From the water in Flint, MI, the proverbial knee on the neck of people of color, to a global pandemic, it seems as if systemic racism finds its way into almost every facet of life when you are Black or a person of color. The wealth gap having an impact on COVID-19 resistance is understandable because people in impoveri
While data and news reports show that Black and Hispanic communities are disproportionately affected by the 2019 Coronavirus Disease (COVID-19) pandemic, the role that neighborhood income plays in COVID-19 deaths is less clear. New analyses by a team of researchers at NYU Grossman School of Medicine examine the interplay between race/ethnicity and income on COVID-19 cases and related deaths in 10 major U.S. cities. The researchers found that non-white counties had higher cumulative incidences and deaths compared to predominantly white counties—and this was true for both low-income and high-income communities.
How the Study was Conducted
Using publicly available data from the 2018 U.S. Census Small Areas Income and Poverty Estimates program, the Centers for Disease Control, and state health departments, the researchers examined cumulative COVID-19 cases and deaths per 100,000 across 158 urban counties (accounting for 64 percent of confirmed COVID-19 cases) spanning 10 large U.S. cities: New York City, Boston, New Orleans, Detroit, Los Angeles, Atlanta, Miami, Chicago, Philadelphia, and Seattle. Using the census data, the team linked median income and proportion of non-white residents in each county and used statistical analysis to identify differences in cumulative incidents and death, and their association with neighborhood race/ethnicity and poverty levels. All data analyzed included COVID-19 cases and deaths observed through May 10, 2020.
“We have known for decades that racism kills. Racism is a public health issue which has been implicated in the racial gap in mortality and in health outcomes,” says Gbenga Ogedegbe, MD, MPH, professor of Population Health and Medicine at NYU Langone and one of the study’s co-authors.
“Because the differences in COVID-19 cases and mortality cannot be explained by poverty alone, our findings give credence to our hypothesis that structural racism underlies the disproportionately higher rates of COVID-19 infections and alarmingly high rates of deaths in predominantly Black communities. The fact that non-white residents died from the virus at higher rates than white residents in both wealthier and poorer communities should be a major alarm bell to policymakers at the national and local government levels, academic medical centers, and the country at large,” says Ogedegbe.
One of the study’s limitations, according to Adhikari, is that it covers only large metropolitan areas and that the data analyzed are aggregated at the county level. More granular data at the individual level, as well as a breakdown of residents by race and ethnicity, would provide greater insight into the drivers of this troubling association, as well as expose most affected neighborhoods in need of more robust public health interventions, says Adhikari.
In addition to Adhikari and Ogedegbe, additional co-authors from NYU Langone Health are senior author Andrea Troxel, ScD; Lorna Thorpe, PhD, MPH; Justin Feldman, ScD; and Nicholas Pantaleo. Dr. Adhikari is funded by National Institute of Health and Johnson & Johnson.
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