Apollo's Arrow: The Profound and Enduring Impact of Coronavirus on the Way We Live

by Nicholas A. Christakis MD PhD

This issue of controlling for other attributes that vary across groups in turn raises the issue of what statisticians call a causal model. If one adjusts for where people live, their wealth, their occupations, and their chronic health conditions, it’s true that the “effect” of race may disappear or be minimized. But what does this really mean? On the one hand, we could take this parsing of COVID-19 data to be good news because it means that there is no net effect of race—that racial difference is simply a red herring, and the real difference relates to the differential prevalence of health conditions or variation in the nature of occupations and so on. On the other hand, if in fact the way our society is structured ensures that ethnicity and race are associated with worse outcomes in these social factors, then adjusting for those factors and concluding that race has no effect is precisely the wrong thing to do. When I teach about these issues in my undergraduate classes, I observe that dismissing racial differences in health outcomes on the grounds of their being mediated by other factors is a bit like saying that, after adjusting for the quality of ingredients, the ambience, the sophistication of the menu, and the existence of a good wine list, there is no difference between a meal at McDonald’s and a meal at the fanciest restaurant in New York City.