"Do I Have to Be Tested?": Understanding Reluctance to Be Screened for COVID-19

Widespread severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing by public health systems is widely acknowledged as necessary. Many communities distrust these systems, however, given their histories of racist treatment1 and their current roles in perpetuating inequities in health outcomes. Those outcomes are driven by both racial and class inequities beyond public health systems and exacerbated by economic barriers to and discrimination within health care. Racialized inequities are further exacerbated by America's immigration policies and practices. Together, these dynamics explain the disproportionately higher COVID-19 mortality rates in Black and Latinx communities. To understand and address why members of minority communities might decline testing, then, we must situate the pandemic and the public health responses to it within both the ethno-racial dynamics of everyday life in America and the racialized state (in)actions in the face of emergencies. The current pandemic is the latest emergency inordinately affecting American communities of color. These emergencies are often described as natural disasters, but their inequitable effects reflect the social organization of "normal" life.