Race, explicit racial attitudes, implicit racial attitudes, and COVID-19 cases and deaths: An analysis of counties in the United States.

George B Cunningham,Lisa T Wigfall,Natalie J Shook

doi:10.1371/journal.pone.0242044

Abstract

ObjectivesTo examine the potential moderating effects of explicit racial attitudes and implicit racial attitudes on the relationship between percent of Black county residents and COVID-19 cases and deaths.MethodsWe collected data from a variety of publicly available sources for 817 counties in the US. (26% of all counties). Cumulative COVID-19 deaths and cases from January 22 to August 31, 2020 were the dependent variables; explicit racial attitudes and implicit racial attitudes served as the moderators; subjective poor or fair health, food insecurity, percent uninsured, percent unemployed, median family income, percent women, percent of Asian county resident, percent of Hispanic county residents, and percent of people 65 or older were controls.ResultsThe percent of Black county residents was positively associated with COVID-19 cases and deaths at the county level. The relationship between percent of Black residents and COVID-19 cases was moderated by explicit racial attitudes and implicit racial attitudes.ConclusionsImplicit racial attitudes can take on a shared property at the community level and effectively explain racial disparities. COVID-19 cases are highest when both the percent of Black county residents and implicit racial attitudes are high.

Highlights

Whereas everyone has an exposure risk for COVID-19, the severity of illness varies
The percent of Black county residents was positively associated with COVID-19 cases and deaths at the county level
The relationship between percent of Black residents and COVID19 cases was moderated by explicit racial attitudes and implicit racial attitudes

Summary

Introduction

There is a growing body of evidence that suggests racial and ethnic minorities are more affected by severe illness from COVID-19 compared to White people [1,2,3,4]. Even more alarming is the fact that some researchers have shown that Black individuals are at a higher risk than their White counterparts of having severe illness from COVID-19 that requires hospitalization [3,5]. We draw from publicly available data to examine the role of racial attitudes on COVID19 cases and deaths, at the county level. We hypothesize that explicit and implicit racial attitudes uniquely explain COVID-19 cases and deaths, and serve to moderate the relationship between the percent of Black county residents and COVID-19 outcomes

Objectives

Methods

Results