@article{a17e81677c324836899f9f951495cc91,
title = "Residential racial segregation and social distancing in the United States during COVID-19",
abstract = "Background: Our objective is to examine whether residential racial segregation may be constraining capacities for social distancing thus leaving African Americans potentially more exposed to contracting COVID-19. We hypothesized that residential racial segregation constrains African Americans{\textquoteright} spatial mobility when the whole population is locked down but increases their need for moving under reopening orders. Methods: We employ a Black/White dissimilarity index as our independent variable and county-level mobility ratios as our dependent variable. Using generalized estimating equations for longitudinal data, we analyzed the effects of Black/White segregation on population mobility by counties across the United States from March 8 to August 7, 2020 under two different COVID-19 related policy conditions: lockdown and reopening. Findings: While higher county-wide levels of segregation were significantly associated with decreased mobility under lockdown and stay-at-home orders, we found that this relationship between segregation and mobility dissipated under reopening orders. Interpretations: Investigating the effects of health policy without considering differing effects due to structural racism will likely ignore complexities that may create unintended consequences of health policy. Our conclusions suggest African Americans may face structural limitations to effective social distancing as evidenced by higher rates of mobility after reopening policies go into effect.",
author = "Alexandre White and Lingxin Hao and Xiao Yu and Thorpe, {Roland J.}",
note = "Funding Information: Alexandre White is the Primary Investigator of this article. He conducted the literature search, developed the design and assisted in data collection, interpretation and authored the final manuscript. Lingxin Hao is the Co-PI of this article and led the development for the quantitative data analysis and assisted in data interpretation, data collection and editing of the final manuscript. Xiao Yu assisted in the study design and conducted the data analysis, producing all figures and tables for the article. Yu assisted in the interpretation and writing of this article. Roland Thorpe Jr. Assisted in the study design and the interpretation of the data and findings. Thorpe Jr. also assisted in the editing and framing of the final manuscript. The authors wish to thank the anonymous reviewers for their aid in strengthening this article. The authors would also like to thank the funding support of the National Institute of Child Health and Human Development, the National Institute on Aging and the National Institute on Minority Health and Health Disparities. Funding was provided by The National Institute of Child Health and Human Development (R24HD042854), the National Institute on Aging (K02AG059140; R01AG054363) and the Eunice Kennedy Shriver National Institute on Minority Health and Health Disparities (U54MD000214). All data are available publicly. We draw county-day data from the COVID-19 Data Hub of the Hopkins Population Center (https://github.com/QFL2020/COVID_DataHub). The Data Hub includes publicly available data from The Johns Hopkins CSSE COVID-19 tracking system, Census Bureau, CDC, Bureau of Labor Statistics (BLS), Bureau of Economic Analysis and the Internal Revenue Service which were employed in this study. Mobility data from Descartes Labs are available at: https://github.com/descarteslabs/DL-COVID-19, The reporting of this study conforms to the STROBE Statement. Funding Information: Funding was provided by The National Institute of Child Health and Human Development (R24HD042854), the National Institute on Aging ( K02AG059140 ; R01AG054363 ) and the Eunice Kennedy Shriver National Institute on Minority Health and Health Disparities ( U54MD000214 ). Funding Information: The authors wish to thank the anonymous reviewers for their aid in strengthening this article. The authors would also like to thank the funding support of the National Institute of Child Health and Human Development, the National Institute on Aging and the National Institute on Minority Health and Health Disparities. Publisher Copyright: {\textcopyright} 2021 The Authors",
year = "2021",
month = may,
doi = "10.1016/j.eclinm.2021.100840",
language = "English (US)",
volume = "35",
journal = "EClinicalMedicine",
issn = "2589-5370",
publisher = "Lancet Publishing Group",
}