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Racial Capitalism within Public Health: How Occupational Settings Drive COVID-19 Disparities


McClure, Elizabeth S.; Vasudevan, Pavithra; Bailey, Zinzi D.; Patel, Snehal; & Robinson, Whitney R. (2020). Racial Capitalism within Public Health: How Occupational Settings Drive COVID-19 Disparities. American Journal of Epidemiology, 189(11), 1244-1253. PMCID: PMC7337680


Epidemiology of the U.S. COVID-19 outbreak focuses on individuals' biology and behaviors, despite centrality of occupational environments in the viral spread. This demonstrates collusion between epidemiology and racial capitalism because it obscures structural influences, absolving industries of responsibility for worker safety. In an empirical example, we analyze economic implications of race-based metrics widely used in occupational epidemiology. In the U.S., White adults have better average lung function and worse hearing than Black adults. Both impaired lung function and hearing are criteria for Worker's compensation, which is ultimately paid by industry. Compensation for respiratory injury is determined using a race-specific algorithm. For hearing, there is no race adjustment. Selective use of race-specific algorithms for workers' compensation reduces industries' liability for worker health, illustrating racial capitalism operating within public health. Widespread and unexamined belief in inherent physiological inferiority of Black Americans perpetuates systems that limit industry payouts for workplace injuries. We see a parallel in the epidemiology of COVID-19 disparities. We tell stories of industries implicated in the outbreak and review how they exemplify racial capitalism. We call on public health professionals to: critically evaluate who is served and neglected by data analysis; and center structural determinants of health in etiological evaluation.


Reference Type

Journal Article

Year Published


Journal Title

American Journal of Epidemiology


McClure, Elizabeth S.
Vasudevan, Pavithra
Bailey, Zinzi D.
Patel, Snehal
Robinson, Whitney R.




United States of America