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标题：Assessing inequities underlying racial disparities of COVID-19 mortality in Louisiana parishes
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作者：Guangxiao Hu ; Nora Hamovit ; Kristen Croft 等
期刊名称：Proceedings of the National Academy of Sciences
印刷版ISSN：0027-8424
电子版ISSN：1091-6490
出版年度：2022
卷号：119
期号：27
DOI：10.1073/pnas.2123533119
语种：English
出版社：The National Academy of Sciences of the United States of America
摘要：Significance Black communities, both historically and contemporaneously, experience higher levels of underlying social, economic, and environmental stressors. These stressors contribute to stark and persistent racial disparities in wealth and health, particularly between White and Black Americans. We examine the role of stressors and risks in contributing to higher COVID-19 exposure for Black Louisianans. We find that Black communities in parishes with both higher and lower population densities experience higher levels of stressors, leading to greater COVID-19 mortality rates. Our work using the COVID-19 pandemic, particularly as observed in Louisiana, makes clear that communities with high levels of social, economic, and environmental racism are significantly more vulnerable to a public health crisis. High COVID-19 mortality among Black communities heightened the pandemic’s devastation. In the state of Louisiana, the racial disparity associated with COVID-19 mortality was significant; Black Americans accounted for 50% of known COVID-19–related deaths while representing only 32% of the state’s population. In this paper, we argue that structural racism resulted in a synergistic framework of cumulatively negative determinants of health that ultimately affected COVID-19 deaths in Louisiana Black communities. We identify the spatial distribution of social, environmental, and economic stressors across Louisiana parishes using hot spot analysis to develop aggregate stressors. Further, we examine the correlation between stressors, cumulative health risks, COVID-19 mortality, and the size of Black populations throughout Louisiana. We hypothesized that parishes with larger Black populations (percentages) would have larger stressor values and higher cumulative health risks as well as increased COVID-19 mortality rates. Our results suggest two categories of parishes. The first group has moderate levels of aggregate stress, high population densities, predominately Black populations, and high COVID-19 mortality. The second group of parishes has high aggregate stress, lower population densities, predominantly Black populations, and initially low COVID-19 mortality that increased over time. Our results suggest that structural racism and inequities led to severe disparities in initial COVID-19 effects among highly populated Black Louisiana communities and that as the virus moved into less densely populated Black communities, similar trends emerged.
关键词：enCOVID-19racial disparitystructuraljustice