Understanding COVID-19 risks and vulnerabilities among black communities in America: the lethal force of syndemics

Ann Epidemiol. 2020 Jul;47:1-3. doi: 10.1016/j.annepidem.2020.05.004. Epub 2020 May 14.


Black communities in the United States are bearing the brunt of the COVID-19 pandemic and the underlying conditions that exacerbate its negative consequences. Syndemic theory provides a useful framework for understanding how such interacting epidemics develop under conditions of health and social disparity. Multiple historical and present-day factors have created the syndemic conditions within which black Americans experience the lethal force of COVID-19. These factors include racism and its manifestations (e.g., chattel slavery, mortgage redlining, political gerrymandering, lack of Medicaid expansion, employment discrimination, and health care provider bias). Improving racial disparities in COVID-19 will require that we implement policies that address structural racism at the root of these disparities.

Keywords: Black Americans; COVID-19; HIV; Health disparities; Syndemic theory.

MeSH terms

  • African Americans*
  • Betacoronavirus
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / ethnology*
  • Health Status Disparities*
  • Healthcare Disparities / ethnology*
  • Humans
  • Pandemics
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / ethnology*
  • Racism
  • SARS-CoV-2
  • Socioeconomic Factors
  • Syndemic*
  • United States / epidemiology