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Published on: February 3, 2023
Population-Level Disparities in Exposure to COVID-19 Mitigation Policies, April 2020-April 2021
Megan D Douglas1, Chaohua Li, Robina Josiah Willock
1National Center for Primary Care (Drs Douglas, Baltrus, Mack, and Gaglioti and Mr Li), Department of Community Health and Preventive Medicine (Drs Douglas, Josiah Willock, Baltrus, Caplan, and Hopkins), Department of Microbiology, Biochemistry & Immunology (Dr Immergluck), Satcher Health Leadership Institute (Drs McKinney and Hopkins), and Department of Family Medicine (Dr Mack), Morehouse School of Medicine, Atlanta, Georgia; and Population Health Research Institute at MetroHealth and Center for Community Health Integration, Case Western Reserve University, Cleveland, Ohio (Dr Gaglioti).
COVID-19 stay-at-home orders and mask policies showed unequal exposure across US populations. Racial and ethnic minorities experienced higher exposure to stricter policies, highlighting significant health inequities.
Area of Science:
- Public Health
- Epidemiology
- Health Equity
Background:
- COVID-19 mitigation policies like stay-at-home orders (SHOs) and face mask policies (FMPs) reduced transmission.
- Variations in policy exposure by sociodemographic characteristics across the US population were previously unknown.
Purpose of the Study:
- To quantify and characterize the sociodemographic characteristics and geographic distribution of populations exposed to evidence-based COVID-19 mitigation policies.
- To identify disparities in exposure to COVID-19 mitigation policies.
Main Methods:
- Utilized statewide SHOs and FMPs for all US counties (April 2020-April 2021).
- Categorized counties into four exposure groups: low SHO-low FMP, high SHO-low FMP, low SHO-high FMP, and high SHO-high FMP.
- Described exposure groups by COVID-19 rates and sociodemographic characteristics.
Main Results:
- The majority of the US population resided in areas with high exposure to both SHOs and FMPs.
- Populations in high SHO-high FMP counties had the lowest percentage of non-Hispanic Black (NHB) and highest percentage of non-Hispanic White (NHW) individuals.
- Populations in high SHO-low FMP counties had the highest percentage of NHB and Hispanic individuals and the lowest percentage of NHW individuals.
Conclusions:
- Identified significant county-level racial, ethnic, and sociodemographic disparities in exposure to statewide COVID-19 mitigation policies.
- Policy exposure is a critical factor in understanding the root causes of health inequities.
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