The Structure of Pandemic Vulnerability: Housing Wealth, Residential Segregation, and COVID-19 Mortality

Abstract

Abstract The COVID-19 pandemic has been particularly devastating for those with limited economic resources. Extensive research demonstrates the negative relationship between wealth and mortality at both the individual and area levels. In addition, residential segregation has been linked to poor health and greater mortality. Home equity is the largest asset that many Americans own, but residential segregation devalues homes located in Black neighborhoods. Despite the interlocking relationships between wealth, residential segregation, and mortality, it remains unclear how wealth and residential segregation work to predict COVID-19 deaths. Using U.S. Census data and county-level COVID-19 data from Johns Hopkins University ( n = 1164), I deploy median home value as a wealth proxy and negative binomial regression models to interrogate two questions. (1) What is the relationship between home value and COVID-19 deaths? (2) How does the relationship vary by level of residential segregation? Results indicate that COVID-19 mortality is 64 percent greater in the lowest wealth counties than in the wealthiest counties. At average median home value, the most segregated counties with the largest Black populations suffer 28 percent more COVID-19 deaths than similarly situated counties with low levels of residential segregation and small Black populations. This study underscores the importance of accounting for residential segregation in examinations of the well-established relationship between socioeconomic status and health and mortality.