ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Understanding Drivers of Coronavirus Disease 2019 (COVID-19) Racial Disparities: A Population-Level Analysis of COVID-19 Testing Among Black and White Populations.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers.
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Who cites it
40 citing papers in PubMed.
- Provision of COVID-19 Self-Test Kits to Patients for Distribution to Social Contacts: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Trial
- The COVID-19 Self-Testing through Rapid Network Distribution (C-STRAND) trial: A randomized controlled trial to increase COVID-19 testing in underserved populations.Contemporary clinical trials · 2021Trial
- Disparities in COVID-19 Testing and Infection Among Beneficiaries in the Military Health System During the First Year of the Pandemic.Journal of racial and ethnic health disparities · 2026Article
- Leveraging Multiple Administrative Data Sources to Reduce Missing Race and Ethnicity Data: A Descriptive Epidemiology Cross-Sectional Study of COVID-19 Case Relative Rates.Journal of racial and ethnic health disparities · 2025Article
- Diagnostic Testing Preferences in Rural and Vulnerable Populations During a Pandemic: Discrete Choice Experiment.JMIR public health and surveillance · 2025Article
- Graphical displays and related statistical measures of health disparities between groups in complex sample surveys.Journal of the Royal Statistical Society. Series A, (Statistics in Society) · 2025Article
- Racial and Ethnic Disparities in COVID-19 Treatments in the United States.Journal of racial and ethnic health disparities · 2025Article
- Racism in public health authorities-A scoping review and situational analysis.PLOS global public health · 2025Article
- The effects of mass media messages, perceived susceptibility and self-rated health on public attitude towards COVID-19 in South Africa.BMC public health · 2024Article
- Adaption and Validation of Scales to Measure COVID-19 Stigma Attitudes and Perceptions.Stigma and health · 2024Article
- Factors Associated With Surveillance Testing in Individuals With COVID-19 Symptoms During the Last Leg of the Pandemic: Multivariable Regression Analysis.JMIR public health and surveillance · 2024Article
- COVID-19 Death Determination Methods, Minnesota, USA, 2020-2022Emerging infectious diseases · 2024Article
- Racial/ethnic differences in the associations between trust in the U.S. healthcare system and willingness to test for and vaccinate against COVID-19.BMC public health · 2024Article
- Race, Ethnicity, and Delayed Time to COVID-19 Testing Among US Health Care Workers.JAMA network open · 2024Article
- The Importance of Community-Based and Community-Partnered COVID-19 Testing for Reducing Disparities Among African American Populations.Health equity · 2024Review
- Early Pandemic Access to COVID-19 Testing in the Somali Community in King County, Washington, USA: a Mixed-Methods Evaluation.Journal of racial and ethnic health disparities · 2023Article
- An Exploratory Qualitative Analysis of Explanations for COVID-19-Related Racial Disparities Among St. Louis Residents: "I Don't Really Pay Attention to the Racial Stuff Very Much".Preventing chronic disease · 2023Article
- Understanding social risk factors of county-level disparities in COVID-19 tests per confirmed case in South Carolina using statewide electronic health records data.BMC public health · 2023Article
- Quantifying the impact of SARS-CoV-2 temporal vaccination trends and disparities on disease control.Science advances · 2023Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundDisparities in coronavirus disease 2019 (COVID-19) testing-the pandemic's most critical but limited resource-may be an important but modifiable driver of COVID-19 inequities.
methodsWe analyzed data from the Missouri State Department of Health and Senior Services on all COVID-19 tests conducted in the St Louis and Kansas City regions. We adapted a well-established tool for measuring inequity-the Lorenz curve-to compare COVID-19 testing rates per diagnosed case among Black and White populations.
resultsBetween 14/3/2020 and 15/9/2020, 606 725 and 328 204 COVID-19 tests were conducted in the St Louis and Kansas City regions, respectively. Over time, Black individuals consistently had approximately half the rate of testing per case than White individuals. In the early period (14/3/2020 to 15/6/2020), zip codes in the lowest quartile of testing rates accounted for only 12.1% and 8.8% of all tests in the St Louis and Kansas City regions, respectively, even though they accounted for 25% of all cases in each region. These zip codes had higher proportions of residents who were Black, without insurance, and with lower median incomes. These disparities were reduced but still persisted during later phases of the pandemic (16/6/2020 to 15/9/2020). Last, even within the same zip code, Black residents had lower rates of tests per case than White residents.
conclusionsBlack populations had consistently lower COVID-19 testing rates per diagnosed case than White populations in 2 Missouri regions. Public health strategies should proactively focus on addressing equity gaps in COVID-19 testing to improve equity of the overall response.
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