Why do minority populations have higher rates of the novel coronavirus in Massachusetts? Why did Chelsea, a city where two-thirds of residents identify as Latino, have a COVID-19 infection rate six times higher than the state average?
Researchers from the Harvard T.H. Chan School of Public Health and the Israel Deaconess Medical Center used these questions to create a county-by-county review about race, ethnicity, and COVID-19 in Massachusetts. The study appears in Health Affairs and analyzed COVID-19 infections over a four-month period in 351 towns and cities in Massachusetts. The researchers analyzed how variables, such as income, education, occupation, and age, coincide with COVID-19 case rates and may contribute to racial and ethnic disparities.
Counties with higher numbers of foreign-born non-U.S. residents, food service workers, and with a higher number of people living in one household had higher COVID-19 infection rates per 100,000 residents. After controlling for race and ethnicity, the researchers found these variables explained why predominantly Latino communities, such as Chelsea, had higher COVID-19 case rates. However, immigration status, higher numbers of food-service workers, and household size didn’t explain why counties with higher proportions of Black residents had higher COVID-19 case rates. The authors suspect social inequities, or structural racism, influenced COVID-19 transmission rates in communities with a higher proportion of Black residents. Incarceration rates, neighborhood segregation, and public transportation are examples of factors that may have increased COVID-19 transmission and limited access to testing and treatment.
The researchers recommend using the review to tailor public health responses to COVID-19 and provide detailed suggestions for Massachusetts communities. The authors also recommend future research that studies how social inequities contribute to COVID-19 health disparities, which can strengthen public health responses to the pandemic. The study was supported by funding from the National Heart, Lung, and Blood Institute.