The COVID-19 pandemic disproportionately impacted the Black community in the United States, exacerbating existing health disparities. This study investigated the risk and protective factors affecting residents of Miami Gardens, a predominantly Black city in Florida, during the pandemic. The study's importance lies in addressing the critical need to understand the unique challenges faced by this community and to inform the development of targeted public health interventions. The high morbidity and mortality rates associated with COVID-19, coupled with its significant economic and mental health consequences, necessitated a closer examination of the pandemic's impact on racial minority groups. Black Americans, comprising approximately 12.4% of the US population, accounted for about 23% of reported COVID-19 cases, highlighting a significant disparity. This disproportionate impact underscores the urgent need for research that goes beyond broad generalizations about the Black population and instead considers the nuances and heterogeneities within this community. The researchers intended to explore the intersection of systemic factors, such as socioeconomic disparities, structural racism, and healthcare access, with the lived experiences of Miami Gardens residents to unravel the complex determinants of COVID-19 vulnerability within this population. By studying Miami Gardens, a predominantly Black municipality, they sought to provide valuable insights into the specific vulnerabilities within this community and inform public health strategies focused on health equity.

Existing literature demonstrates a strong link between COVID-19 racial health disparities and various structural disadvantages faced by Black communities. These include inequities in healthcare access, economic deprivation, poor quality of life, and higher prevalence of pre-existing health conditions. The Social Determinants of Health framework provides a useful lens for understanding these disparities. Black communities experience a higher burden of chronic diseases (heart disease, high blood pressure, diabetes, etc.), factors that increase COVID-19 severity. Socioeconomic factors, such as lower income, lack of health insurance, and residence in disadvantaged neighborhoods, further compound these risks. Systemic racism, including residential segregation and biased healthcare practices, contributes to mistrust of the healthcare system and impacts healthcare utilization. The challenge of social distancing in densely populated areas and occupational roles as essential workers also increase risk exposure for Black individuals. The minority stress model explains the higher prevalence of psychosocial stress among marginalized groups due to racial classification and the cumulative impact of stressors faced by the Black community. Prior studies have noted the varied coping mechanisms used by Black communities to address racism, but the pandemic's impact on these mechanisms has not been fully understood. Existing literature pointed to the need to consider both racial disparities and the heterogeneity within Black communities to understand the varying degrees of impact during the pandemic. Previous studies frequently lacked attention to specific ethnic subgroups like Afro-Caribbeans within the broader Black American population. This highlights the limitations of generalizing about the experiences of all Black individuals, underscoring the need for a more nuanced approach that takes into consideration the diversity of this group.

The study employed a mixed-methods approach, collecting quantitative and qualitative data from an anonymous online survey of 83 residents of Miami Gardens, Florida, between late January and early February 2021. Convenience and snowball sampling techniques were utilized. QuestionPro, an online survey platform, hosted the survey, which included 54 closed-ended questions covering sociodemographics, protective measures, COVID-19 infection and vaccination history, health behaviors, and assistance needs, along with one open-ended question for additional comments. Data analysis involved descriptive statistics using SPSS 27 for quantitative data to explore differences between Black and non-Black participants and within Black participants (Black Americans vs. Afro-Caribbeans) regarding risk exposure, protective measures, and COVID-19 experiences. A machine learning (ML) approach, using four feature selectors in Weka software (ReliefF, Correlation Ranking, ZeroR, Correlation-based), was used to identify critical variables distinguishing the two racial groups. The ensemble method was employed to combine results from these selectors and rank features. Thematic analysis was performed on qualitative data to identify recurring themes and patterns in participants' comments on the pandemic's impact. The study's sample size of 83 participants was relatively small, limiting the capacity for detailed between- and within-group comparisons. This methodological approach was chosen to provide a comprehensive understanding of both the quantitative and qualitative aspects of the pandemic's influence on the Miami Gardens community. Combining statistical analysis with machine learning techniques allowed the researchers to identify important predictors and patterns in their data, improving the study's analytical power. The open-ended question also provided valuable qualitative context, enriching the data and adding depth to the findings.

The study's sociodemographic characteristics revealed a sample primarily comprising Black (83.1%) participants, with 23.8% identifying as Afro-Caribbean. Black participants engaged more frequently in activities increasing their COVID-19 risk (attending gatherings, dining out, etc.) compared to non-Black participants. Afro-Caribbean participants showed a higher propensity to frequent tourist locations, whereas Black Americans were less inclined to work remotely. Conversely, Black participants exhibited a higher prevalence of adopting protective measures (handwashing, social distancing, quarantine). However, Black participants, particularly Afro-Caribbeans, had higher rates of COVID-19 infection and household members testing positive. Vaccination rates and attitudes revealed that Blacks were less likely to plan vaccination, more inclined to refuse it, and were more undecided, despite experiencing higher infection rates. Black participants indicated a greater need for employment, mental health, housing, and childcare assistance than non-Black participants. Interestingly, despite the higher infection rates and needs, Black participants expressed fewer negative emotions (anxiety, fear, anger) but more indifference and loneliness compared to non-Black participants. Machine learning analysis identified "washing hands regularly" (both for self and others) and "working from home" as key variables differentiating Black and non-Black participants. The ML model also highlighted differences in weight gain, indifference levels, and receipt of childcare assistance between the two groups. Qualitative data corroborated findings, with some participants expressing resilience and gratitude, while others highlighted needs for assistance and vaccines.

The study findings directly address the research question by demonstrating significant racial and ethnic disparities in COVID-19 risk exposure, infection rates, access to services, and mental health resilience among Miami Gardens residents. The higher rates of COVID-19 infection among Black residents, particularly Afro-Caribbeans, despite higher adoption of protective measures, point to the complex interplay of social determinants of health. Occupational segregation, hindering access to remote work, and the challenges of social distancing in close-knit communities, further highlight these disparities. The greater need for various types of assistance expressed by Black participants, particularly Black Americans, underscores the impact of socioeconomic vulnerabilities on their ability to cope with the pandemic. The unexpected finding of lower negative emotion reporting but higher indifference and loneliness among Black participants merits further investigation. Their high social connectedness and utilization of Afro-cultural coping mechanisms, such as faith-based support, might have contributed to their resilience. However, the lower vaccination rates and hesitancy among Black individuals warrant interventions to increase trust and address misinformation. The study significantly contributes to the literature by considering the heterogeneity within the Black community and offering insights for culturally sensitive interventions.

This study provides valuable insights into the racial and ethnic disparities in COVID-19 outcomes and support needs within the Miami Gardens community. The findings demonstrate the complex interplay of social determinants of health, occupational segregation, and cultural factors influencing vulnerability to the virus. Future research should focus on larger, more representative samples, including detailed information on nativity and immigration status to better understand the heterogeneity within the Black community. The study's findings can inform the development of targeted, culturally sensitive interventions to reduce health disparities and address the unique needs of this population, thereby contributing to health equity.

The study's relatively small sample size and convenience sampling method limit the generalizability of the findings. The reliance on self-reported data introduces potential bias (social desirability and recall bias). Further research with larger, more representative samples, including detailed information on nativity and immigration status, is necessary to confirm and expand upon these findings. The lack of data on specific coping mechanisms employed by participants is another limitation. Future studies should explore this dimension to gain a more complete understanding of the community's resilience strategies during the pandemic.