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Empirical evidence on structural racism as a driver of racial inequities in COVID-19 mortality.

Publication ,  Journal Article
Brown, TH; Kamis, C; Homan, P
Published in: Frontiers in public health
January 2022

This study contributes to the literature by empirically testing the extent to which place-based structural racism is a driver of state-level racial inequalities in COVID-19 mortality using theoretically-informed, innovative approaches.CDC data are used to measure cumulative COVID-19 death rates between January 2020 and August 2022. The outcome measure is a state-level Black-White (B/W) ratio of age-adjusted death rates. We use state-level 2019 administrative data on previously validated indicators of structural racism spanning educational, economic, political, criminal-legal and housing to identify a novel, multi-sectoral latent measure of structural racism (CFI = 0.982, TLI = 0.968, and RMSEA = 0.044). We map B/W inequalities in COVID-19 mortality as well as the latent measure of structural racism in order to understand their geographic distribution across U.S. states. Finally, we use regression analyses to estimate the extent to which structural racism contributes to Black-White inequalities in COVID-19 mortality, net of potential confounders.Results reveal substantial state-level variation in the B/W ratio of COVID-19 death rates and structural racism. Notably, regression estimates indicate that the relationship between the structural racism and B/W inequality in COVID-19 mortality is positive and statistically significant (p < 0.001), both in the bivariate model (adjusted R2 = 0.37) and net of the covariates (adjusted R2 = 0.54). For example, whereas states with a structural racism value 2 standard deviation below the mean have a B/W ratio of approximately 1.12, states with a structural racism value 2 standard deviation above the mean have a ratio of just above 2.0.Findings suggest that efficacious health equity solutions will require bold policies that dismantle structural racism across numerous societal domains.

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Published In

Frontiers in public health

DOI

EISSN

2296-2565

ISSN

2296-2565

Publication Date

January 2022

Volume

10

Start / End Page

1007053

Related Subject Headings

  • Systemic Racism
  • Policy
  • Humans
  • COVID-19
  • 4206 Public health
  • 4203 Health services and systems
  • 1117 Public Health and Health Services
 

Citation

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Brown, T. H., Kamis, C., & Homan, P. (2022). Empirical evidence on structural racism as a driver of racial inequities in COVID-19 mortality. Frontiers in Public Health, 10, 1007053. https://doi.org/10.3389/fpubh.2022.1007053
Brown, Tyson H., Christina Kamis, and Patricia Homan. “Empirical evidence on structural racism as a driver of racial inequities in COVID-19 mortality.Frontiers in Public Health 10 (January 2022): 1007053. https://doi.org/10.3389/fpubh.2022.1007053.
Brown TH, Kamis C, Homan P. Empirical evidence on structural racism as a driver of racial inequities in COVID-19 mortality. Frontiers in public health. 2022 Jan;10:1007053.
Brown, Tyson H., et al. “Empirical evidence on structural racism as a driver of racial inequities in COVID-19 mortality.Frontiers in Public Health, vol. 10, Jan. 2022, p. 1007053. Epmc, doi:10.3389/fpubh.2022.1007053.
Brown TH, Kamis C, Homan P. Empirical evidence on structural racism as a driver of racial inequities in COVID-19 mortality. Frontiers in public health. 2022 Jan;10:1007053.

Published In

Frontiers in public health

DOI

EISSN

2296-2565

ISSN

2296-2565

Publication Date

January 2022

Volume

10

Start / End Page

1007053

Related Subject Headings

  • Systemic Racism
  • Policy
  • Humans
  • COVID-19
  • 4206 Public health
  • 4203 Health services and systems
  • 1117 Public Health and Health Services