Department of Geographical Sciences, University of Maryland, College Park, MD 20742.
Department of Biological Sciences, University of Maryland, College Park, MD 20742.
Proc Natl Acad Sci U S A. 2022 Jul 5;119(27):e2123533119. doi: 10.1073/pnas.2123533119. Epub 2022 Jun 27.
High COVID-19 mortality among Black communities heightened the pandemic's devastation. In the state of Louisiana, the racial disparity associated with COVID-19 mortality was significant; Black Americans accounted for 50% of known COVID-19-related deaths while representing only 32% of the state's population. In this paper, we argue that structural racism resulted in a synergistic framework of cumulatively negative determinants of health that ultimately affected COVID-19 deaths in Louisiana Black communities. We identify the spatial distribution of social, environmental, and economic stressors across Louisiana parishes using hot spot analysis to develop aggregate stressors. Further, we examine the correlation between stressors, cumulative health risks, COVID-19 mortality, and the size of Black populations throughout Louisiana. We hypothesized that parishes with larger Black populations (percentages) would have larger stressor values and higher cumulative health risks as well as increased COVID-19 mortality rates. Our results suggest two categories of parishes. The first group has moderate levels of aggregate stress, high population densities, predominately Black populations, and high COVID-19 mortality. The second group of parishes has high aggregate stress, lower population densities, predominantly Black populations, and initially low COVID-19 mortality that increased over time. Our results suggest that structural racism and inequities led to severe disparities in initial COVID-19 effects among highly populated Black Louisiana communities and that as the virus moved into less densely populated Black communities, similar trends emerged.
在新冠疫情期间，黑人群体的高死亡率加剧了这场大流行的破坏。在路易斯安那州，与新冠死亡率相关的种族差异显著；非裔美国人占已知与新冠相关的死亡人数的 50%，而仅占该州人口的 32%。在本文中，我们认为，结构性种族主义导致了一个协同框架，其中包含了一系列累积的健康决定因素，这些因素最终影响了路易斯安那州黑人社区的新冠死亡人数。我们使用热点分析来确定路易斯安那州各县的社会、环境和经济压力因素的空间分布，以制定综合压力因素。此外，我们还检查了压力因素、累积健康风险、新冠死亡率以及整个路易斯安那州黑人人口之间的相关性。我们假设，黑人人口比例较大的县（百分比）将具有更大的压力值和更高的累积健康风险，以及更高的新冠死亡率。我们的研究结果表明，各县可以分为两类。第一组县的综合压力水平中等、人口密度高、黑人人口为主，且新冠死亡率高。第二类县的综合压力大、人口密度低、黑人人口为主，最初的新冠死亡率较低，但随着时间的推移有所增加。我们的研究结果表明，结构性种族主义和不平等导致了人口众多的路易斯安那州黑人社区在新冠疫情初期的严重差异，随着病毒传播到人口密度较低的黑人社区，类似的趋势也出现了。
