Black Americans have been disproportionately affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) pandemic. Since the pandemic’s start, we have observed compounded health, social, and economic impacts for communities of color, fueled in part by profound residential segregation in the United States that, for centuries prior to the pandemic, created differences in access to opportunity and resources. Based on a longitudinal cohort of Black residents living in two racially isolated Pittsburgh neighborhoods, we sought to: 1) describe the experiences of behavioral responses to COVID-19 conditions (e.g., closures of businesses, schools, government offices) and illness experiences reported by residents within these disinvested, urban areas and 2) determine if these experiences were associated with perceptions of risk, negative mental health outcomes, and food insecurity; and 3) examine whether any of the associations were explained by social isolation or modified by neighborhood walkability. We found direct associations between residents’ experience with COVID-19-related closures and with the illness, with perceived risk, and change in psychological distress, sleep quality, and food insecurity from pre-COVID-19 levels. Social isolation was a statistically significant mediator of all of these associations, most strongly mediating the pathway to psychological distress. We found neighborhood walkability to be a significant moderator of the association between closure experiences and sleep quality. The results suggest that experiences of COVID-19 closures and illness were associated with serious threats to public health in Black, disinvested, urban neighborhoods, beyond those caused directly by the virus. Outcomes of the pandemic appear very much dependent on the extent to which social and physical resources are available to meet the demands of stress.

美国黑人受到严重急性呼吸系统综合症冠状病毒 2（SARS-CoV-2 或 COVID-19）大流行的影响尤为严重。自大流行开始以来，我们观察到对有色人种社区的健康、社会和经济的复合影响，部分原因是美国严重的居住隔离在大流行之前的几个世纪里造成了机会和资源获取方面的差异。基于居住在匹兹堡两个种族隔离社区的黑人居民的纵向队列，我们​​试图：1) 描述对 COVID-19 情况（例如，企业、学校、政府办公室关闭）的行为反应经历和报告的疾病经历这些被撤资的城市地区的居民，以及 2) 确定这些经历是否与风险认知相关，负面的心理健康结果和粮食不安全；和 3) 检查是否有任何关联可以用社会隔离来解释或由邻里步行性修改。我们发现居民与 COVID-19 相关关闭的经历与疾病、感知风险以及心理困扰、睡眠质量和食品不安全从 COVID-19 之前水平的变化之间存在直接关联。社会孤立是所有这些关联的统计显着调解者，最强烈地调解了心理困扰的途径。我们发现邻里步行能力是封闭体验与睡眠质量之间关联的重要调节因素。结果表明，COVID-19 关闭和疾病的经历与黑人、投资减少的城市社区对公共健康的严重威胁有关，除了那些直接由病毒引起的。大流行的结果似乎在很大程度上取决于社会和物质资源可用于满足压力需求的程度。