Understanding the COVID-19, Racism, and Violence Syndemic and its Effects on COVID-19 Testing Disparities

Project SummaryBlack communities in the US are experiencing three converging public health crises: COVID-19, systemicracism, and community and police violence. Black Americans are significantly less likely to receive a neededCOVID-19 test and have higher rates of COVID-19 infection and death than white Americans. Additionally,Black communities have experienced a surge in gun violence in 2020 and continue to be victims of policeharassment and violence, resulting in large-scale social justice demonstrations. The convergence of theseepidemics has created a syndemic, wherein racism, violence, and COVID-19 cluster in predominantly Blackand low-income communities. The proposed study aims to characterize this syndemic to understand howpersonal and systemic racism and violence in Black communities may influence COVID-19 testing decisions.This mixed-method study with Black residents of Chicago, IL will result in community-driven recommendationsto enhance COVID-19 testing and prevention strategies and address this emerging syndemic. We will examinethe potential mediating pathways of medical mistrust, psychological trauma and stress, and economic injustice.Additionally, we will take a strengths-based approach to understand potential protective factors includingneighborhood cohesion, social support, and access to health care. The specific aims of the study are to: 1)Qualitatively examine how experiences of racial discrimination, community violence, and police violenceinfluence trust in and engagement with healthcare systems and contribute to decisions around COVID-19testing and mitigation strategies (e.g. social distancing) among Black individuals in Chicago (N=50); 2)Quantitatively assess the prevalence and correlates of COVID-19 testing among Black residents in Chicago (N= 500) and characterize the COVID-19, racism, and violence syndemic; and 3) In partnership with aCommunity Advisory Council, use an integrative translational workshop approach and intervention mappingtechniques to develop community and data-driven recommendations and an intervention blueprint for localhealth departments, researchers, and public health organizations to improve COVID-19 testing among BlackAmericans. This study will result in policy and research recommendations, community resources, and a'shovel-ready' intervention blueprint to enhance COVID-19 testing and address this emerging syndemic.