# Understanding the COVID-19, Racism, and Violence Syndemic and its Effects on COVID-19 Testing Disparities

> **NIH NIH R21** · MEDICAL COLLEGE OF WISCONSIN · 2021 · $470,715

## Abstract

Project Summary
Black communities in the US are experiencing three converging public health crises: COVID-19, systemic
racism, and community and police violence. Black Americans are significantly less likely to receive a needed
COVID-19 test and have higher rates of COVID-19 infection and death than white Americans. Additionally,
Black communities have experienced a surge in gun violence in 2020 and continue to be victims of police
harassment and violence, resulting in large-scale social justice demonstrations. The convergence of these
epidemics has created a syndemic, wherein racism, violence, and COVID-19 cluster in predominantly Black
and low-income communities. The proposed study aims to characterize this syndemic to understand how
personal and systemic racism and violence in Black communities may influence COVID-19 testing decisions.
This mixed-method study with Black residents of Chicago, IL will result in community-driven recommendations
to enhance COVID-19 testing and prevention strategies and address this emerging syndemic. We will examine
the potential mediating pathways of medical mistrust, psychological trauma and stress, and economic injustice.
Additionally, we will take a strengths-based approach to understand potential protective factors including
neighborhood cohesion, social support, and access to health care. The specific aims of the study are to: 1)
Qualitatively examine how experiences of racial discrimination, community violence, and police violence
influence trust in and engagement with healthcare systems and contribute to decisions around COVID-19
testing and mitigation strategies (e.g. social distancing) among Black individuals in Chicago (N=50); 2)
Quantitatively assess the prevalence and correlates of COVID-19 testing among Black residents in Chicago (N
= 500) and characterize the COVID-19, racism, and violence syndemic; and 3) In partnership with a
Community Advisory Council, use an integrative translational workshop approach and intervention mapping
techniques to develop community and data-driven recommendations and an intervention blueprint for local
health departments, researchers, and public health organizations to improve COVID-19 testing among Black
Americans. This study will result in policy and research recommendations, community resources, and a
‘shovel-ready’ intervention blueprint to enhance COVID-19 testing and address this emerging syndemic.

## Key facts

- **NIH application ID:** 10253208
- **Project number:** 3R21MH122010-01S1
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Katherine G Quinn
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $470,715
- **Award type:** 3
- **Project period:** 2020-05-01 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10253208

## Citation

> US National Institutes of Health, RePORTER application 10253208, Understanding the COVID-19, Racism, and Violence Syndemic and its Effects on COVID-19 Testing Disparities (3R21MH122010-01S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10253208. Licensed CC0.

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