Counties with High COVID-19 Incidence and Relatively Large Racial and Ethnic Minority Populations — United States, April 1–December 22, 2020

Lee, Florence C.; Adams, Laura; Graves, Sierra J; Massetti, Greta M.; Calanan, Renee; Penman-Aguilar, Ana; Henley, S. Jane; Annor, Francis; Handel, Michelle Van; Aleshire, Noah; Durant, Tonji; Fuld, Jennifer; Griffing, Sean M.; Mattocks, Laura; Liburd, Leandris

doi:10.15585/mmwr.mm7013e1

Cited by 31 publications

(25 citation statements)

References 8 publications

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“…We also find that the increase in school-based COVID-19 transmission is driven by households that reside in counties in the bottom income quartiles. This finding is particularly relevant, as it suggests that the socioeconomic disparities observed in other studies also exist for school reopening policies (Panovska-Griffiths et al 2020;Jay et al 2020;Lee et al 2021).…”

Section: Introductionmentioning

confidence: 64%

“…A substantial literature documents race and income disparities in the health and non-health impacts of the COVID-19 pandemic (Ogedegbe et al 2020;Jay et al 2020;Khazanchi, Evans, and Marcelin 2020;Moore 2020;Lee et al 2021). The effects of school reopenings on COVID transmission may also show similar disparities.…”

Section: Differences By County-level Income Compositionmentioning

confidence: 99%

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Back to School: The Effect of School Visits During COVID-19 on COVID-19 Transmission

Bravata

Cantor

Sood

et al. 2021

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for helpful comments. We also thank seminar participants at the RAND Education and Labor Brownbag. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.

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Section: Introductionmentioning

confidence: 64%

Section: Differences By County-level Income Compositionmentioning

confidence: 99%

Back to School: The Effect of School Visits During COVID-19 on COVID-19 Transmission

Bravata

Cantor

Sood

et al. 2021

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“…More than one full year into the COVID-19 pandemic, we are still seeing marked racial/ethnic disparities in COVID-19 morbidity and mortality rates across the USA [ 1 ]. Although these disparities have been well documented at the national [ 2 ] and state [ 3 ] levels, there is a great need to better characterize these disparities at more localized levels of geography, such as at the county level.…”

Section: Introductionmentioning

confidence: 99%

Actual Racial/Ethnic Disparities in COVID-19 Mortality for the Non-Hispanic Black Compared to Non-Hispanic White Population in 353 US Counties and Their Association with Structural Racism

Siegel

Critchfield‐Jain

Boykin

et al. 2021

J. Racial and Ethnic Health Disparities

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Introduction Although disparities in COVID-19 mortality have been documented at the national and state levels, no previous study has quantified such disparities at the county level by explicitly measuring race-specific COVID-19 death rates. In this paper, we quantify the racial/ethnic disparities in COVID-19 mortality between the non-Hispanic Black and non-Hispanic White populations at the county level by estimating age-adjusted, race-specific death rates. Methods Using COVID-19 case data from the Centers for Disease Control and Prevention, we calculated crude and indirect age-adjusted COVID-19 mortality rates for the non-Hispanic White and non-Hispanic Black populations in each of 353 counties for the period February 2, 2020, through January 30, 2021. Using linear regression analysis, we examined the relationship between several county-level measures of structural racism and the observed differences in racial disparities in COVID-19 mortality across counties. Results Ninety-three percent of the counties in our study experienced higher death rates among the Black compared to the White population, with an average ratio of Black to White death rates of 1.9 and a 17.5-fold difference between the disparity in the lowest and highest counties. Three traditional measures of structural racism were significantly related to the magnitude of the Black-White racial disparity in COVID-19 mortality rates across counties. Conclusions There are large disparities in COVID-19 mortality rates between the Black and White populations at the county level, there are profound differences in the level of these disparities, and those differences are directly related to the level of structural racism in a given county.

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“…The COVID-19 pandemic has affected all communities in the United States, but infections, deaths, and financial and social disruption have been most severe in low-income, socially vulnerable, and predominantly racial and ethnic minority communities, both rural and urban. [1][2][3][4][5][6][7] Consequently, among all outpatient practices, those that serve these communities may have been disproportionately affected, including federally qualified health centers (FQHCs), Indian Health Service (IHS) and tribal health centers, community mental health and drug treatment centers, and other safety-net practices.…”

mentioning

confidence: 99%

Experiences of Safety-Net Practice Clinicians Participating in the National Health Service Corps During the COVID-19 Pandemic

et al. 2021

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Objectives The impact of the COVID-19 pandemic has been particularly harsh for low-income and racial and ethnic minority communities. It is not known how the pandemic has affected clinicians who provide care to these communities through safety-net practices, including clinicians participating in the National Health Service Corps (NHSC). Methods In late 2020, we surveyed clinicians who were serving in the NHSC as of July 1, 2020, in 20 states. Clinicians reported on work and job changes and their current well-being, among other measures. Analyses adjusted for differences in subgroup response rates and clustering of clinicians within practices. Results Of 4263 surveyed clinicians, 1890 (44.3%) responded. Work for most NHSC clinicians was affected by the pandemic, including 64.5% whose office visit numbers fell by half and 62.5% for whom most visits occurred virtually. Fewer experienced changes in their jobs; for example, only 14.9% had been furloughed. Three-quarters (76.6%) of these NHSC clinicians scored in at-risk levels for their well-being. Compared with primary care and behavioral health clinicians, dental clinicians much more often had been furloughed and had their practices close temporarily. Conclusions The pandemic has disrupted the work, jobs, and mental health of NHSC clinicians in ways similar to its reported effects on outpatient clinicians generally. Because clinicians’ mental health worsens after a pandemic, which leads to patient disengagement and job turnover, national programs and policies should help safety-net practices build cultures that support and give greater priority to clinicians’ work, job, and mental health needs now and before the next pandemic.

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Counties with High COVID-19 Incidence and Relatively Large Racial and Ethnic Minority Populations — United States, April 1–December 22, 2020

Cited by 31 publications

References 8 publications

Back to School: The Effect of School Visits During COVID-19 on COVID-19 Transmission

Back to School: The Effect of School Visits During COVID-19 on COVID-19 Transmission

Actual Racial/Ethnic Disparities in COVID-19 Mortality for the Non-Hispanic Black Compared to Non-Hispanic White Population in 353 US Counties and Their Association with Structural Racism

Experiences of Safety-Net Practice Clinicians Participating in the National Health Service Corps During the COVID-19 Pandemic

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