COVID-19 in Context: Racism, Segregation, and Racial Inequities in Philadelphia

Data Brief
June 2020

View the brief: COVID in Context - RACISM, SEGREGATION, AND RACIAL INEQUITIES IN PHILADELPHIA [PDF]

Racial Inequities in COVID-19

On March 10, 2020, the city of Philadelphia reported its first case of coronavirus disease (COVID-19)—an infectious disease caused by the novel coronavirus SARS-Cov-2.

While interpretations of early data framed the COVID-19 pandemic as the “great equalizer,” racial inequities in the city began to emerge in late March, with Blacks being disproportionately impacted.

Summary and Conclusions

Racially segregated communities in Philadelphia are being disproportionately impacted by the COVID-19 pandemic. Neighborhoods with the highest levels of residential segregation are more likely to have structural characteristics that increase likelihood of exposure, community transmission, and mortality, making segregation a fundamental driver of racial inequities in the city. These findings have implications for both short- and long-term multi-sectoral solutions to mitigate inequities.

During the pandemic:

• Sustained access to free testing and follow-up treatment coupled with increased public health capacity to engage in community-based contact tracing and access to safe and humane facilities for isolation and quarantine
• Personal protective equipment, hazard pay, paid sick leave and employment protections for low-wage essential workers to limit exposure and mitigate household and community transmission
• A moratorium on evictions and disruptions in utility services
• Modifications to public transportation systems that are responsive to the unique challenges of segregated communities (e.g. more frequent service to limit crowding)
• Uniform and coordinated data collection on COVID-19 cases, hospitalizations, and deaths disaggregated by multiple dimensions of marginalization (e.g. race/ethnicity, zip code, income, occupation) to document the disproportionate impact and monitor efforts to mitigate inequities

Beyond the pandemic:

• Free, universal healthcare coupled with investments in public health infrastructure for the most marginalized communities
• Equitable employment opportunities that offer living wages and worker’s right
• Equitable public and private investments in racially segregated communities (without displacement) to improve housing, transportation, access to employment and other services necessary for communities to thrive

Far from being a great equalizer, COVID-19 is reinforcing longstanding inequities that existed in Philadelphia prior to the pandemic. As this public health crisis continues to unfold, data on racial inequities must be properly contextualized and grounded in history and foundational frameworks that place structural racism at the center.

Data must also be rooted in the lived experiences of the individuals and communities most directly impacted by the pandemic and used as a tool for action and not as a weapon that further stigmatizes Black communities. Emerging data on other racial groups that have been impacted by systems of structural marginalization (e.g. xenophobia) must also be contextualized in a similar manner. Finally, efforts to mitigate the effects of this pandemic must work in tandem with an ongoing commitment to anti-racist policies and practices that dismantle the structural and institutional drivers of racial health inequities that existed before this crisis.

Read the full brief, which includes data on racial inequities in COVID-19 and racial residential segregation in Philadelphia.

References for the brief:

Racial Inequities in COVID-19 in Philadelphia

• Philadelphia Department of Public Health. (2020). Safer at Home: Protecting Vulnerable Populations. https://www.phila.gov/guides/safer-at-home/protecting-vulnerable-populations/

Racial Residential Segregation

• Bailey, Z. D., Krieger, N., Agénor, M., Graves, J., Linos, N., & Bassett, M. T. (2017). Structural racism and health inequities in the USA: evidence and interventions. The Lancet, 389(10077), 1453–1463.
• Brown, L. (2020, April 8). The Coronapacalypse: Why COVID-19 Targets Redlined Black Neighborhoods in Hypersegregated Cities. Medium. https://medium.com/@BmoreDoc/the-coronapacalypse-why-covid-19-targets-redlined-black-neighborhoods-in-hypersegregated-cities-cdea3edfea
• Drexel University Urban Health Collaborative, & Philadelphia Department of Public Health. (2019). Close to home: The health of Philadelphia’s neighborhoods. Philadelphia Department of Public Health. https://www.phila.gov/media/20190801133844/Neighborhood-Rankings_7_31_19.pdf
• Du Bois, W. E. B., & Eaton, I. (1996). The Philadelphia Negro: A social study. University of Pennsylvania Press.
• Frey, W. H. (2018, December 17). Black-white segregation edges downward since 2000, census shows. The Avenue: The Brookings Institution. https://www.brookings.edu/blog/the-avenue/2018/12/17/black-white-segregation-edges-downward-since-2000-census-shows/
• Grabell, M., Yeung, B., & Jameel, M. (2020, April 16). Millions of Essential Workers Are Being Left Out of COVID-19 Workplace Safety Protections, Thanks to OSHA. ProPublica. https://www.propublica.org/article/millions-of-essential-workers-are-being-left-out-of-covid-19-workplace-safety-protections-thanks-to-osha
• Logan, J. R., & Bellman, B. (2016). Before The Philadelphia Negro: Residential segregation in a nineteenth-century Northern city. Social Science History, 40(4), 683–706.
• Massey, D. S., & Tannen, J. (2015). A research note on trends in black hypersegregation. Demography, 52(3), 1025–1034.
• Nelson, R. K., Winling, L., Marciano, R., & Connolly, N. (n.d.). Mapping Inequality: Redlining in New Deal America. In R. K. Nelson & E. L. Ayers (Eds.), American Panorama. Retrieved June 11, 2020, from https://dsl.richmond.edu/panorama/redlining/
• Perry, A. M. (2020, March 20). Black Americans were forced into ‘social distancing’ long before the coronavirus. The Avenue: The Brookings Institution. https://www.brookings.edu/blog/the-avenue/2020/03/20/black-americans-were-forced-into-social-distancing-long-before-the-coronavirus/
• Philadelphia Department of Public Health. (2019). Health of the city 2019: Philadelphia’s community health assessment (Health of the City). Philadelphia Department of Public Health. https://www.phila.gov/media/20191219114641/Health_of_City_2019-FINAL.pdf
• Rothstein, R. (2017). The color of law: A forgotten history of how our government segregated America. Liveright Publishing.
• Taylor, K.-Y. (2019). Race for profit: How banks and the real estate industry undermined black homeownership. University of North Carolina Press.
• Trounstine, J. (2018). Segregation by design: Local politics and inequality in American cities. Cambridge University Press.
• Williams, D. R., & Collins, C. (2016). Racial residential segregation: A fundamental cause of racial disparities in health. Public Health Reports.

Critical Race Theory and Systems of Racism Impacting COVID-19

• Alexander, M. (2012). The new Jim Crow: mass incarceration in the age of colorblindness. New York: New Press.
• Bailey, Z., Barber, S., Robinson, W., Slaughter-Acey, J., Ford, C., & Sealy-Jefferson, S. (2020, April 8). Racism in the Time of COVID-19. IAPHS - Interdisciplinary Association for Population Health Science. https://iaphs.org/racism-in-the-time-of-covid-19/
• Ford, C. L., & Airhihenbuwa, C. O. (2010). Critical race theory, race equity, and public health: Toward antiracism praxis. American Journal of Public Health, 100(S1), S30–S35.
• Gamble, V. N. (2010). “There Wasn’t a Lot of Comforts in Those Days:” African Americans, Public Health, and the 1918 Influenza Epidemic. Public Health Reports, 125(3_suppl), 113–122.
• Kershaw, K. N., & Albrecht, S. S. (2015). Racial/ethnic residential segregation and cardiovascular disease risk. Current Cardiovascular Risk Reports, 9(3), 10.
• Laster Pirtle, W. N. (2020). Racial capitalism: A fundamental cause of novel coronavirus (COVID-19) pandemic inequities in the United States. Health Education & Behavior, 1090198120922942.
• Lofgren, E., Lum, K., Horowitz, A., Madubuowu, B., & Fefferman, N. (2020). The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. MedRxiv.
• Powell, J. A. (2007). Structural racism: Building upon the insights of John Calmore. North Carolina Law Review, 86, 791.
• Reinhart, E., & Chen, D. (2020). Incarceration and Its Disseminations: COVID-19 Pandemic Lessons from Chicago’s Cook County Jail: Study examines how arrest and pre-trial detention practices may be contributing to the spread of COVID-19. Health Affairs. https://doi.org/10.1377/hlthaff.2020.00652
• Reskin, B. (2012). The race discrimination system. Annual Review of Sociology, 38, 17–35.
• Ross, M., & Bateman, N. (2019). Meet the Low-Wage Workforce. The Brookings Institution. https://www.brookings.edu/wp-content/uploads/2019/11/201911_Brookings-Metro_low-wage-workforce_Ross-Bateman.pdf
• Schuster, L., & Mattos, T. (2020, April 13). A Profile of Frontline Workers in Massachusetts. Boston Indicators: Measuring What We Value. https://www.bostonindicators.org/article-pages/2020/april/frontline_workers
• Watson-Daniels, J., Milner, Y., Triplett, N., Headen, I., Day, D., Bailey, Z. D., Styles, M., Clinton, L., Andrews, C., Wilson, M., Ezeokoli, N., Jebbett Bullard, S., & Mason-Brown, L. (2020). Data for Black Lives COVID-19 Movement Pulse Check and Roundtable Report. http://d4bl.org/reports
• Williams, D. R., & Cooper, L. A. (2020). COVID-19 and Health Equity—A New Kind of “Herd Immunity.” JAMA. https://doi.org/10.1001/jama.2020.8051

Data and Analysis 

• Chen, J. T., & Krieger, K. (2020). Revealing the unequal burden of COVID-19 by income, race/ethnicity, and household crowding: US county vs. ZIP code analyses. Harvard Center for Population and Development Studies Working Paper Series, 19(1).
• Krieger, N., Waterman, P. D., Spasojevic, J., Li, W., Maduro, G., & Van Wye, G. (2016). Public health monitoring of privilege and deprivation with the index of concentration at the extremes. American Journal of Public Health, 106(2), 256–263.
• Philadelphia Department of Public Health. (2020). Testing and data: Coronavirus disease 2019 (COVID-19). City of Philadelphia. https://www.phila.gov/programs/coronavirus-disease-2019-covid-19/testing-and-data/

Summary and Recommendations

• Benfer, E. A., & Wiley, L. F. (2020, March 19). Health Justice Strategies To Combat COVID-19: Protecting Vulnerable Communities During A Pandemic. Health Affairs Blog. https://www.healthaffairs.org/do/10.1377/hblog20200319.757883/full/
• City of Chicago. (2020). Chicago COVID Contact Tracing Corps. City of Chicago. https://www.chicago.gov/content/city/en/sites/covid-19/home/chicago-covid-contact-tracing-corps.html
• Chowkwanyun, M., & Reed Jr, A. L. (2020). Racial health disparities and Covid-19—Caution and context. New England Journal of Medicine.
• Hutchins, S. S., Fiscella, K., Levine, R. S., Ompad, D. C., & McDonald, M. (2009). Protection of Racial/Ethnic Minority Populations During an Influenza Pandemic. American Journal of Public Health, 99(S2), S261–S270. https://doi.org/10.2105/AJPH.2009.161505
• Kinder, M. (2020). COVID-19’s essential workers deserve hazard pay. Here’s why—and how it should work. The Brookings Institution. https://www.brookings.edu/research/covid-19s-essential-workers-deserve-hazard-pay-heres-why-and-how-it-should-work/
• Krieger, N., Gonsalves, G., Bassett, M. T., Hanage, W., & Krumholz, H. M. (2020, April 14). The Fierce Urgency Of Now: Closing Glaring Gaps In US Surveillance Data On COVID-19. Health Affairs Blog. https://www.healthaffairs.org/do/10.1377/hblog20200414.238084/full/
• Poor People’s Campaign. (2020). Poverty Amidst Pandemic: A Moral Response to COVID-19. https://sign.moveon.org/petitions/this-pandemic-demands-a-systemic-response-an-urgent-message-from-the-poor-people-s-campaign. 
• Tomer A and Kane J W. (2020). How to protect essential workers during COVID-19. The Brookings Institution. https://www.brookings.edu/research/how-to-protect-essential-workers-during-covid-19/. 

Citation:

Barber S, Headen I, Branch B, Tabb L, Yadeta K. COVID-19 in Context: Racism, Segregation and Racial Inequities in Philadelphia: Drexel University Urban Health Collaborative; June 2020.