [...]this book is an important entry point for the general public seeking perspective on this pandemic, as well as for physicians, public health experts, and health workers trying to understand why and how COVID-19 health measures have provoked the sociopolitical and cultural responses we have seen.

Residential racial segregation and social distancing in the United States during COVID-19.

BACKGROUND: Our objective is to examine whether residential racial segregation may be constraining capacities for social distancing thus leaving African Americans potentially more exposed to contracting COVID-19. We hypothesized that residential racial segregation constrains African Americans' spatial mobility when the whole population is locked down but increases their need for moving under reopening orders. METHODS: We employ a Black/White dissimilarity index as our independent variable and county-level mobility ratios as our dependent variable. Using generalized estimating equations for longitudinal data, we analyzed the effects of Black/White segregation on population mobility by counties across the United States from March 8 to August 7, 2020 under two different COVID-19 related policy conditions: lockdown and reopening. FINDINGS: While higher county-wide levels of segregation were significantly associated with decreased mobility under lockdown and stay-at-home orders, we found that this relationship between segregation and mobility dissipated under reopening orders. INTERPRETATIONS: Investigating the effects of health policy without considering differing effects due to structural racism will likely ignore complexities that may create unintended consequences of health policy. Our conclusions suggest African Americans may face structural limitations to effective social distancing as evidenced by higher rates of mobility after reopening policies go into effect.

The public's role in COVID-19 vaccination: Human-centered recommendations to enhance pandemic vaccine awareness, access, and acceptance in the United States.

Given the social and economic upheavals caused by the COVID-19 pandemic, political leaders, health officials, and members of the public are eager for solutions. One of the most promising, if they can be successfully developed, is vaccines. While the technological development of such countermeasures is currently underway, a key social gap remains. Past experience in routine and crisis contexts demonstrates that uptake of vaccines is more complicated than simply making the technology available. Vaccine uptake, and especially the widespread acceptance of vaccines, is a social endeavor that requires consideration of human factors. To provide a starting place for this critical component of a future COVID-19 vaccination campaign in the United States, the 23-person Working Group on Readying Populations for COVID-19 Vaccines was formed. One outcome of this group is a synthesis of the major challenges and opportunities associated with a future COVID-19 vaccination campaign and empirically-informed recommendations to advance public understanding of, access to, and acceptance of vaccines that protect against SARS-CoV-2. While not inclusive of all possible steps than could or should be done to facilitate COVID-19 vaccination, the working group believes that the recommendations provided are essential for a successful vaccination program.