Disparities in COVID-19 mortality by county racial composition and the role of spring social distancing measures
| Autor: | Mary K. Hamman |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
media_common.quotation_subject Physical Distancing Population Economics Econometrics and Finance (miscellaneous) Psychological intervention Comorbidity Article 03 medical and health sciences Race (biology) 0302 clinical medicine Humans 030212 general & internal medicine education media_common education.field_of_study Schools 030505 public health SARS-CoV-2 Social distance Mortality rate COVID-19 Grandparent Health Status Disparities United States Health equity Black or African American Geography Socioeconomic Factors Intergenerational Relations Small-Area Analysis Unemployment Female Health disparities 0305 other medical science Demography |
| Zdroj: | Economics & Human Biology Economics and Human Biology |
| ISSN: | 1570-677X |
| DOI: | 10.1016/j.ehb.2020.100953 |
| Popis: | Available COVID-19 data shows higher shares of cases and deaths occur among Black Americans, but reporting of data by race is poor. This paper investigates disparities in county-level mortality rates across counties with higher and lower than national average Black population shares using nonlinear regression decomposition and estimates potential differential impact of social distancing measures. I find counties with Black population shares above the national share have mortality rates 2 to 3 times higher than in other counties. Observable differences in living conditions, health, and work characteristics reduce the disparity to approximately 1.25 to 1.65 overall, and explain 100% of the disparity at 21 days after the first case. Though higher rates of comorbidities in counties with higher Black population shares are an important predictor, living situation factors like single parenthood and population density are just as important. Higher rates of co-residence with grandchildren explain 11% of the 21 day disparity but do not appear important by 42 days, suggesting families may have been better able to protect vulnerable family members later in the epidemic. To analyze differential effects of social distancing measures use two approaches. First, I exploit the timing of interventions relative to the first case among counties that began their epidemic at the same time. Second, I use event study analysis to analyze within-county changes in mortality. Findings for social distancing measures are not always consistent across approaches. Overall, I find no evidence that school closures were less effective in counties with larger Black population shares, and some estimates suggest closures may have disproportionately helped more diverse counties and counties with high rates of grandparent and grandchild co-residence. Conversely, stay at home orders are less clearly associated with mortality in any counties, reaching peak unemployment did not reduce mortality in any models, and some estimates indicate reaching peak unemployment before the first case was associated with higher mortality rates, especially in more diverse counties. |
| Databáze: | OpenAIRE |
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