Dataset Information

The impact of COVID-19 on African American communities in the United States.

ABSTRACT: Importance: The novel Coronavirus Disease 2019 (COVID-19), declared a pandemic in March 2020, may present with disproportionately higher rates in underrepresented racial/ethnic minority populations in the United States, including African American communities who have traditionally been over-represented in negative health outcomes.

Study objective: To understand the impact of the density of African American communities (defined as the percentage of African Americans in a county) on COVID-19 prevalence and death rate within the three most populous counties in each U.S. state and territory (n=152). Design: An ecological study using linear regression was employed for the study.

Setting: The top three most populous counties of each U.S. state and territory were included in analyses for a final sample size of n=152 counties.

Participants: Confirmed COVID-19 cases and deaths that were accumulated between January 22, 2020 and April 12, 2020 in each of the three most populous counties in each U.S. state and territory were included.

Main outcome measures: Linear regression was used to determine the association between African American density and COVID-19 prevalence (defined as the percentage of cases for the county population), and death rate (defined as number of deaths per 100,000 population). The models were adjusted for median age and poverty.

Results: There was a direct association between African American density and COVID-19 prevalence; COVID-19 prevalence increased 5% for every 1% increase in county AA density (p<.01). There was also an association between county AA density and COVID-19 deaths, such; the death rate increased 2 per 100,000 for every percentage increase in county AA density (p=.02).

Conclusion: These study findings indicate that communities with a high African American density have been disproportionately burdened with COVID-19. Further study is needed to indicate if this burden is related to environmental factors or individual factors such as types of employment or comorbidities that members of these community have.

SUBMITTER: Cyrus E

PROVIDER: S-EPMC7273254 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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The impact of COVID-19 on African American communities in the United States.

Cyrus E E Clarke R R Hadley D D Bursac Z Z Trepka M J MJ Dévieux J G JG Bagci U U Furr-Holden D D Coudray M M Mariano Y Y Kiplagat S S Noel I I Ravelo G J GJ Paley M M Wagner E E

medRxiv : the preprint server for health sciences 20200519

<h4>Importance</h4>The novel Coronavirus Disease 2019 (COVID-19), declared a pandemic in March 2020, may present with disproportionately higher rates in underrepresented racial/ethnic minority populations in the United States, including African American communities who have traditionally been over-represented in negative health outcomes.<h4>Study objective</h4>To understand the impact of the density of African American communities (defined as the percentage of African Americans in a county) on C ...[more]

PMID: 32511486

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Project description:BackgroundCOVID-19 remains an ongoing public health crisis. Black Americans remain underrepresented among those vaccinated and overrepresented in both COVID-19 morbidity and mortality. Medical misinformation, specifically related to COVID-19, has exacerbated the impact of the disease in Black American communities. Communication tools and strategies to build relationships and disseminate credible and trustworthy diagnostic and preventative health information are necessary to improve outcomes and equity for historically oppressed populations.ObjectiveAs the initial phase of a larger mixed methods project to develop, pilot, and evaluate a mobile health (mHealth) intervention among a population at high risk for COVID-19 and cardiovascular comorbidities, this study sought to explore COVID-19 information behavior among Black Americans. Specifically, this study examined (1) preferences for COVID-19 education via mHealth, (2) barriers and facilitators to COVID-19 education and diagnostic testing and routine care for associated cardiovascular and respiratory comorbidities in the local community, and (3) key content for inclusion in a COVID-19 mHealth app.MethodsThis qualitative study used principles of community-based participatory research and information systems research to conduct 7 focus groups across 3 sites. Focus groups were audio recorded and transcribed for thematic analysis using an abductive approach.ResultsThe study sample included 54 individuals across sites with a mean age of 50.24 (SD 11.76; range 20-71) years. Participants were primarily female (n=42, 78%) and Black (n=54, 100%) with varied education levels. Over half (n=29, 54%) of the participants were employed full-time, and nearly three-fourths (n=40, 74%) had household incomes <US $65,000. Participants used both Android (n=23, 43%) and iOS devices (n=29, 54%) and were "very comfortable" (n=37, 69%) using their mobile devices. Participants reported using a variety of sources for health information. Content-related preferences reported focus on visual presentation, user-friendly design, and privacy and highlighted the importance of community relevance, access, and community-specific content. Key barriers identified included health literacy-limiting app use, access to technology and information, and lack of trust. Increasing community relevance through community-specific messaging and the inclusion of Black providers were noted as facilitators that may increase credibility and trust. Key content identified included user-specific information such as where to get vaccines and tests, updated local COVID-19 data, travel protocols, information about long COVID-19 (post COVID-19 condition), comorbidities, frequently asked questions, and testimonials or personal stories.ConclusionsIncreasing transparency and building trust are 2 key strategies that may improve the impact of health information messaging in Black communities. Focusing on content over context fails in the provision of critical health information and perpetuates health inequities by reinforcing systemic and structural racism. COVID-19 messaging must consider contextual information, patient needs and preferences, and patient information-seeking and information-search behaviors to establish trust and credibility, positively impact patient health outcomes, and improve health equity.

Dataset Information

The impact of COVID-19 on African American communities in the United States.

Publications

The impact of COVID-19 on African American communities in the United States.

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