Social Determinants of Health and Health Disparities: COVID-19 Exposures and Mortality Among African American People in the United States

Abstract

The coronavirus disease 2019 (COVID-19) pandemic in the United States provides yet another example of the enduring and pernicious effect of social determinants of health (SDH) on African American communities. SDH, as defined by the Healthy People 2020 SDH framework, include domains of economic stability, education, social and community context, health and health care, and neighborhood and built environment.1 Within each domain, key areas represent elements of focus for the decade (Box). Compared with non-Hispanic White people, African American people have higher rates of COVID-19 cases (2.6 times higher), hospitalization (4.7 times higher), and death (2.1 times higher).2-4 Although the pandemic is ongoing, it is not premature to call attention to the root causes of health inequity in the United States that have persisted for decades and are being highlighted in the current crisis.