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Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States

Mounting evidence reveals considerable racial inequities in coronavirus disease 2019 (COVID-19) outcomes in the United States (US). Area-level racial bias has been associated with multiple adverse health outcomes, but its association with COVID-19 is yet unexplored. Combining county-level data from...

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Autores principales: Thomas, Marilyn D., Michaels, Eli K., Darling-Hammond, Sean, Nguyen, Thu T., Glymour, M. Maria, Vittinghoff, Eric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700363/
https://www.ncbi.nlm.nih.gov/pubmed/33238526
http://dx.doi.org/10.3390/ijerph17228695
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author Thomas, Marilyn D.
Michaels, Eli K.
Darling-Hammond, Sean
Nguyen, Thu T.
Glymour, M. Maria
Vittinghoff, Eric
author_facet Thomas, Marilyn D.
Michaels, Eli K.
Darling-Hammond, Sean
Nguyen, Thu T.
Glymour, M. Maria
Vittinghoff, Eric
author_sort Thomas, Marilyn D.
collection PubMed
description Mounting evidence reveals considerable racial inequities in coronavirus disease 2019 (COVID-19) outcomes in the United States (US). Area-level racial bias has been associated with multiple adverse health outcomes, but its association with COVID-19 is yet unexplored. Combining county-level data from Project Implicit on implicit and explicit anti-Black bias among non-Hispanic Whites, Johns Hopkins Coronavirus Resource Center, and The New York Times, we used adjusted linear regressions to estimate overall COVID-19 incidence and mortality rates through 01 July 2020, Black and White incidence rates through 28 May 2020, and Black–White incidence rate gaps on average area-level implicit and explicit racial bias. Across 2994 counties, the average COVID-19 mortality rate (standard deviation) was 1.7/10,000 people (3.3) and average cumulative COVID-19 incidence rate was 52.1/10,000 (77.2). Higher racial bias was associated with higher overall mortality rates (per 1 standard deviation higher implicit bias b = 0.65/10,000 (95% confidence interval: 0.39, 0.91); explicit bias b = 0.49/10,000 (0.27, 0.70)) and higher overall incidence (implicit bias b = 8.42/10,000 (4.64, 12.20); explicit bias b = 8.83/10,000 (5.32, 12.35)). In 957 counties with race-specific data, higher racial bias predicted higher White and Black incidence rates, and larger Black–White incidence rate gaps. Anti-Black bias among Whites predicts worse COVID-19 outcomes and greater inequities. Area-level interventions may ameliorate health inequities.
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spelling pubmed-77003632020-11-30 Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States Thomas, Marilyn D. Michaels, Eli K. Darling-Hammond, Sean Nguyen, Thu T. Glymour, M. Maria Vittinghoff, Eric Int J Environ Res Public Health Article Mounting evidence reveals considerable racial inequities in coronavirus disease 2019 (COVID-19) outcomes in the United States (US). Area-level racial bias has been associated with multiple adverse health outcomes, but its association with COVID-19 is yet unexplored. Combining county-level data from Project Implicit on implicit and explicit anti-Black bias among non-Hispanic Whites, Johns Hopkins Coronavirus Resource Center, and The New York Times, we used adjusted linear regressions to estimate overall COVID-19 incidence and mortality rates through 01 July 2020, Black and White incidence rates through 28 May 2020, and Black–White incidence rate gaps on average area-level implicit and explicit racial bias. Across 2994 counties, the average COVID-19 mortality rate (standard deviation) was 1.7/10,000 people (3.3) and average cumulative COVID-19 incidence rate was 52.1/10,000 (77.2). Higher racial bias was associated with higher overall mortality rates (per 1 standard deviation higher implicit bias b = 0.65/10,000 (95% confidence interval: 0.39, 0.91); explicit bias b = 0.49/10,000 (0.27, 0.70)) and higher overall incidence (implicit bias b = 8.42/10,000 (4.64, 12.20); explicit bias b = 8.83/10,000 (5.32, 12.35)). In 957 counties with race-specific data, higher racial bias predicted higher White and Black incidence rates, and larger Black–White incidence rate gaps. Anti-Black bias among Whites predicts worse COVID-19 outcomes and greater inequities. Area-level interventions may ameliorate health inequities. MDPI 2020-11-23 2020-11 /pmc/articles/PMC7700363/ /pubmed/33238526 http://dx.doi.org/10.3390/ijerph17228695 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Thomas, Marilyn D.
Michaels, Eli K.
Darling-Hammond, Sean
Nguyen, Thu T.
Glymour, M. Maria
Vittinghoff, Eric
Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States
title Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States
title_full Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States
title_fullStr Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States
title_full_unstemmed Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States
title_short Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States
title_sort whites’ county-level racial bias, covid-19 rates, and racial inequities in the united states
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700363/
https://www.ncbi.nlm.nih.gov/pubmed/33238526
http://dx.doi.org/10.3390/ijerph17228695
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