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

• Type of Material: Article
• Authors: Ahmad Khanijahani, Duquesne University; Larisa Tomassoni, Emory University
• Language: English
• Date: 2022-01-01
• Publisher: Springer (part of Springer Nature)
• Publication Version: Final Published Version
• Copyright Statement: © W. Montague Cobb-NMA Health Institute 2021
• Final Published Version (URL): http://dx.doi.org/10.1007/s40615-021-00965-1
• Title of Journal or Parent Work: Journal of Racial and Ethnic Health Disparities
• Volume: 9
• Issue: 1
• Start Page: 367
• End Page: 375
• Keywords: Social segregation; African Americans; Vulnerable populations; COVID-19 (coronavirus disease 2019); Health disparities; Socioeconomic factors
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Public Health

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.