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Structural Inequality and COVID-19 Mortality in Chicago: An Ecological Analysis
Evelyn J Patterson1, Lallen T Johnson2
1Department of Sociology, Vanderbilt University, Nashville, TN, USA. evelyn.patterson@vanderbilt.edu.
Journal of Racial and Ethnic Health Disparities
|November 8, 2022
Summary
Structural inequality amplifies COVID-19 mortality risk in older Black communities. This study reveals racial composition significantly increases the impact of age on COVID-19 deaths in Black neighborhoods.
Area of Science:
- Public Health
- Sociology
- Epidemiology
Background:
- Previous research indicates higher COVID-19 death rates in Black neighborhoods and among older individuals.
- Existing studies often examine age and racial disparities in COVID-19 mortality independently, overlooking combined structural impacts.
Purpose of the Study:
- To investigate the combined effects of community racial composition and age structure on COVID-19 mortality.
- To analyze how structural conditions interact with race and age to influence COVID-19 death rates.
Main Methods:
- Utilized weekly COVID-19 death data (n=4168) from Chicago (March 2020-July 2021).
- Incorporated structural characteristics from the 2019 American Community Survey at the ZIP code level.
- Employed negative binomial regression models to predict COVID-19 mortality.
Main Results:
- In predominantly Black neighborhoods, racial composition amplified the association between older age (65+) and COVID-19 mortality by 40%.
- This multiplicative risk was not observed in non-predominantly Black neighborhoods.
- Findings attribute elevated mortality risk in older Black communities to historical and ongoing structural inequalities.
Conclusions:
- Pandemics are often framed as natural disasters, masking underlying societal marginalization that increases vulnerability.
- Addressing entrenched institutional limitations is crucial to eliminate health inequalities and improve care for marginalized populations.
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