Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Berkman Klein Center for Internet & Society, Harvard University, Cambridge, MA, USA.
Soc Sci Med. 2021 May;276:113741. doi: 10.1016/j.socscimed.2021.113741. Epub 2021 Feb 9.
In the United States, Black Americans are suffering from a significantly disproportionate incidence of COVID-19. Going beyond mere epidemiological tallying, the potential for racial-justice interventions, including reparations payments, to ameliorate these disparities has not been adequately explored.
We compared the COVID-19 time-varying R curves of relatively disparate polities in terms of social equity (South Korea vs. Louisiana). Next, we considered a range of reproductive ratios to back-calculate the transmission rates β for 4 cells of the simplified next-generation matrix (from which R is calculated for structured models) for the outbreak in Louisiana. Lastly, we considered the potential structural effects monetary payments as reparations for Black American descendants of persons enslaved in the U.S. would have had on pre-intervention β and consequently R.
Once their respective epidemics begin to propagate, Louisiana displays R values with an absolute difference of 1.3-2.5 compared to South Korea. It also takes Louisiana more than twice as long to bring R below 1. Reasoning through the consequences of increased equity via matrix transmission models, we demonstrate how the benefits of a successful reparations program (reflected in the ratio β/β) could reduce R by 31-68%.
While there are compelling moral and historical arguments for racial-injustice interventions such as reparations, our study considers potential health benefits in the form of reduced SARS-CoV-2 transmission risk. A restitutive program targeted towards Black individuals would not only decrease COVID-19 risk for recipients of the wealth redistribution; the mitigating effects would also be distributed across racial groups, benefiting the population at large.
在美国，非裔美国人 COVID-19 的发病率明显不成比例。除了简单的流行病学统计之外，包括赔偿支付在内的种族正义干预措施来改善这些差异的潜力尚未得到充分探索。
我们比较了在社会公平方面存在显著差异的相对不同政体的 COVID-19 时变 R 曲线（韩国与路易斯安那州）。其次，我们考虑了一系列繁殖率，以回溯计算路易斯安那州疫情爆发时简化下一代矩阵的 4 个细胞的传播率β（用于计算结构模型的 R）。最后，我们考虑了货币支付作为对美国被奴役黑人后裔的赔偿的潜在结构影响，这些赔偿对干预前β和随后的 R 会产生影响。
一旦各自的疫情开始传播，路易斯安那州的 R 值与韩国相比存在 1.3-2.5 的绝对差异。路易斯安那州将 R 值降低到 1 以下所需的时间也超过两倍。通过矩阵传播模型推断增加公平性的后果，我们展示了成功赔偿计划的收益（反映在β/β的比例中）如何将 R 降低 31-68%。
虽然种族正义干预措施（如赔偿）具有强烈的道德和历史论据，但我们的研究考虑了以降低 SARS-CoV-2 传播风险的形式的潜在健康益处。针对黑人的赔偿计划不仅会降低财富再分配接受者的 COVID-19 风险；缓解效果还将在各个种族群体中分布，使整个人口受益。
