Elizabeth L. Tung (
Monica E. Peek is a professor in the Section of General Internal Medicine, University of Chicago.
Health Aff (Millwood). 2021 Nov;40(11):1784-1791. doi: 10.1377/hlthaff.2021.00695.
Racial health inequities exemplified during the COVID-19 crisis have awakened a sense of urgency among public health and policy experts to examine contributing factors. One potential factor includes the socioeconomic disadvantage of racially segregated neighborhoods. This study quantified associations of neighborhood socioeconomic disadvantage in Chicago, Illinois, as measured by the Area Deprivation Index (ADI), with racial disparities in COVID-19 positivity. A retrospective cohort included 16,684 patients tested for COVID-19 at an academic medical center and five community-based testing sites during Chicago's "first wave" (March 12, 2020-June 25, 2020). Patients living in Black majority neighborhoods had two times higher odds of COVID-19 positivity relative to those in White majority neighborhoods. The ADI accounted for 20 percent of the racial disparity; however, COVID-19 positivity remained substantially higher at every decile of the ADI in Black relative to White neighborhoods. The remaining disparities (80 percent) suggest a large, cumulative effect of other structural disadvantages in urban communities of color.
在 COVID-19 危机期间，种族健康不平等现象突显出来，这促使公共卫生和政策专家们感到迫切需要研究其促成因素。其中一个潜在因素是种族隔离社区的社会经济劣势。本研究通过区域剥夺指数（ADI）量化了伊利诺伊州芝加哥市社区社会经济劣势与 COVID-19 阳性率种族差异之间的关联。该回顾性队列纳入了在学术医疗中心和五个社区检测点进行 COVID-19 检测的 16684 名患者，检测时间为芝加哥“第一波”（2020 年 3 月 12 日至 6 月 25 日）。与居住在白人为主的社区的患者相比，居住在黑人为主的社区的患者 COVID-19 阳性的几率高两倍。ADI 解释了 20%的种族差异；然而，在黑人社区的 ADI 每一百分位，COVID-19 阳性率仍明显高于白人社区。其余的差异（80%）表明，在城市有色人种社区中，其他结构性劣势具有较大的累积效应。
