LAUSR

The COVID-19 pandemic is not the first pandemic in which we have witnessed health inequities [1], whether it will be the last is dependent on how well we identify, understand, and address the fundamental causes of these inequities. Few studies have examined the association between fundamental causes of health inequities, such as structural racism, and COVID-19 health outcomes. These studies have found that greater racial residential segregation, a measure of structural racism, is associated with higher county-level case and mortality rates [2 4]. However, even fewer studies have examined the ways in which structural racism influences the ability to prevent these outcomes. In this issue of EClinicalMedicine, White and colleagues [5] begin to address this gap in the literature by reporting their findings of a national study in the United States of the association between racial residential segregation and social mobility under different mobility-related government policies: lockdown orders and reopening. The results of their longitudinal analysis were that county-level racial residential segregation was associated with decreased social mobility under lockdown orders and slightly increased social mobility after reopening. These results have important policy implications, given that social mobility is associated with increased risk of COVID-19 transmission. The authors speculate that increased social mobility may lead to increased risk of COVID-19 health outcomes among Black people, although, they were unable to directly demonstrate this in their analysis. The use of de-identified, aggregated social mobility data precludes the ability to determine which racial groups in segregated counties may benefit from reduced social mobility during lockdown orders or may be harmed when social mobility increases after reopening. Improving the measurement of social mobility disaggregated by sociodemographic factors, including race, is an important next step. While White and colleagues [5] are to be applauded for taking on this important topic and complex analysis, more research is urgently