Racial Income Inequality and COVID-19 Burden in Louisiana: A Spatial Analysis of Public Health Disparities

Abstract: Background. Louisiana has experienced one of the highest COVID-19 burdens in the United States. This article investigates the geospatial pattern of COVID-19 in Louisiana using the perspective of racial capitalism. Methods. Using data from the Louisiana Department of Health and the American Community Survey, we employed spatial autoregressive models to assess how racial income inequality between White and Black residents was connected to COVID-19 case rates in Louisiana parishes, controlling for other parish-level characteristics. Results. When a parish was characterized by greater White–Black income inequality, there was a higher risk of COVID-19 in the state of Louisiana. The relationship is primarily attributable to conditions in parishes with greater racial income inequality, rather than to the diffusion of COVID-19 cases across parish boundaries. Conclusions. Racial and socioeconomic inequity is an ecological driver associated with the COVID-19 burden in Louisiana. Based on Louisiana’s historical and sociocultural contexts, implications are further discussed.