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. 2022 Feb;9(1):367-375.
doi: 10.1007/s40615-021-00965-1. Epub 2021 Jan 19.

Socioeconomic and Racial Segregation and COVID-19: Concentrated Disadvantage and Black Concentration in Association with COVID-19 Deaths in the USA

Ahmad Khanijahani  1 , Larisa Tomassoni  2
Affiliations

Socioeconomic and Racial Segregation and COVID-19: Concentrated Disadvantage and Black Concentration in Association with COVID-19 Deaths in the USA

Ahmad Khanijahani et al. J Racial Ethn Health Disparities. 2022 Feb.

Abstract

Introduction: This study's objective was to examine the association of the percentage of county population residing in concentrated disadvantage and Black-concentrated census tracts with county-level confirmed COVID-19 deaths in the USA, concentrated disadvantage and Black concentration at census tract-level measure socioeconomic segregation and racial segregation, respectively.

Methods: We performed secondary data analysis using tract (N = 73,056) and county (N = 3142) level data from the US Census Bureau and other sources for the USA. Confirmed COVID-19 deaths per 100,000 population was our outcome measure. We performed mixed-effect negative binomial regression to examine the association of county population's percentage residing in concentrated disadvantage and Black-concentrated tracts with COVID-19 deaths while controlling for several other characteristics.

Results: For every 10% increase in the percentage of county population residing in concentrated disadvantage and Black-concentrated tracts, the rate for confirmed COVID-19 deaths per 100,000 population increases by a factor of 1.14 (mortality rate ratio [MMR] = 1.14; 95% confidence interval [CI]:1.11, 1.18) and 1.11 (MMR = 1.11; 95% CI:1.08, 1.14), respectively. These relations stayed significant in all models in further sensitivity analyses. Moreover, a joint increase in the percentage of county population residing in racial and socioeconomic segregation was associated with a much greater increase in COVID-19 deaths.

Conclusions: It appears that people living in socioeconomically and racially segregated neighborhoods may be disproportionately impacted by COVID-19 deaths. Future multilevel and longitudinal studies with data at both individual and aggregated tract level can help isolate the potential impacts of the individual-level characteristics and neighborhood-level socioeconomic and racial segregation with more precision and confidence.

Keywords: African Americans; COVID-19 (coronavirus disease 2019); Health disparities; Social segregation; Socioeconomic factors; Vulnerable populations.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Mortality rate ratios (MRR) and 95% confidence intervals from the select models included in the sensitivity analysis. MRR can be interpreted as a percentage increase in the confirmed COVID-19 deaths with a 10% increase in the county population’s percentage residing in tracts with concentrated disadvantage or Black concentration
Fig. 2
Fig. 2
Interaction between the percentage of county population residing in concentrated disadvantage tracts and the percentage of county population residing in concentrated Black tracts. The joint increase in both percentages is associated with a greater increase in COVID-19 deaths than an increase in either measure of segregation
See this image and copyright information in PMC

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