"Roughly one in five U.S. counties are disproportionately black and they accounted for five of ten COVID-19 diagnoses and nearly six of ten COVID-19 deaths nationally. Greater health disparities in places with a greater concentration of black Americans are not unique to COVID-19. Similar patterns have been reported for other conditions such as HIV, air pollution, cancer, and low birth weight and may be derived from the fact that in the United States, race often determines place of residence. Ninety-one percent of disproportionately black counties in these analyses are located in the southern United States—a region where most black Americans reside (58%) that also ranks highest in unemployment, uninsurance, and limited health system capacity or investment. These deficits are underscored by the finding that COVID-19 deaths in disproportionally black counties occurred at higher rates in rural and small metro counties. Higher county-level unemployment was associated with fewer COVID-19 diagnoses. Employment presumably increases the likelihood of exposure to COVID-19, and this might differentially impact black Americans because only one in five black Americans have an occupation that permits working from home. Furthermore, black Americans are overly represented in jobs that require both travel and regular interaction with the public, which can increase exposure to the virus, such as in the service industry (e.g., grocery store clerks, cashiers), transportation (e.g., bus drivers, subway train conductors), and health care (e.g., nurses, medical aides, home health-care workers). Being an ‘essential worker’ during the COVID-19 crisis carries risk, which is borne out in recent reports: CDC reported that over 9000 health-care workers nationwide have acquired COVID-19 and that black health-care workers were disproportionately impacted (21% of infections; 13% of the population). Likewise, a report of New York City transit workers found more than 2000 cases of COVID-19 and 50 deaths in a workforce that is 40% black, despite the black community comprising only a quarter of the New York City population."