We Need to Talk About Racism—In All of Its Forms—To Understand COVID-19 Disparities

Milner, Adrienne; Franz, Berkeley; Braddock, Jomills Henry

doi:10.1089/heq.2020.0069

Cited by 25 publications

(25 citation statements)

References 25 publications

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“…This research suggests that structural racism itself should be considered an underlying cause of COVID-19 racial/ethnic disparities. Thus, it provides empirical data to support the view that structural or institutionalized racism must be viewed as the fundamental or root cause of COVID-19-related racial health disparities [60,[66][67][68][69][70][71][72][73][74].…”

Section: Discussionmentioning

confidence: 99%

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

Siegel

Critchfield‐Jain

Boykin

et al. 2021

J. Racial and Ethnic Health Disparities

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Introduction While the increased burden of COVID-19 among the Black population has been recognized, most attempts to quantify the extent of this racial disparity have not taken the age distribution of the population into account. In this paper, we determine the Black–White disparity in COVID-19 mortality rates across 35 states using direct age standardization. We then explore the relationship between structural racism and differences in the magnitude of this disparity across states. Methods Using data from the Centers for Disease Control and Prevention, we calculated both crude and age-adjusted COVID-19 mortality rates for the non-Hispanic White and non-Hispanic Black populations in each state. We explored the relationship between a state-level structural racism index and the observed differences in the racial disparities in COVID-19 mortality across states. We explored the potential mediating effects of disparities in exposure based on occupation, underlying medical conditions, and health care access. Results Relying upon crude death rate ratios resulted in a substantial underestimation of the true magnitude of the Black–White disparity in COVID-19 mortality rates. The structural racism index was a robust predictor of the observed racial disparities. Each standard deviation increase in the racism index was associated with an increase of 0.26 in the ratio of COVID-19 mortality rates among the Black compared to the White population. Conclusions Structural racism should be considered a root cause of the Black–White disparity in COVID-19 mortality. Dismantling the long-standing systems of racial oppression is critical to adequately address both the downstream and upstream causes of racial inequities in the disease burden of COVID-19.

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Section: Discussionmentioning

confidence: 99%

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

Siegel

Critchfield‐Jain

Boykin

et al. 2021

J. Racial and Ethnic Health Disparities

View full text Add to dashboard Cite

show abstract

“…The COVID-19 pandemic has revealed and widened racial health and social inequities, traceable to structural inequities stemming from a legacy of legally sanctioned racism and contemporary forms of racial discrimination. [1][2][3][4][5][6][7][8] Racism has caused excess deaths in communities of color during the pandemic, from COVID-19 and other sources. 1,2,9 Clear instances include the racially motivated murders of Black people and police brutality.…”

mentioning

confidence: 99%

Vicarious Racism and Vigilance During the COVID-19 Pandemic: Mental Health Implications Among Asian and Black Americans

et al. 2021

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Objectives Experiences of vicarious racism—hearing about racism directed toward one’s racial group or racist acts committed against other racial group members—and vigilance about racial discrimination have been salient during the COVID-19 pandemic. This study examined vicarious racism and vigilance in relation to symptoms of depression and anxiety among Asian and Black Americans. Methods We used data from a cross-sectional study of 604 Asian American and 844 Black American adults aged ≥18 in the United States recruited from 5 US cities from May 21 through July 15, 2020. Multivariable linear regression models examined levels of depression and anxiety by self-reported vicarious racism and vigilance. Results Controlling for sociodemographic characteristics, among both Asian and Black Americans, greater self-reported vicarious racism was associated with more symptoms of depression (Asian: β = 1.92 [95% CI, 0.97-2.87]; Black: β = 1.72 [95% CI, 0.95-2.49]) and anxiety (Asian: β = 2.40 [95% CI, 1.48-3.32]; Black: β = 1.98 [95% CI, 1.17-2.78]). Vigilance was also positively related to symptoms of depression (Asian: β = 1.54 [95% CI, 0.58-2.50]; Black: β = 0.90 [95% CI, 0.12-1.67]) and anxiety (Asian: β = 1.98 [95% CI, 1.05-2.91]; Black: β = 1.64 [95% CI, 0.82-2.45]). Conclusions Mental health problems are a pressing concern during the COVID-19 pandemic. Results from our study suggest that heightened racist sentiment, harassment, and violence against Asian and Black Americans contribute to increased risk of depression and anxiety via vicarious racism and vigilance. Public health efforts during this period should address endemic racism as well as COVID-19.

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“…To be clear, the fact that Americans who are White may feel insecure, uncomfortable, or threatened by the mere presence of POC using public spaces for leisure-time physical activity or other types of recreation is a White person problem—a problem that manifests as unwarranted harassment, injury, and death among POC. Despite evidence of ongoing implicit racism, there had been little effort on the part of researchers to measure or address this as a social determinant of health in our studies [ 76 ].…”

Section: Dramatic Systemic Solutions Needed To Overcome Pa-related Health Disparities Among Pocmentioning

confidence: 99%

Still striding toward social justice? Redirecting physical activity research in a post-COVID-19 world

Lee

Joseph

Carr

et al. 2021

Translational Behavioral Medicine

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The COVID-19 crisis and parallel Black Lives Matter movement have amplified longstanding systemic injustices among people of color (POC). POC have been differentially affected by COVID-19, reflecting the disproportionate burden of ongoing chronic health challenges associated with socioeconomic inequalities and unhealthy behaviors, including a lack of physical activity. Clear and well-established benefits link daily physical activity to health and well-being—physical, mental, and existential. Despite these benefits, POC face additional barriers to participation. Thus, increasing physical activity among POC requires additional considerations so that POC can receive the same opportunities to safely participate in physical activity as Americans who are White. Framed within the Ecologic Model of Physical Activity, this commentary briefly describes health disparities in COVID-19, physical activity, and chronic disease experienced by POC; outlines underlying putative mechanisms that connect these disparities; and offers potential solutions to reduce these disparities. As behavioral medicine leaders, we advocate that solutions must redirect the focus of behavioral research toward community-informed and systems solutions.

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We Need to Talk About Racism—In All of Its Forms—To Understand COVID-19 Disparities

Cited by 25 publications

References 25 publications

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

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

Vicarious Racism and Vigilance During the COVID-19 Pandemic: Mental Health Implications Among Asian and Black Americans

Still striding toward social justice? Redirecting physical activity research in a post-COVID-19 world

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