Context: Segregation has been linked to unequal life chances.  Individuals from marginalized communities experience more crime, higher levels of poverty, poor health, and less civic engagement; and segregated metropolitan regions witness inequality in access to basic services. This paper builds on this previous work by linking segregation to infection and deaths from COVID-19.

Methods: Using Census data matched to COVID infection and death statistics at the county level, we offer a theoretical basis for our choice of segregation measures and predictions for different racial groups. We analyze the relationship between two dimensions of segregation, racial isolation and racial unevenness, and COVID outcomes for different racial and ethnic groups.

Findings: We find that in counties where Black and Latino residents live in more isolated neighborhoods, they were much more likely to contract COVID-19. This pattern was exacerbated in counties with a high proportion of front-line workers. We also find that racial segregation increased COVID-19 death rates for Black, Latino, and white residents.

Conclusions: Our findings suggest that devastating outcomes of the coronavirus pandemic were linked to a long history of racial marginalization and entrenched discrimination produced by structural inequalities embedded in our geographies and should inform public health planning going forward. 

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