The Impact of COVID-19 on African American Communities in the United States

Elena Cyrus, Rachel Clarke, Dexter Hadley, Zoran Bursac, Mary Jo Trepka, Jessy G Dévieux, Ulas Bagci, Debra Furr-Holden, Makella Coudray, Yandra Mariano, Sandra Kiplagat, Ines Noel, Gira Ravelo, Michelle Paley, Eric F Wagner, Elena Cyrus, Rachel Clarke, Dexter Hadley, Zoran Bursac, Mary Jo Trepka, Jessy G Dévieux, Ulas Bagci, Debra Furr-Holden, Makella Coudray, Yandra Mariano, Sandra Kiplagat, Ines Noel, Gira Ravelo, Michelle Paley, Eric F Wagner

Abstract

Purpose: The purpose of this ecological study was to understand the impact of the density of African American (AA) communities on coronavirus disease 2019 (COVID-19) prevalence and death rate within the three most populous counties in each U.S. state and territory (n=152). Methods: An ecological design was employed for the study. The top three most populous counties of each U.S. state and territory were included in analyses for a final sample size of n=152 counties. Confirmed COVID-19 cases and deaths that were accumulated between January 22, 2020 and April 12, 2020 in each of the three most populous counties in each U.S. state and territory were included. Linear regression was used to determine the association between AA density and COVID-19 prevalence (defined as the percentage of cases for the county population), and death rate (defined as number of deaths per 100,000 population). The models were adjusted for median age and poverty. Results: There was a direct association between AA density and COVID-19 prevalence; COVID-19 prevalence increased 5% for every 1% increase in county AA density (p<0.01). There was also an association between county AA density and COVID-19 deaths; the death rate increased 2 per 100,000 for every percentage increase in county AA density (p=0.02). Conclusion: These findings indicate that communities with a high AA density have been disproportionately burdened with COVID-19. To help develop effective interventions and programs that address this disparity, further study is needed to understand social determinants of health driving inequities for this community.

Keywords: African American; COVID-19; health disparities; infectious disease.

Conflict of interest statement

No competing financial interests exist.

© Elena Cyrus et al. 2020; Published by Mary Ann Liebert, Inc.

Figures

FIG. 1.
FIG. 1.
Timeline of COVID-19 pandemic events from December 2019 to March 2020. Flags and other images in the figure indicate an important point in the COVID-19 timeline. COVID-19, coronavirus disease 2019.
FIG. 2.
FIG. 2.
COVID-19 prevalence and death rates by AA density per county (n=152) in the United States, January–April 2020. Orange bars: percentage of COVID-19 confirmed cases in county population (case rate). Gray bars: COVID-19 deaths per 100,000 county population (death rate). Blue line: AA density in each county. AA, African American.

References

    1. World Health Organization (WHO). Coronavirus disease (COVID-19) outbreak. Emergencies-Dis. 2020. Available at Accessed May20, 2020
    1. Centers for Disease Control and Prevention. Cases of Coronavirus Disease (COVID-19) in the U.S. Available at Accessed July2, 2020
    1. Yancy CW. COVID-19 and African Americans. JAMA. 2020;323:1891–1892
    1. Dyers O. Covid-19: Black people and other minorities are hardest hit in US. BMJ. 2020;369:m1483.
    1. Anderson KM. Roundtable on the promotion of health equity and the elimination of health disparities board on population health and public health practice. National Academies Press; 2012. Available at Accessed May20, 2020
    1. Cunningham TJ, Croft JB, Liu Y, et al. . Vital signs: racial disparities in age-specific mortality among blacks or African Americans—United States, 1999–2015. Morb Mortal Wkly Rep. 2017;66:444–456
    1. U.S. Department of Health and Human Services Office of Minority Health. Diabetes and African Americans. Available at Accessed May21, 2020
    1. Centers for Disease Control and Prevention. HIV and African Americans. 2020. Available at Accessed May21, 2020
    1. U.S. Department of Health and Human Services Office of Minority Health. Heart Disease and African Americans. Available at Accessed May21, 2020
    1. Centers for Disease Control and Prevention. Most Recent National Asthma Data. Available at Accessed May21, 2020
    1. U.S. Department of Health and Human Services Office of Minority Health. Obesity and African Americans. Available at Accessed May21, 2020
    1. Office of Disease Prevention and Health Promotion. Social Determinants of Health | Healthy People 2020. Heal People 2020 Top Object. 2015. Available at Accessed May29, 2020
    1. Artiga, Samantha; Garfield, Rachel; Kendal O. Communities of Color at Higher Risk for Health and Economic Challenges due to COVID-19. Available at Accessed May29, 2020
    1. Centers for Disease Control and Prevention. COVID-19 in Racial and Ethnic Minority Groups. Available at Accessed May21, 2020
    1. Sohn H. Racial and ethnic disparities in health insurance coverage: dynamics of gaining and losing coverage over the life-course. Popul Res Policy Rev. 2017;36:181–201
    1. Centers for Disease Control and Prevention. People who are at higher risk for severe illness | CDC. 2020. Available at Accessed May20, 2020
    1. Noonan AS, Velasco-Mondragon HE, Wagner FA. Improving the health of African Americans in the USA: An overdue opportunity for social justice. Public Health Rev. 2016;37:1–20
    1. USAFacts. Coronavirus Locations: COVID-19 Map by County and State. Available at Accessed July2, 2020
    1. United States Census Bureau. United States Census Bureau. Available at Accessed May15, 2020
    1. Choi J, Ki M, Kwon HJ, et al. . Health indicators related to disease, death, and reproduction. J Prev Med Public Health. 2019;52:14–20
    1. IBM Corp. Released. 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp
    1. Berger M, Shammas B, Shaban H, et al. . Hospitalizations in at least nine states are on the rise; U.S. nears 2 million cases. Available at Accessed June9, 2020
    1. Selig D. Coronavirus: Florida reports 6,336 new cases of COVID-19 and 47 resident deaths. Available at Accessed June9, 2020
    1. Harvard TH. Chan School of Public Health. The Latest on Coronavirus. Available at Accessed June9, 2020
    1. Gardner EM, McLees MP, Steiner JF, et al. . The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011;52:793–800
    1. Cyrus E, Villalba K, Jean-Gilles M, et al. Barriers and facilitators for women of color in South Florida to access viable biomedical HIV preventive methods: Report from the Empowering Women's Health Summit, Miami, FL, 2018. In: International AIDS Conference on HIV Science. Mexico City, Mexico; 2019
    1. Farmer B. Long-Standing Racial and Income Disparities Seen Creeping Into COVID-19 Care. Available at Accessed June8, 2020
    1. Kinder M, Ford T. Black essential workers' lives matter. They deserve real change, not just lip service. Available at Accessed June9, 2020
    1. Cori L, Bianchi F, Cadum E, et al. . Risk perception and COVID-19. Int J Environ Res Public Health. 2020;17:3114–3119
    1. Al-Tawfiq JA, Al-Homoud AH, Memish ZA. Remdesivir as a possible therapeutic option for the COVID-19. Travel Med Infect Dis. 2020;34:101615.
    1. Richiardi L. A dictionary of epidemiology. Int J Epidemiol. 2015;DOI:10.1093/ije/dyu238
    1. Rahman SMA, Zou X. Flu epidemics: a two-strain flu model with a single vaccination. J Biol Dyn. 2011;DOI:10.1080/17513758.2010.510213
    1. van DA, Cooney RE, Sabin ML. COVID-19 exacerbating inequalities in the US. Lancet (London, England). 2020;395(10232):1243–1244
    1. Fisher D, Wilder-Smith A. The global community needs to swiftly ramp up the response to contain COVID-19. Lancet. 2020;395(10230):1109–1110
    1. Dhama K, Sharun K, Tiwari R, et al. . COVID-19, an emerging coronavirus infection: advances and prospects in designing and developing vaccines, immunotherapeutics, and therapeutics. Hum Vaccines Immunother. 2020;16:1232–1238
    1. Human Rights Watch. Covid-19: a human rights checklist. Available at Accessed May29, 2020

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir