COVID-19 in Racial and Ethnic Minority Groups
Factors that influence racial and ethnic minority group health
Health differences between racial and ethnic groups are often due to economic
and social conditions that are more common among some racial and ethnic
minorities than whites. In public health emergencies, these conditions can
also isolate people from the resources they need to prepare for and respond to
outbreaks.1,13, 14
Living conditions
For many people in racial and ethnic minority groups, living conditions may
contribute to underlying health conditions and make it difficult to follow
steps to prevent getting sick with COVID-19 or to seek treatment if they do
get sick.

Members of racial and ethnic minorities may be more likely to live in densely populated areas because of institutional racism in the form of residential housing segregation. People living in densely populated areas may find it more difficult to practice prevention measures such as social distancing.
Research also suggests that racial residential segregation is a fundamental cause of health disparities. For example, racial residential segregation is linked with a variety of adverse health outcomes and underlying health conditions.2-5 These underlying conditions can also increase the likelihood of severe illness from COVID-19.
Many members of racial and ethnic minorities live in neighborhoods that are further from grocery stores and medical facilities , making it more difficult to receive care if sick and stock up on supplies that would allow them to stay home.
Multi-generational households , which may be more common among some racial and ethnic minority families6, may find it difficult to take precautions to protect older family members or isolate those who are sick, if space in the household is limited.
Racial and ethnic minority groups are over-represented in jails, prisons, and detention centers , which have specific risks due to congregate living, shared food service, and more.

Work circumstances
The types of work and policies in the work environments where people in some
racial and ethnic groups are overrepresented can also contribute to their risk
for getting sick with COVID-19. Examples include:

Critical workers: The risk of infection may be greater for workers in essential industries who continue to work outside the home despite outbreaks in their communities, including some people who may need to continue working in these jobs because of their economic circumstances. 
Nearly a quarter of employed Hispanic and Black or African American workers are employed in service industry jobs compared to 16% of non-Hispanic whites.
Hispanic workers account for 17% of total employment but constitute 53% of agricultural workers; Black or African Americans make up 12% of all employed workers, but account for 30% of licensed practical and licensed vocational nurses.7


A lack of paid sick leave: Workers without paid sick leave might be more likely to continue to work even when they are sick for any reason. This can increase workers exposure to other workers who may have COVID-19, or, in turn, expose others them if they themselves have COVID-19. Hispanic workers have lower rates of access to paid leave than white non-Hispanic workers.8

Underlying health conditions and lower access to care
Existing health disparities, such as poorer underlying health and barriers to
getting health care, might make members of many racial and ethnic minority
groups especially vulnerable in public health emergencies like outbreaks of
COVID-19.

Not having health insurance: Compared to whites, Hispanics are almost 3 times as likely to be uninsured, and African Americans are almost twice as likely to be uninsured.9 In all age groups, blacks were more likely than whites to report not being able to see a doctor in the past year because of cost.10
Inadequate access is also driven by a long-standing distrust of the health care system, language barriers, and financial implications associated with missing work to receive care.
S erious underlying medical conditions : Compared to whites, black Americans experience higher death rates, and higher prevalence rates of chronic conditions.10
Stigma and systemic inequalities may undermine prevention efforts, increase levels of chronic and toxic stress, and ultimately sustain health and health care disparities.