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The coronavirus disease 2019 (COVID-19) (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) pandemic has disproportionately impacted racial and ethnic communities across the United States. According to the Centers for Disease Control and Prevention (CDC), racial and ethnic individuals have a higher risk of COVID-19 illness, hospitalization, and death compared with their White counterparts. 1 A study analyzing county-level data comparing counties with higher and lower proportions of Black people found that COVID-19 diagnoses and deaths were higher in counties that were disproportionately Black, with 52% of COVID-19 cases and 58% of COVID-19 deaths occurring in disproportionately Black counties within the United States. 2 The same study also found that higher county-level unemployment was associated with fewer COVID-19 diagnoses, likely due to lower likelihood of exposure. Another study conducted by the Utah Department of Health found that the odds of infection with SARS-CoV-2 (the virus that causes COVID-19), and rates of hospitalization and testing were higher in areas of Utah with geographic social and economic inequities, including: (1) large proportions of Hispanic/Latinx and non-White residents; (2) persons working in manual, essential and public-facing employment sectors; (3) more crowded housing conditions; and (4) food and health care insecurity. 3
Crowded living conditions and unstable housing can also contribute significantly to the transmission of infectious diseases and can hinder the use of recommended prevention strategies (eg, social distancing and self-quarantine). A study using data from the 2017 American Housing Survey found that isolation or quarantine was impossible in 25.3 million (or 20.8%) of all US residential units because they did not have a sufficient number of bedrooms, bathrooms, or both. Indigenous and Latinx people were 2-3 times more likely, and Black and Asian people were 1.7 times more likely to occupy units where isolation or quarantine was not possible. 4 Another study describing clinical outcomes of patients of color who were hospitalized for COVID-19 at an urban hospital found a COVID-19 associated death incidence of 38.6% among Black and Latinx patients. These individuals resided in areas of New Jersey with higher population densities, housing units, and lower income levels than the rest of the state. 5 There have also been COVID-19 outbreaks in congregate settings such as prisons, homeless shelters, and long-term care facilities, where Black, Indigenous,...