A Geography of Risk: Structural Racism and COVID-19 Mortality in the United States

Citation

Zalla, Lauren C.; Martin, Chantel L.; Edwards, Jessie K.; Gartner, Danielle R.; & Noppert, Grace A. (2021). A Geography of Risk: Structural Racism and COVID-19 Mortality in the United States. American Journal of Epidemiology, 190(8), 1439-1446. PMCID: PMC7989642

Abstract

Coronavirus disease 2019 (COVID-19) is disproportionately burdening racial and ethnic minority groups in the US. 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 CDC statistically accounts for the geographic distribution of deaths throughout the US to reflect the fact that deaths are concentrated in areas with different racial and ethnic distributions than that of the larger US. 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 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 US. 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.

URL

https://doi.org/10.1093/aje/kwab059

Reference Type

Journal Article

Year Published

2021

Journal Title

American Journal of Epidemiology

Author(s)

Zalla, Lauren C.
Martin, Chantel L.
Edwards, Jessie K.
Gartner, Danielle R.
Noppert, Grace A.

Article Type

Commentary

PMCID

PMC7989642

Data Set/Study

COVID Tracking Project

Continent/Country

United States of America

State

Nonspecific

Race/Ethnicity

Black
Indigenous
Hispanic/Latinx

ORCiD

Martin, C. - 0000-0003-1907-0810
Noppert - 0000-0002-2040-960x
Zalla - 0000-0001-7665-2230
Edwards, J -0000-0002-1741-335X