Structural racism and COVID-19 response: higher risk of exposure drives disparate COVID-19 deaths among Black and Hispanic/Latinx residents of Illinois, USA.
Structural racism and COVID-19 response: higher risk of exposure drives disparate COVID-19 deaths among Black and Hispanic/Latinx residents of Illinois, USA.
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DOI：
10.1186/s12889-022-12698-9
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发表时间：
2022-02-15
影响因子：
4.5
通讯作者：
Gerardin J
中科院分区：
文献类型：
--
作者：
Holden TM;Simon MA;Arnold DT;Halloway V;Gerardin J
结构性种族主义已经并将继续推动创造社会、经济和社区因素的政策，导致居住隔离、缺乏足够的医疗保健以及缺乏实现经济流动的就业机会。这导致少数群体的总体健康状况较差。 2020 年，包括伊利诺伊州在内的美国各地黑人和西班牙裔/拉丁裔社区的 COVID-19 病例和死亡率异常高。伊利诺伊州的公共卫生官员在州和地方各级实施了有针对性的计划，以增加干预机会并减少差距。为了量化整个流行病中 COVID 结果的差异如何演变，从伊利诺伊州国家电子疾病监测系统获得了 2020 年 3 月 1 日至 12 月 31 日期间的 SARS-CoV-2 诊断测试、COVID-19 病例和 COVID-19 死亡数据。计算了黑人和西班牙裔/拉丁裔居民与白人居民的 COVID-19 病例和死亡的相对风险，并按年龄组和流行间隔进行分层。通过反事实模拟估计了因发病率和病死率方面的种族/民族差异造成的死亡。 2020 年 5 月后，病例数和死亡率的差异不再那么严重，但并没有消失，而且在年轻时更为明显。 2020 年 3 月至 5 月，所有年龄段的黑人和西班牙裔/拉丁裔人群感染 COVID-19 病例的风险是白人的两倍多。在疫情早期，与年龄匹配的白人相比，50 岁以下的黑人和西班牙裔/拉丁裔人士的 COVID-19 死亡相对风险达到 10 以上。在伊利诺伊州所有县中，与白人相比，少数族裔患 COVID-19 病例的相对风险相同或显着增加。黑人和西班牙裔/拉丁裔人口的死亡差异分别有 79.3% 和 86.7% 归因于与白人人口相比年龄调整发病率的差异，而不是病死率的差异。 COVID-19 大流行中的种族和民族差异是社会的产物，而不是生物学的产物。除了种族/民族之外，考虑年龄和地理位置有助于确定导致某些群体的不良结果的结构性因素。旨在减少疾病暴露不平等的研究和政策可能比关注死亡驱动因素的研究和政策更能减少死亡率的差异。在线版本包含可在 10.1186/s12889-022-12698-9 获取的补充材料。
Structural racism has driven and continues to drive policies that create the social, economic, and community factors resulting in residential segregation, lack of access to adequate healthcare, and lack of employment opportunities that would allow economic mobility. This results in overall poorer population health for minoritized people. In 2020, Black and Hispanic/Latinx communities throughout the United States, including the state of Illinois, experienced disproportionately high rates of COVID-19 cases and deaths. Public health officials in Illinois implemented targeted programs at state and local levels to increase intervention access and reduce disparities. To quantify how disparities in COVID outcomes evolved through the epidemic, data on SARS-CoV-2 diagnostic tests, COVID-19 cases, and COVID-19 deaths were obtained from the Illinois National Electronic Disease Surveillance System for the period from March 1 to December 31, 2020. Relative risks of COVID-19 cases and deaths were calculated for Black and Hispanic/Latinx vs. White residents, stratified by age group and epidemic interval. Deaths attributable to racial/ethnic disparities in incidence and case fatality were estimated with counterfactual simulations. Disparities in case and death rates became less drastic after May 2020, but did not disappear, and were more pronounced at younger ages. From March to May of 2020, the risk of a COVID-19 case for Black and Hispanic/Latinx populations was more than twice that of Whites across all age groups. The relative risk of COVID-19 death reached above 10 for Black and Hispanic/Latinx individuals under 50 years of age compared to age-matched Whites in the early epidemic. In all Illinois counties, relative risk of a COVID-19 case was the same or significantly increased for minoritized populations compared to the White population. 79.3 and 86.7% of disparities in deaths among Black and Hispanic/Latinx populations, respectively, were attributable to differences in age-adjusted incidence compared to White populations rather than differences in case fatality ratios. Racial and ethnic disparities in the COVID-19 pandemic are products of society, not biology. Considering age and geography in addition to race/ethnicity can help to identify the structural factors driving poorer outcomes for certain groups. Studies and policies aimed at reducing inequalities in disease exposure may reduce disparities in mortality more than those focused on drivers of case fatality. The online version contains supplementary material available at 10.1186/s12889-022-12698-9.
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影响因子：
4.5
作者：
Holden TM;Richardson RAK;Arevalo P;Duffus WA;Runge M;Whitney E;Wise L;Ezike NO;Patrick S;Cobey S;Gerardin J
通讯作者：
Gerardin J
影响因子：
8
作者：
Trent, Maria;Dooley, Danielle G.;Zapata, Lauren B.
通讯作者：
Zapata, Lauren B.
影响因子：
9.7
作者：
Reinhart, Eric;Chen, Daniel L.
通讯作者：
Chen, Daniel L.
DOI：
10.1093/cid/ciaa1723
发表时间：
2021-03-01
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Zelner J;Trangucci R;Naraharisetti R;Cao A;Malosh R;Broen K;Masters N;Delamater P
通讯作者：
Delamater P
影响因子：
3.4
作者：
Yearby, Ruqaiijah;Mohapatra, Seema
通讯作者：
Mohapatra, Seema