COVID-19, Social Determinants Past, Present, and Future, and African Americans’ Health

Abstract

As the COVID-19 pandemic progresses, more African Americans than whites are falling ill and dying from the virus and more are losing livelihoods from the accompanying recession. The virus thereby exploits structural disadvantages, rooted partly in historical and contemporary anti-Black sentiments, working against African Americans. These include higher rates of comorbid illness and more limited health care access, higher rates of disadvantageous labor market positioning and community and housing conditions, greater exposure to long-term care residence, and higher incarceration rates. COVID-19 also exposes African Americans' greater vulnerability to recession, and possibly greater susceptibility to accompanying behavioral health problems. If they are left unaddressed, the very vulnerabilities COVID-19 exploits may perpetuate themselves. However, continuing and supplementing health and economic COVID mitigation policies can disproportionately benefit African Americans and reduce short-and long-term adverse effects. The greater impact of COVID-19 on African Americans demonstrates the consequences of pervasive social and economic inequality and marks this as a critical time to prevent further compounding of adverse effects. Keywords African American health disparities. COVID-19. African American economic disparities. Policy

Racial/Ethnic Heterogeneity and Rural-Urban Disparity of COVID-19 Case Fatality Ratio in the USA: a Negative Binomial and GIS-Based Analysis

“…It is apparent that COVID-19 has exacerbated health inequality and reduced life expectancy in the USA [ 31 , 34 ]. This study has shown the disparity in COVID-19 case fatality ratio, and it aligns with other studies situated within the social determinant of health framework, as shown in the literature [ 17 , 18 , 48 ]. According to the World Health Organization [ 49 ], the social determinant of health suggests that race/ethnicity, power, and location determine health outcomes for an individual or a group of people.…”

“…For example, African Americans have intergenerational poverty, which reflects in their health conditions [ 50 ]. In the pre-pandemic, African Americans and Hispanics had the least access to health care in the USA due to their inability to access health insurance principally because of low income [ 18 ]. Our study further provides evidence of health disparity by race/ethnicity and by place of residence, corroborating studies on racial and ethnic health disparity in the USA.…”

“…Fatality arising from COVID-19 in the USA is determined by several contextual (rural/intermediate/urban, college town/noncollege town, presence of institutions such as prisons, nursing homes) [ 13 ] and compositional (racial composition, age, sex) factors. This pattern has been explained using the social determinants of health (SDOH) framework in several studies, including research on COVID-19 [ 16 – 18 ]. The urban areas are often the focus of many studies and public health interventions.…”

Association of Vitamin D Status With Hospital Morbidity and Mortality in Adult Hospitalized Patients With COVID-19

“…Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), disproportionately affects the elderly, African Americans, those with obesity, and institutionalized individuals (nursing home residents) ( 5 , 6 ), all of which are also identified as a high-risk population for vitamin D deficiency ( 2 , 3 , 4 , 7 ). This association could potentially contribute to higher COVID-19 morbidity and mortality rates appreciated in this population.…”

Inclusive Health: Modeling Covid-19 in Correctional Facilities and Communities

“…As such, future models would do well to incorporate information on the varied population densities within correctional housing spaces to better understand viral spread. Another important characteristic that future models should consider is the disproportional impact of the pandemic on minorities (25,26) . To elaborate, Blacks and Hispanics are overrepresented by 5.6 and 3.0 times more than White adults (22) in U.S. correctional facilities, which contributes to disparities of these groups in COVID-19 testing, cases, and deaths.…”