Abstract
BACKGROUND: Mask wearing has varied considerably throughout the COVID-19 pandemic and has been most often associated with political affiliation and specific health beliefs. The purpose of this study was to determine the relationship between mask usage, neighborhood racial segregation, and racial disparities in COVID-19 deaths. METHODS: We used linear regression to assess whether the racial/ethnic composition of deaths and residential segregation predicted Americans' decisions to wear masks in July 2020. RESULTS: After controlling for mask mandates, mask usage increased when White death rates relative to Black and Hispanic rates increased. CONCLUSIONS: Mask wearing may be shaped by an insensitivity to Black and Hispanic deaths and a corresponding unwillingness to engage in health-protective behaviors. The broader history of systemic racism and residential segregation may also explain why white Americans do not wear masks or perceive themselves to be at risk when communities of color are disproportionately affected by COVID-19.