A Geography of Risk: Structural Racism and Coronavirus Disease 2019 Mortality in the United States.
Am J Epidemiol
; 190(8): 1439-1446, 2021 08 01.
Article
in English
| MEDLINE | ID: covidwho-1337250
ABSTRACT
Coronavirus disease 2019 (COVID-19) is disproportionately burdening racial and ethnic minority groups in the United States. Higher risks of infection and mortality among racialized minorities are a consequence of structural racism, reflected in specific policies that date back centuries and persist today. Yet our surveillance activities do not reflect what we know about how racism structures risk. When measuring racial and ethnic disparities in deaths due to COVID-19, the Centers for Disease Control and Prevention statistically accounts for the geographic distribution of deaths throughout the United States to reflect the fact that deaths are concentrated in areas with different racial and ethnic distributions from those of the larger United States. In this commentary, we argue that such an approach misses an important driver of disparities in COVID-19 mortality, namely the historical forces that determine where individuals live, work, and play, and that consequently determine their risk of dying from COVID-19. We explain why controlling for geography downplays the disproportionate burden of COVID-19 on racialized minority groups in the United States. Finally, we offer recommendations for the analysis of surveillance data to estimate racial disparities, including shifting from distribution-based to risk-based measures, to help inform a more effective and equitable public health response to the pandemic.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Ethnicity
/
Racial Groups
/
Health Status Disparities
/
COVID-19
/
Minority Groups
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Am J Epidemiol
Year:
2021
Document Type:
Article
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