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    Do racial and ethnic disparities in following stay-at-home orders influence COVID-19 health outcomes? A mediation analysis approach

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    Author
    Hu, Songhua
    Luo, Weiyu
    Darzi, Aref
    Pan, Yixuan
    Zhao, Guangchen
    Liu, Yuxuan
    Xiong, Chenfeng
    Date
    2021-11-11
    Journal
    PLoS ONE
    Publisher
    Public Library of Science
    Type
    Article
    
    Metadata
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    See at
    https://doi.org/10.1371/journal.pone.0259803
    Abstract
    Racial/ethnic disparities are among the top-selective underlying determinants associated with the disproportional impact of the COVID-19 pandemic on human mobility and health outcomes. This study jointly examined county-level racial/ethnic differences in compliance with stay-at-home orders and COVID-19 health outcomes during 2020, leveraging two-year geo-tracking data of mobile devices across ~4.4 million point-of-interests (POIs) in the contiguous United States. Through a set of structural equation modeling, this study quantified how racial/ethnic differences in following stay-at-home orders could mediate COVID-19 health outcomes, controlling for state effects, socioeconomics, demographics, occupation, and partisanship. Results showed that counties with higher Asian populations decreased most in their travel, both in terms of reducing their overall POIs' visiting and increasing their staying home percentage. Moreover, counties with higher White populations experienced the lowest infection rate, while counties with higher African American populations presented the highest case-fatality ratio. Additionally, control variables, particularly partisanship, median household income, percentage of elders, and urbanization, significantly accounted for the county differences in human mobility and COVID-19 health outcomes. Mediation analyses further revealed that human mobility only statistically influenced infection rate but not case-fatality ratio, and such mediation effects varied substantially among racial/ethnic compositions. Last, robustness check of racial gradient at census block group level documented consistent associations but greater magnitude. Taken together, these findings suggest that US residents' responses to COVID-19 are subject to an entrenched and consequential racial/ethnic divide.
    Keyword
    stay-at-home orders
    COVID-19
    Race Factors
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17147
    ae974a485f413a2113503eed53cd6c53
    10.1371/journal.pone.0259803
    Scopus Count
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    UMB Coronavirus Publications
    UMB Open Access Articles

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