Inequities in the social determinants of health-income and wealth, health-care access and utilization, education, occupation, discrimination, and housing-are interrelated and put some racial and ethnic minority groups at increased risk of contracting and dying from COVID-19 (Centers for Disease Control and Prevention 2020c). The COVID-19 crisis has also had differential impacts among various racial and ethnic groups. The Southeast, Southwest, and Far West regions all experienced their peaks at the end of July and first week of August. COVID-19–related deaths then peaked in the New England and Rocky Mountain regions during the third week of April, followed by the Great Lakes region in the fourth week of April, and the Mideast (excluding New York and New Jersey) and the Plains regions during the first week of May.

By April 9 there had been more COVID-19–related deaths in New York and New Jersey than in the rest of the United States combined (New York Times 2020). Early on, COVID-19 cases were concentrated in coastal population centers, particularly in the Northeast, with cases in New York, New Jersey, and Massachusetts peaking in April (Desjardins 2020). region from late February to late August 2020. Figure A shows the weekly number of deaths caused by COVID-19 in each U.S. On the public health front, the spread of the virus has exhibited clear geographic trends, starting in the densely populated urban centers and then spreading to more-rural parts of the country (Desjardins 2020).

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