Structurally vulnerable neighbourhood environments and racial/ethnic COVID-19 inequities

Abstract

Preliminary evidence indicates that the experience of the novel coronavirus is not shared equally across geographic areas. Findings in the United States suggest that the burden of COVID-19 morbidity and mortality may be hardest felt in disadvantaged and racially segregated places. Deprived neighbourhoods are disproportionately populated by people of colour, the same populations that are becoming sicker and dying more often from COVID-19. This commentary examines how structurally vulnerable neighbourhoods contribute to racial/ethnic inequities in SARS-COV-2 exposure and COVID-19 morbidity and mortality and considers opportunities to intervene through place-based initiatives and the implementation of a Health in All Policies strategy.

Facing a Second Wave from a Regional View: Spatial Patterns of COVID-19 as a Key Determinant for Public Health and Geoprevention Plans

“…Regarding the relation between COVID-19 and socio-economic profile [ 19 , 20 , 21 , 22 ], our study reveals that there is the highest case concentration in areas with low income levels (up to 11,000 euros per household per year) and with a larger average size (mainly from 2 people per household). Thus, a much laxer behavior of cases are observed in sections with higher income levels and reduced average household sizes.…”

“…Moreover, in the analysis of vulnerability to COVID-19 carried out at the level of health areas, other papers identify a clear vulnerability derived from overcrowding and social content, as well as location, in the case of the latter referring to the economic orientation of several urban areas and finding a greater vulnerability in areas of important commercial activity [ 18 ]. Social vulnerability and the configuration of depressed areas into the cities increase the differences in the incidence of COVID-19, a pattern of socio-spatial affection that some studies even link to the ethnic or racial component, in that these populations tend to be located in socially vulnerable areas and eventually they end up being more affected by morbidity and mortality [ 19 , 20 ]. Similarly, income is other of the variables that positively correlates with the incidence of COVID-19, allowing to limit neighborhoods with the highest incidence on the intra-urban scale and to disentangle other social variables that could be decisive [ 21 , 22 ].…”

Racial/ethnic minority and neighborhood disadvantage leads to disproportionate mortality burden and years of potential life lost due to COVID-19 in Chicago, Illinois

“…Our results highlight that underlying structural inequalities have a drastic impact on the burden of disease experienced by long-standing neighbrohood disadvantage that is ultimately tied to racial and economic segregation. The legacy of residential segregation as a result of discriminatory 20 th century housing policies is particularly evident in Chicago where limited economic investment into communities with larger populations of NH Black and Hispanic individuals has led to structurally vulnerable neighborhoods with crowded housing, food insecurity, employment instability, higher rates of uninsured residents, and increased reliance on crowded public transit ( Berkowitz et al, 2020 , Egede and Walker, 2020 ). In this way, structural racism has led to increased COVID-19 transmission and disease severity in communities with larger populations of NH Black and Hispanic individuals.…”

“…The novel coronavirus disease 2019 (COVID-19) has disproportionately impacted racial and ethnic minorities and socioeconomically disadvantaged communities in the United States (US) due, in large part, to historical discrimination and enduring structural racism ( Wadhera et al, 2020 , Price-Haywood et al, 2020 , Berkowitz et al, 2020 ). Data from New York City (NYC), one epicenter of COVID-19 in the US, demonstrate that boroughs with higher proportions of racial/ethnic minorities have had the highest rates of hospitalizations and mortality from COVID-19 ( Wadhera et al, 2020 ).…”

COVID-19 and the worsening of health inequities in Santiago, Chile

“… 2 Wide inequities in COVID-19 outcomes have been reported in other settings. 3 However, policymakers in some Latin American countries have expressed scepticism about the existence of health inequities in COVID-19 mortality. 4 We used mortality, population and census data to show a worsening of pre-existing inequities in mortality in the municipalities that make up the metropolitan region of Santiago (Chile) during the COVID-19 pandemic.…”