White Counties Stand Apart: The Primacy of Residential Segregation in COVID-19 and HIV Diagnoses.
White Counties Stand Apart: The Primacy of Residential Segregation in COVID-19 and HIV Diagnoses.
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DOI：
10.1089/apc.2020.0155
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发表时间：
2020-10
影响因子：
4.9
通讯作者：
Sayas A
中科院分区：
文献类型：
--
作者：
Millett GA;Honermann B;Jones A;Lankiewicz E;Sherwood J;Blumenthal S;Sayas A
新出现的流行病学数据表明，美国白人感染COVID-19的风险较低。尽管许多研究指出了系统性种族主义在2019冠状病毒病种族/民族差异中的作用，但很少有研究考察了种族隔离的作用。居住隔离与不同种族/族裔对各种疾病（包括艾滋病毒）的不同健康结果有关。本评论记录了不同种族/族裔对艾滋病毒和COVID-19的不同结果和服务提供情况，以及种族隔离的关键作用。利用公开的人口普查数据，我们按非西班牙裔白人居民的百分比将美国各县分为五分之一，并检查每10万人中的艾滋病毒诊断和COVID-19。随着美国各县白人居民比例的增加，艾滋病诊断率下降。COVID-19的诊断也遵循类似的模式：白人居民比例最高的县，无论地理区域或州政党倾向如何（即红州或蓝州），COVID-19病例最少。此外，在美国COVID-19大流行期间，主要白人县的COVID-19诊断相对较少。系统性驱动因素使少数种族面临更大的感染COVID-19和艾滋病毒的风险。个人层面的特征（例如，COVID-19的潜在健康状况或艾滋病毒的风险行为）并不能完全解释少数种族社区的过度疾病负担。相应的干预措施必须使用结构和政策层面的解决办法来解决种族和族裔健康差异。
Emerging epidemiological data suggest that white Americans have a lower risk of acquiring COVID-19. Although many studies have pointed to the role of systemic racism in COVID-19 racial/ethnic disparities, few studies have examined the contribution of racial segregation. Residential segregation is associated with differing health outcomes by race/ethnicity for various diseases, including HIV. This commentary documents differing HIV and COVID-19 outcomes and service delivery by race/ethnicity and the crucial role of racial segregation. Using publicly available Census data, we divide US counties into quintiles by percentage of non-Hispanic white residents and examine HIV diagnoses and COVID-19 per 100,000 population. HIV diagnoses decrease as the proportion of white residents increase across US counties. COVID-19 diagnoses follow a similar pattern: Counties with the highest proportion of white residents have the fewest cases of COVID-19 irrespective of geographic region or state political party inclination (i.e., red or blue states). Moreover, comparatively fewer COVID-19 diagnoses have occurred in primarily white counties throughout the duration of the US COVID-19 pandemic. Systemic drivers place racial minorities at greater risk for COVID-19 and HIV. Individual-level characteristics (e.g., underlying health conditions for COVID-19 or risk behavior for HIV) do not fully explain excess disease burden in racial minority communities. Corresponding interventions must use structural- and policy-level solutions to address racial and ethnic health disparities.
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影响因子：
12.7
作者：
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通讯作者：
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通讯作者：
Steenbergen, Renske D. M.
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3.7
作者：
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通讯作者：
National HIV Behavioral Surveillance Study Group