Study links racism, segregation to increased COVID deaths

Death rate was higher among Black individuals because of social environments rather than physiology or genetics, researchers found

New data from a number of big cities and states is shedding light on current inequalities in health care.

Death rates among both Black and white people were higher in areas with more residential segregation, with rates for Black individuals almost twice as high, according to a study by Ohio University researcher Berkeley Franz.

Franz and her team examined the relationship between systemic racism, residential segregation and racial/ethnic disparities in COVID-19 deaths in the United States.

“We were interested in doing this study because racial and ethnic disparities have been apparent amid COVID-19, and for some Americans, this may have been one of the first times they’ve learned about disparities,” Franz said. “Health disparities are present with almost every illness and have persisted for years, and the gap isn’t closing, especially between Black and white Americans. We wanted to understand what was driving those disparities to find better ways to reduce them.”

The researchers looked at systemic racism measures, as well as socioeconomic factors between Black and white residents, in every state. Using data on deaths through December 2020, they assessed whether state-level systemic racism and residential segregation predicted the probability of COVID-19 deaths among Americans, considering sociodemographic factors in the process.

What they found was the death rate was higher among Black individuals because of social environments rather than physiology or genetics. They hypothesized that in segregated neighborhoods, residents are less likely to have access to good quality schools, employment opportunities, health care and other resources.

“Race doesn’t strongly shape if an individual gets infected with COVID-19, as infection rates are similar by race. But race does relate to how severe the disease is and if you die from it,” Franz said. “Racial disparities are baked into American institutions, whether that is in education systems, health care or neighborhoods, and we found that the more residential segregation there was in a state, the better (a) predictor it was for how many people were dying of COVID and who was dying.”

The results of the study demonstrate that residential segregation is associated with negative outcomes for Black and white Americans, but disproportionately affects Black residents, the authors wrote. The death rate varies considerably by race, with 102.1 of every 100,000 Black residents dying of COVID-19 compared to 73.1 of every 100,000 white residents.

Franz added that the implications of residential segregation and systemic racism are important when looking at COVID mortality rates, because social factors — not individual decisions — are what shaped these deaths. Differences in socioeconomic factors, like having health insurance and accessible resources, can contribute to the likelihood of recovering from COVID.

“Health disparities will never go away if we don’t get rid of the basic inequalities,” she said. “Having an unequal society makes everyone vulnerable and leads to bad outcomes. By addressing these social factors, we can help prevent illness and death. Racial equality benefits society all around.”

You can read the full study in the journal Ethnicity & Disease.

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