RADx-UP project studies intersection of violence & COVID in Chicago

11.15.2022

The RADx-UP consortium gathers each month to hear program updates and presentations about community-engaged research activities across the United States, its territories, and Tribal Nations. This article recaps a recent project presentation by Katherine Quinn of the Medical College of Wisconsin.

In the spring of 2020, Black residents of Chicago faced two compounding crises. First, they were experiencing a disproportionate share of COVID-19 mortality – 75% of deaths were among Black and Latino residents, and they were clustered in the majority-Black south and west sides of the city.

Heatmap that shows African American Population by Census Tract in Chicago, IL (2017).

And the disproportionate death toll wasn’t ending with COVID-19; neighborhood and police violence were impacting Black communities, as well. In June, 80% of firearm-related death victims in Chicago were Black – and exposure to violence can negatively impact the mental health of the next generation.

It was the culmination of these events that prompted VOICES: The Violence and COVID Equity Study. Katherine Quinn and her team at the Medical College of Wisconsin sought to investigate what they called the COVID-19 Racism and Violence Syndemic.

Syndemics, Quinn explained, occur when two or more epidemics interact and mutually reinforce the adverse health outcomes of the other. Though syndemics is a term more commonly used in a biomedical context, Quinn’s team recognized racism and violence as epidemics, contributing to the disparities in COVID-19 outcomes and vaccination rates. They sought to understand how racism, violence, mental health, and other social and structural factors may influence COVID-19 vaccination disparities in Chicago.

Graphic that shows the definition of "syndemic: the clustering and synergistic interaction of two or more epidemics that exacerbate adverse health outcomes."

STUDY FINDINGS

The data from both the surveys and the interviews are still being assessed, but preliminary interview analyses identified four primary themes:

There is a prominent intersection of racism and violence in Chicago
Longstanding structural inequities in the city were laid bare by COVID-19
The pervasiveness of racism and violence contributes to poor mental health
COVID-19, racism, and violence interact to create syndemic conditions

Quinn highlighted several quotes from participants that spoke to structural inequity in Chicago, a lack of trust in the government and healthcare, and the distress caused by exposure to violence.

“I think these…excerpts really start to shed light on how much the violence and mistreatment reverberate through communities contributing to this toxic chronic stress, anxiety, and depression,” Quinn said.

The preliminary survey results indicated something similar. Neighborhood violence and interpersonal racism were both associated with an increase in medical mistrust – especially in regard to COVID-19 information – and an increase in depressive symptoms. Police violence was associated with an increase in depressive symptoms, as well.

CONCLUSIONS AND LESSONS LEARNED

These preliminary analyses suggest that racism and neighborhood violence indirectly influence COVID-19 vaccination. And they do so through proxies, such as medical mistrust and distrust of COVID-related information.

“We cannot think about and talk about and address the disparities in COVID without acknowledging and addressing some of the larger barriers and larger structural challenges that many communities – not just Chicago – are experiencing,” Quinn said.

Going forward, public health efforts must consider related social and structural inequities, Quinn said. And ongoing efforts to increase COVID-19 vaccination must include community leaders in order to reduce medical mistrust.