Racial Disparities in Coronavirus Incidence, Knowledge, and Exposure

A recent US survey showed African American men were more likely to know someone infected by coronavirus 2019 (COVID-19), had a greater knowledge disparity of how the virus spread, and were more likely to be exposed to the virus.

Marcella Alsan, MD, MPH, PhD, associate professor of medicine, Stanford University, led a team of investigators who developed the survey and analyzed the results. The survey’s findings were reported in JAMA.

The electronic survey was conducted between March 29 and April 13. There were 5198 total respondents, with 2336 men and 2850 women. There were 3759 white, 830 African Americans, and 609 Hispanic respondents. The survey respondent needed to be 18 years or older, and to have been living in the US.

The investigators pointed out that younger African American men were at the greatest risk to COVID-19.

“The largest differences in COVID-19—related knowledge and behaviors were associated with race/ethnicity, sex, and age, with African American participants, men, and people younger than 55 years showing less knowledge than other groups,” Alsan and collaborators wrote.

Overall, African American respondents were more likely to report COVID-19 infection by a mean 3.5 percentage points (95% CI, 1.5-5.5; P = .001) than white respondents.

Men of all ethnicities were also more likely than women to report COVID-19 infection, by a mean 3.2 percentage points (95% CI, 2.0-4.4; P <.001).

Findings confirmed racial disparities in looking at COVID-19.

For example, African American respondents were less likely to know about fomite transmission, asymptomatic transmission, respiratory droplet transmission or the 3 common symptoms of COVID-19.

In terms of exposure, African American men were more likely to leave the house. The investigators surmised the differences might stem from socioeconomics.

“African American individuals are less likely to be able to telecommute and more likely to work in the service sector and use public transportation than other racial/ethnic groups (23% among African American individuals vs 15% among Hispanic individuals and 7% among white individuals),” investigators wrote.

Looking at these findings, the team saw a correlation between behaviors and knowledge.

“Groups in which behaviors put people more at risk for disease were also groups in which knowledge of appropriate behaviors are weakest,” Alsan and collaborators wrote. “These findings suggest that greater efforts to communicate risk and safe practices to racial/ethnic minorities and younger people may be particularly crucial moving forward.”

Survey limitations included accessibility to the survey with it being electronic and thus possibly being limited to those with Internet access. The other limitation the authors noted was the changing information associated with knowledge and behaviors.

“These findings confirm anecdotal reports of concerning gaps in reported prevalence and knowledge regarding COVID-19 across demographic characteristics in the US population,” the authors concluded. “More effort will be needed to address the knowledge and behavior gaps between white and African American individuals, between men and women, and between older and younger populations.”