{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:52:16Z","timestamp":1789523536694,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In 2020, early U.S. COVID\u201019 testing sites offered diagnostic capacity to patients and were important sources of epidemiological data about the spread of the novel pandemic disease. However, little research has comprehensively described American testing sites\u2019 distribution by race\/ethnicity and sought to identify any relation to known disparities in COVID\u201019 outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Locations of U.S. COVID\u201019 testing sites were gathered from 16 April to 28 May 2020. Geographic testing disparities were evaluated with comparisons of the demographic makeup of zip codes around each testing site versus Monte Carlo simulations, aggregated to statewide and nationwide levels. State testing disparities were compared with statewide disparities in mortality observed one to 3\u00a0weeks later using multivariable regression, controlling for confounding disparities and characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nationwide, COVID\u201019 testing sites geographically overrepresented White residents on 7 May, underrepresented Hispanic residents on 16 April, 7 May and 28 May and overrepresented Black residents on 28 May compared with random distribution within counties, with new sites added over time exhibiting inconsistent disparities for Black and Hispanic populations. For every 1 percentage point increase in underrepresentation of Hispanic populations in zip codes with testing, mortality among the state's Hispanic population was 1.04 percentage points more over\u2010representative (SE\u00a0=\u00a00.415, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>American testing sites were not distributed equitably by race during this analysis, often underrepresenting minority populations who bear a disproportionate burden of COVID\u201019 cases and deaths. With an easy\u2010to\u2010implement measure of geographic disparity, these results provide empirical support for the consideration of access when distributing preventive resources.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13669","type":"journal-article","created":{"date-parts":[[2021,8,14]],"date-time":"2021-08-14T13:08:01Z","timestamp":1628946481000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Racial and ethnic inequities in the early distribution of U.S. COVID\u201019 testing sites and mortality"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8530-7516","authenticated-orcid":false,"given":"Nathan P.","family":"Dalva\u2010Baird","sequence":"first","affiliation":[{"name":"Department of Humanities and Sciences Stanford University Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4360-0658","authenticated-orcid":false,"given":"Wilson M.","family":"Alobuia","sequence":"additional","affiliation":[{"name":"Department of Surgery Stanford University School of Medicine Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8364-4711","authenticated-orcid":false,"given":"Eran","family":"Bendavid","sequence":"additional","affiliation":[{"name":"Department of Medicine Center for Health Policy and the Center for Primary Care and Outcomes Research Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3867-3174","authenticated-orcid":false,"given":"Jay","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Department of Medicine Center for Health Policy and the Center for Primary Care and Outcomes Research Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,27]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Centers for Disease Control and Prevention.Cases of Coronavirus Disease (COVID\u201019) in the U.S.Published online 2020.https:\/\/www.cdc.gov\/coronavirus\/2019\u2010ncov\/cases\u2010updates\/cases\u2010in\u2010us.html"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2020.05.003"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-06081-w"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdaa070"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-020-00468-0"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2020.07.007"},{"key":"e_1_2_8_8_1","first-page":"w20225","article-title":"COVID\u201019 epidemic in Switzerland: on the importance of testing, contact tracing and isolation","volume":"150","author":"Marcel S","year":"2020","journal-title":"Swiss Med Wkly"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.20-0216"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-020-00461-z"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/M20-3936"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2139\/ssrn.3572329"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2020.06.005"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0361198105192400110"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3549(04)50068-7"},{"key":"e_1_2_8_16_1","article-title":"\u2018We\u2019re behind the curve\u2019: U.S. hospitals confront the challenges of large\u2010scale coronavirus testing","author":"Cohen J","year":"2020","journal-title":"Science"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jtm\/taaa076"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.188029"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17249528"},{"key":"e_1_2_8_20_1","unstructured":"CaballeroJ KemendoA DiMarcoA Coders Against COVID. 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