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      COVID-19 And Racial/Ethnic Disparities In Health Risk, Employment, And Household Composition : Study examines potential explanations for racial-ethnic disparities in COVID-19 hospitalizations and mortality.

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      Health Affairs
      Health Affairs (Project Hope)

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          Abstract

          We used data from the Medical Expenditure Panel Survey to explore potential explanations for racial/ethnic disparities in coronavirus disease 2019 (COVID-19) hospitalizations and mortality. Black adults in every age group were more likely than White adults to have health risks associated with severe COVID-19 illness. However, Whites were older, on average, than Blacks. Thus, when all factors were considered, Whites tended to be at higher overall risk compared with Blacks, with Asians and Hispanics having much lower overall levels of risk compared with either Whites or Blacks. We explored additional explanations for COVID-19 disparities-namely, differences in job characteristics and how they interact with household composition. Blacks at high risk for severe illness were 1.6 times as likely as Whites to live in households containing health-sector workers. Among Hispanic adults at high risk for severe illness, 64.5 percent lived in households with at least one worker who was unable to work from home, versus 56.5 percent among Black adults and only 46.6 percent among White adults.

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          Most cited references5

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          Racial residential segregation: A fundamental cause of racial disparities in health

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            The Sociology of Discrimination: Racial Discrimination in Employment, Housing, Credit, and Consumer Markets

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              Stress-Related Biosocial Mechanisms of Discrimination and African American Health Inequities

              This review describes stress-related biological mechanisms linking interpersonal racism to life course health trajectories among African Americans. Interpersonal racism, a form of social exclusion enacted via discrimination, remains a salient issue in the lives of African Americans, and it triggers a cascade of biological processes originating as perceived social exclusion and registering as social pain. Exposure to discrimination increases sympathetic nervous system activation and upregulates the HPA axis, increasing physiological wear and tear and elevating the risks of cardiometabolic conditions. Consequently, discrimination is associated with morbidities including low birth weight, hypertension, abdominal obesity, and cardiovascular disease. Biological measures can provide important analytic tools to study the interactions between social experiences such as racial discrimination and health outcomes over the life course. We make future recommendations for the study of discrimination and health outcomes, including the integration of neuroscience, genomics, and new health technologies; interdisciplinary engagement; and the diversification of scholars engaged in biosocial inequities research.
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                Author and article information

                Journal
                Health Affairs
                Health Affairs
                Health Affairs (Project Hope)
                0278-2715
                1544-5208
                July 14 2020
                : 10.1377/hlthaff
                Affiliations
                [1 ]Thomas M. Selden () is the director of the Division of Research and Modeling, Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, in Rockville, Maryland.
                [2 ]Terceira A. Berdahl is a social science analyst at the Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality.
                Article
                10.1377/hlthaff.2020.00897
                32663045
                42e90f61-0f25-4c81-87d2-60360224349d
                © 2020
                History

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