The visibility of Black-White disparities in overall rates of COVID-19 infection and mortality have become central to the national conversation of COVID-19. In explaining these inequalities, medical science underscores the heightened prevalence of pre-existing health conditions or “comorbidities” among disproportionately impacted groups, often employing the language of genetics and biologic predisposition while ignoring the role of allostatic load and the social determinants of health. In response, we historicize the confluence of structural forces that strongly shape where many African-Americans live, learn, work, and play (i.e., the disinvested urban center). We then identify how the structured conditions of hyper-segregated, urban life result in the elevated prevalence of underlying COVID-19 comorbidities in Black urban communities. In doing this we: (i) challenge the usefulness of biogenetic explanations for the COVID-19 racial death gap, (ii) counter racialized stereotypes that blame the victims of structurally induced health disparities, and (iii) contribute to the health disparities and racial legacies literatures.
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