IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v306y2022ics027795362200404x.html
   My bibliography  Save this article

Do social determinants of health explain racial/ethnic disparities in COVID-19 infection?

Author

Listed:
  • Lee, Haena
  • Andrasfay, Theresa
  • Riley, Alicia
  • Wu, Qiao
  • Crimmins, Eileen

Abstract

Racial/ethnic minorities have experienced higher COVID-19 infection rates than whites, but it is unclear how individual-level housing, occupational, behavioral, and socioeconomic conditions contribute to these disparities in a nationally representative sample. In this study, we assess the extent to which social determinants of health contribute to racial/ethnic differences in COVID-19 infection. Data are from the Understanding America Study's Understanding Coronavirus in America survey (UAS COVID-19 waves 7–29). UAS COVID-19 is one of the only nationally representative longitudinal data sources that collects information on household, work, and social behavioral context during the pandemic. We analyze onset of COVID-19 cases, defined as a positive test or a diagnosis of COVID-19 from a healthcare provider since the previous survey wave, over a year of follow-up (June 2020–July 2021). We consider educational attainment, economic resources, work arrangements, household size, and social distancing as key social factors that may be structured by racism. Cox hazard models indicate that Hispanic people have 48% higher risk of experiencing a COVID-19 infection than whites after adjustment for age, sex, local infection rate, and comorbidities, but we do not observe a higher risk of COVID-19 among Black respondents. Controlling for engagement in any large or small social gathering increases the hazard ratio for Hispanics by 9%, suggesting that had Hispanics had the same social engagement patterns as whites, they may have had even higher risk of COVID-19. Other social determinants—lower educational attainment, working away from home, and number of coresidents—all independently predict higher risk of COVID-19, but do not explain why Hispanic Americans have higher COVID-19 infection risk than whites.

Suggested Citation

  • Lee, Haena & Andrasfay, Theresa & Riley, Alicia & Wu, Qiao & Crimmins, Eileen, 2022. "Do social determinants of health explain racial/ethnic disparities in COVID-19 infection?," Social Science & Medicine, Elsevier, vol. 306(C).
    • Handle: RePEc:eee:socmed:v:306:y:2022:i:c:s027795362200404x
    DOI: 10.1016/j.socscimed.2022.115098
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S027795362200404X
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2022.115098?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Kevin Credit, 2020. "Neighbourhood inequity: Exploring the factors underlying racial and ethnic disparities in COVID‐19 testing and infection rates using ZIP code data in Chicago and New York," Regional Science Policy & Practice, Wiley Blackwell, vol. 12(6), pages 1249-1271, December.
    2. Clouston, Sean A.P. & Natale, Ginny & Link, Bruce G., 2021. "Socioeconomic inequalities in the spread of coronavirus-19 in the United States: A examination of the emergence of social inequalities," Social Science & Medicine, Elsevier, vol. 268(C).
    3. Michelle S. Wong & Taona P. Haderlein & Anita H. Yuan & Ernest Moy & Kenneth T. Jones & Donna L. Washington, 2021. "Time Trends in Racial/Ethnic Differences in COVID-19 Infection and Mortality," IJERPH, MDPI, vol. 18(9), pages 1-14, May.
    4. Francine D. Blau & Josefine Koebe & Pamela A. Meyerhofer, 2021. "Who are the essential and frontline workers?," Business Economics, Palgrave Macmillan;National Association for Business Economics, vol. 56(3), pages 168-178, July.
    5. Rebecca K Fielding-Miller & Maria E Sundaram & Kimberly Brouwer, 2020. "Social determinants of COVID-19 mortality at the county level," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-11, October.
    6. Marc A Garcia & Patricia A Homan & Catherine García & Tyson H Brown & Deborah S Carr, 2021. "The Color of COVID-19: Structural Racism and the Disproportionate Impact of the Pandemic on Older Black and Latinx Adults [Racial disparities in mortality in the adult Hispanic population]," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 76(3), pages 75-80.
    7. Noreen Goldman & Anne R Pebley & Keunbok Lee & Theresa Andrasfay & Boriana Pratt, 2021. "Racial and ethnic differentials in COVID-19-related job exposures by occupational standing in the US," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-17, September.
    8. Joseph Gibbons, 2021. "Distancing the socially distanced: Racial/ethnic composition’s association with physical distancing in response to COVID-19 in the U.S," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-21, May.
    9. Jones, M.R. & Diez-Roux, A.V. & Hajat, A. & Kershaw, K.N. & O'Neill, M.S. & Guallar, E. & Post, W.S. & Kaufman, J.D. & Navas-Acien, A., 2014. "Race/ethnicity, residential segregation, and exposure to ambient air pollution: The Multi-Ethnic Study of Atherosclerosis (MESA)," American Journal of Public Health, American Public Health Association, vol. 104(11), pages 2130-2137.
    10. Jung Ki Kim & Eileen M Crimmins, 2020. "How does age affect personal and social reactions to COVID-19: Results from the national Understanding America Study," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-16, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Wong, Sandy & Ponder, C.S. & Melix, Bertram, 2023. "Spatial and racial covid-19 disparities in U.S. nursing homes," Social Science & Medicine, Elsevier, vol. 325(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Anneliese N. Luck & Irma T. Elo & Samuel H. Preston & Eugenio Paglino & Katherine Hempstead & Andrew C. Stokes, 2023. "COVID-19 and All-Cause Mortality by Race, Ethnicity, and Age Across Five Periods of the Pandemic in the United States," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(4), pages 1-29, August.
    2. Katherine Leggat-Barr & Fumiya Uchikoshi & Noreen Goldman, 2021. "COVID-19 risk factors and mortality among Native Americans," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 45(39), pages 1185-1218.
    3. Cuesta, Lizeth & Ruiz, Yomara, 2021. "Efecto de la globalización sobre la desigualdad. Un estudio global para 104 países usando regresiones cuantílicas [Effect of globalization on inequality. A global study for 104 countries using quan," MPRA Paper 111022, University Library of Munich, Germany.
    4. Luiz Paulo Fávero & Joseph F. Hair & Rafael de Freitas Souza & Matheus Albergaria & Talles V. Brugni, 2021. "Zero-Inflated Generalized Linear Mixed Models: A Better Way to Understand Data Relationships," Mathematics, MDPI, vol. 9(10), pages 1-28, May.
    5. Yanrong Qiu & Kaihuai Liao & Yanting Zou & Gengzhi Huang, 2022. "A Bibliometric Analysis on Research Regarding Residential Segregation and Health Based on CiteSpace," IJERPH, MDPI, vol. 19(16), pages 1-21, August.
    6. Matthias Dütsch, 2022. "COVID-19 and the labour market: What are the working conditions in critical jobs?," Journal for Labour Market Research, Springer;Institute for Employment Research/ Institut für Arbeitsmarkt- und Berufsforschung (IAB), vol. 56(1), pages 1-17, December.
    7. Idorenyin Imoh Udoh & Elias Mpofu & Gayle Prybutok, 2023. "Dementia and COVID-19 among Older African American Adults: A Scoping Review of Healthcare Access and Resources," IJERPH, MDPI, vol. 20(4), pages 1-15, February.
    8. Chenarides, Lauren & Richards, Timothy & Rickard, Bradley, 2021. "COVID-19 Impact on Fruit and Vegetable Markets: One Year Later," Working Papers 309965, Cornell University, Department of Applied Economics and Management.
    9. Chiara Burlina & Andrés Rodríguez-Pose, 2024. "Inequality, poverty, deprivation and the uneven spread of COVID-19 in Europe," Regional Studies, Taylor & Francis Journals, vol. 58(2), pages 263-284, February.
    10. Manzer, Jamie L. & Bell, Ann V., 2022. "The limitations of patient-centered care: The case of early long-acting reversible contraception (LARC) removal," Social Science & Medicine, Elsevier, vol. 292(C).
    11. Andrés Gómez-Lobo & Mauro Gutiérrez & Sandro Huamaní & Diego Marino & Tomás Serebrisky & Ben Solís, 2024. "Access to water and COVID-19: a regression discontinuity analysis for the peri-urban areas of metropolitan Lima, Peru," Water International, Taylor & Francis Journals, vol. 49(1), pages 52-79, January.
    12. Yoo Min Park & Mei-Po Kwan, 2020. "Understanding Racial Disparities in Exposure to Traffic-Related Air Pollution: Considering the Spatiotemporal Dynamics of Population Distribution," IJERPH, MDPI, vol. 17(3), pages 1-14, February.
    13. Mitchell D. Ramuta & Christina M. Newman & Savannah F. Brakefield & Miranda R. Stauss & Roger W. Wiseman & Amanda Kita-Yarbro & Eli J. O’Connor & Neeti Dahal & Ailam Lim & Keith P. Poulsen & Nasia Saf, 2022. "SARS-CoV-2 and other respiratory pathogens are detected in continuous air samples from congregate settings," Nature Communications, Nature, vol. 13(1), pages 1-14, December.
    14. Astorquiza-Bustos, Bilver Adrian & Quintero-Peña, Jose Wilmar, 2023. "Who can work from home? A remote working index for an emerging economy," Telecommunications Policy, Elsevier, vol. 47(10).
    15. Richard Florida & Charlotta Mellander, 2022. "The geography of COVID-19 in Sweden," The Annals of Regional Science, Springer;Western Regional Science Association, vol. 68(1), pages 125-150, February.
    16. Yinon Bar-On & Tatiana Baron & Ofer Cornfeld & Eran Yashiv, 2023. "When to Lock, Not Whom: Managing Epidemics Using Time-Based Restrictions," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 51, pages 292-321, December.
    17. Grineski, Sara & Collins, Tim & Renteria, Roger & Rubio, Ricardo, 2021. "Multigenerational immigrant trajectories and children's unequal exposure to fine particulate matter in the US," Social Science & Medicine, Elsevier, vol. 282(C).
    18. Viridiana Ríos & Edgar Denova-Gutiérrez & Simón Barquera, 2022. "Association between living in municipalities with high crowding conditions and poverty and mortality from COVID-19 in Mexico," PLOS ONE, Public Library of Science, vol. 17(2), pages 1-15, February.
    19. Richard Beem & Christopher Goetz & Martha Stinson & Sean Wang, 2022. "Business Dynamics Statistics for Single-Unit Firms," Working Papers 22-57, Center for Economic Studies, U.S. Census Bureau.
    20. Yinon Bar-On & Tatiana Baron & Ofer Cornfeld & Eran Yashiv, 2023. "When to Lock, Not Whom: Managing Epidemics Using Time-Based Restrictions," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 51, pages 292-321, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:306:y:2022:i:c:s027795362200404x. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.