Race, explicit racial attitudes, implicit racial attitudes, and COVID-19 cases and deaths: An analysis of counties in the United States

Abstract

Objectives To examine the potential moderating effects of explicit racial attitudes and implicit racial attitudes on the relationship between percent of Black county residents and COVID-19 cases and deaths. Methods We collected data from a variety of publicly available sources for 817 counties in the US. (26% of all counties). Cumulative COVID-19 deaths and cases from January 22 to August 31, 2020 were the dependent variables; explicit racial attitudes and implicit racial attitudes served as the moderators; subjective poor or fair health, food insecurity, percent uninsured, percent unemployed, median family income, percent women, percent of Asian county resident, percent of Hispanic county residents, and percent of people 65 or older were controls. Results The percent of Black county residents was positively associated with COVID-19 cases and deaths at the county level. The relationship between percent of Black residents and COVID-19 cases was moderated by explicit racial attitudes and implicit racial attitudes. Conclusions Implicit racial attitudes can take on a shared property at the community level and effectively explain racial disparities. COVID-19 cases are highest when both the percent of Black county residents and implicit racial attitudes are high.

Physical activity and its relationship with COVID-19 cases and deaths: Analysis of U.S. counties

“…Health behaviors and outcomes are a function of factors at multiple levels, including intrapersonal and interpersonal processes, institutional factors, community factors, and societal laws and statutes 9 . With respect to COVID-19, most of the scholarship has focused on intrapersonal factors 1 , 2 , 3 , 4 , 5 , but there is evidence that community and public policy factors can and do influence the incidence of COVID-19 cases and deaths 11 , 12 , 13 , 45 . Nevertheless, scholars have yet to examine the association of PA with COVID-19 cases and deaths.…”

“…Relatedly, economic instability is a health risk factor 35 , so the percentage of unemployed county residents ( Unemployed ) and the natural log of the median household Income served as controls. Finally, a host of personal demographics are related to health outcomes and COVID-19 risk and mortality 12 , 36 , 37 . Thus, the percentage of residents who were female ( Female Residents ), White ( White Residents ), and age 65 or older ( 65 or Older ), as well as the rural designation of the county ( Rural ) all served as controls.…”

“…These effects noted, health behaviors and outcomes are not just a function of the individual but, instead, are also shaped by environmental determinants 8 , 9 . Consistent with this perspective, social and community factors that contribute to COVID-19 cases and deaths include public health ordinances 10 , structural inequalities 11 , collective racial biases 12 , and socioeconomic disparities 13 , among others.…”

Actual Racial/Ethnic Disparities in COVID-19 Mortality for the Non-Hispanic Black Compared to Non-Hispanic White Population in 35 US States and Their Association with Structural Racism

“…With national age-adjusted death rates revealing an even more profound racial disparity in COVID-19 mortality, it is even more crucial to determine the reasons for these disparities. Although many papers have suggested that structural racism is a critical factor in explaining racial disparities in COVID-19 mortality, we are aware of only six that have demonstrated this relationship empirically by explicitly measuring structural racism [42][43][44][45][46][47]. Tan et al [42] examined the relationship between four measures of structural racism (residential segregation and differences in incarceration rates, economic status, and employment status) and county-level COVID-19 death rates, finding that the degree of residential segregation was significantly related to higher overall death rates.…”

Assessing the Impact of the Covid-19 Pandemic on US Mortality: A County-Level Analysis

“…24 These studies make estimates for each state or country individually and do not allow a relationship between all-cause mortality and Covid-19 mortality to be identified through analysis across smaller area units such as counties. While prior research has documented significant racial and socioeconomic inequities in directly assigned Covid-19 deaths, 25–30 few studies have documented how excess mortality in 2020 has differed across sociodemographic or health factors. 31…”