corona virus-Covid19

Social Determinants of COVID-19 Morbidity: Lack of Internet Access and High School Diploma Interview with:

Ankur Dalsania Rutgers New Jersey Medical School (NJMS) M.D. Candidate 2021

Ankur Dalsania

Ankur Dalsania
Rutgers New Jersey Medical School (NJMS)
M.D. Candidate 2021 What is the background for this study?

Response: Similar to past pandemics, prior studies and news articles have highlighted the disproportionate impact of COVID-19 mortality in marginalized populations, especially Black Americans. Rather than biological differences, other factors like neighborhood conditions, educational attainment, economic stability, healthcare access, and social contexts have been hypothesized to influence the racial disparities.

Using county-level data, we sought to quantitatively determine how these factors, collectively referred to as social determinants of health, impact COVID-19 mortality in Black Americans. What are the main findings? 

Response: We found that an increase in a county’s percent of Black residents and adverse social determinants of health increased that county’s COVID-19 mortality. Percentage of adults without internet and percentage of adults without a high school diploma emerged as the most important social determinants. What should readers take away from your report?

Response: Readers should take away that rather than genetic or biological differences, social determinants of health, influenced by structural inequities, are important drivers of COVID-19 racial disparities for Black Americans in the U.S. Our results are consistent over a diverse set of social determinants representing areas of economic stability, healthcare access, educational attainment, and social contexts. This analysis can help inform targeted data-driven public health policies to mitigate racial disparities in the COVID-19 pandemic as well as future health crises. What recommendations do you have for future research as a result of this work?

Response: Public health experts need to continue examining the relationship between social determinants of health and health outcomes, as identifying these determinants is the first step in creating policies to ensure greater health equity. Additionally, an increasing number of studies have begun to suggest that racial disparities may reflect discrimination propagated by mutually reinforcing, inequitable systems referred to as structural racism. Further research is needed to evaluate the effect of validated markers of structural racism on COVID-19 mortality. 


Dalsania AK, Fastiggi MJ, Kahlam A, Shah R, Patel K, Shiau S, Rokicki S, DallaPiazza M. The Relationship Between Social Determinants of Health and Racial Disparities in COVID-19 Mortality. J Racial Ethn Health Disparities. 2021 Jan 5:1–8. doi: 10.1007/s40615-020-00952-y. Epub ahead of print. PMID: 33403652; PMCID: PMC7785288.



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Last Updated on February 4, 2021 by Marie Benz MD FAAD