How Residential Segregation Moderates the Association Between Racial/Ethnic Composition and COVID-19 Vaccination Rates Across Metropolitan Counties in the US

Abstract

Purpose

Since the development of the COVID-19 vaccinations, questions surrounding race have been prominent in the literature on vaccine uptake. Early in the vaccine rollout, public health officials were concerned with the relatively lower rates of uptake among certain racial/ethnic minority groups. We suggest that this may also be patterned by racial/ethnic residential segregation, which previous work has demonstrated to be an important factor for both health and access to health care.

Methodology/Approach

In this study, we examine county-level vaccination rates, racial/ethnic composition, and residential segregation across the U.S. We compile data from several sources, including the American Community Survey (ACS) and Centers for Disease Control (CDC) measured at the county level.

Findings

We find that just looking at the associations between racial/ethnic composition and vaccination rates, both percent Black and percent White are significant and negative, meaning that higher percentages of these groups in a county are associated with lower vaccination rates, whereas the opposite is the case for percent Latino. When we factor in segregation, as measured by the index of dissimilarity, the patterns change somewhat. Dissimilarity itself was not significant in the models across all groups, but when interacted with race/ethnic composition, it moderates the association. For both percent Black and percent White, the interaction with the Black-White dissimilarity index is significant and negative, meaning that it deepens the negative association between composition and the vaccination rate.

Research limitations/implications

The analysis is only limited to county-level measures of racial/ethnic composition and vaccination rates, so we are unable to see at the individual-level who is getting vaccinated.

Originality/Value of Paper

We find that segregation moderates the association between racial/ethnic composition and vaccination rates, suggesting that local race relations in a county helps contextualize the compositional effects of race/ethnicity.

Citation

Wolski, C., Anderson, K.F. and Rambotti, S. (2023), "How Residential Segregation Moderates the Association Between Racial/Ethnic Composition and COVID-19 Vaccination Rates Across Metropolitan Counties in the US", Kronenfeld, J.J. (Ed.) Social Factors, Health Care Inequities and Vaccination (Research in the Sociology of Health Care, Vol. 40), Emerald Publishing Limited, Leeds, pp. 3-24. https://doi.org/10.1108/S0275-495920230000040001