COVID-19-related state-wise racial and ethnic disparities across the USA: an observational study based on publicly available data from The COVID Tracking Project (original) (raw)
Related papers
medRxiv, 2020
Objectives: To evaluate COVID-19 infection and mortality in ethnic and racial sub-groups across all states in the United States. Methods: Publicly available data from The COVID Tracking Project at The Atlantic was accessed between 09/09/2020 and 09/14/2020. For each state and the District of Columbia, % infection, % death, % population proportion for subgroups of race (African American (AA), Asian, American Indian or Alaska Native, (AI/AN) and White), and ethnicity (Hispanic/Latino, and non-Hispanic), were recorded. Absolute and relative excess infection (AEI and REI) and mortality (AEM and REM) were computed as absolute and relative difference between % infection or % mortality and % population proportion for each state. Median (IQR) REI is provided below. Results: The Hispanic population had a median of 158% higher COVID-19 infection relative to their % population proportion (median REI 158%, [IQR: 100% to 200%]). This was followed by AA, with 50% higher COVID-19 infection relativ...
Ethnicity & Health, 2020
Objectives: The objective of this study was to investigate potential county-level disparities among racial/ethnic and socioeconomic groups in confirmed COVID-19 cases and deaths in the United States in 100,000 population. Design: Secondary data analysis using county-level data for 3,142 US counties was conducted in 2020. Hierarchical linear regression and concentration curve analyses were performed. The combined association of COVID-19 cases and deaths was examined separately by the county population's socioeconomic characteristics. Data from the American Community Survey (ACS) 5-year estimates (2014–2018), Area Health Resources File (AHRF) 2018–2019, Kaiser Health News 2020, and 2020 COVID-19 data from Johns Hopkins University were used in this study. Results: After adjusting for covariates, U.S. counties with a higher proportion of the Black population and a higher proportion of adults with less than a high school diploma had disproportionately higher COVID-19 cases and deaths (β > 0, p<0.05 for all relations). A higher proportion of the Hispanic population was associated with higher confirmed cases (β = 0.68, 95% CI = 0.48–0.87). The majority observed disparities in COVID-19 deaths persisted even after controlling for all-cause deaths in 2019 and COVID-19 cases per 100,000 county population. This can potentially aggravate the existing health disparities among these population groups. Conclusions: Identification of disproportionately impacted population groups can pave the way towards narrowing the disparity gaps and guide policymakers and stakeholders in designing and implementing population group-specific interventions to mitigate the negative consequences of the COVID-19 pandemic.
Racial/Ethnic Disparities in the Observed COVID-19 Case Fatality Rate Among the U.S. Population
2022
PurposeDuring the initial 12 months of the pandemic, racial and ethnic disparities in COVID-19 death rates received considerable attention but it has been unclear whether disparities in death rates were due to disparities in case fatality rates (CFRs), incidence rates or both. We examined differences in observed COVID-19 case fatality rates (CFRs) between U.S. Whites, Blacks/African Americans and Latinx during this period.MethodsUsing data from the COVID Tracking Project (CTP) and the CDC’s COVID-19 Case Surveillance Public Use dataset, we calculated CFR ratios comparing minority groups to Whites, both overall and separately by age group. We also used a model of monthly COVID-19 deaths to estimate CFR ratios, adjusting for age, gender, and differences across states and time.ResultsOverall Blacks and Latinx had lower CFRs than Whites. However, when adjusting for age, Blacks and Latinx had higher CFRs than Whites among those younger than 65. CFRs varied substantially across states and...
Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates
PLOS ONE, 2022
Background Racial inequities in Coronavirus 2019 (COVID-19) have been reported over the course of the pandemic, with Black, Hispanic/Latinx, and Native American individuals suffering higher case rates and more fatalities than their White counterparts. Methods We used a unique statewide dataset of confirmed COVID-19 cases across Missouri, linked with historical statewide hospital data. We examined differences by race and ethnicity in raw population-based case and mortality rates. We used patient-level regression analyses to calculate the odds of mortality based on race and ethnicity, controlling for comorbidities and other risk factors. Results As of September 10, 2020 there were 73,635 confirmed COVID-19 cases in the State of Missouri. Among the 64,526 case records (87.7% of all cases) that merged with prior demographic and health care utilization data, 12,946 (20.1%) were Non-Hispanic (NH) Black, 44,550 (69.0%) were NH White, 3,822 (5.9%) were NH Other/Unknown race, and 3,208 (5.0%...
MMWR. Morbidity and Mortality Weekly Report, 2021
On March 24, 2021, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Long-standing systemic social, economic, and environmental inequities in the United States have put many communities of color (racial and ethnic minority groups) at increased risk for exposure to and infection with SARS-CoV-2, the virus that causes COVID-19, as well as more severe COVID-19-related outcomes (1-3). Because race and ethnicity are missing for a proportion of reported COVID-19 cases, counties with substantial missing information often are excluded from analyses of disparities (4). Thus, as a complement to these case-based analyses, population-based studies can help direct public health interventions. Using data from the 50 states and the District of Columbia (DC), CDC identified counties where five racial and ethnic minority groups (Hispanic or Latino [Hispanic], non-Hispanic Black or African American [Black], non-Hispanic Asian [Asian], non-Hispanic American Indian or Alaska Native [AI/AN], and non-Hispanic Native Hawaiian or other Pacific Islander [NH/PI]) might have experienced high COVID-19 impact during April 1-December 22, 2020. These counties had high 2-week COVID-19 incidences (>100 new cases per 100,000 persons in the total population) and percentages of persons in five racial and ethnic groups that were larger than the national percentages (denoted as "large"). During April 1-14, a total of 359 (11.4%) of 3,142 U.S. counties reported high COVID-19 incidence, including 28.7% of counties with large percentages of Asian persons and 27.9% of counties with large percentages of Black persons. During August 5-18, high COVID-19 incidence was reported by 2,034 (64.7%) counties, including 92.4% of counties with large percentages of Black persons and 74.5% of counties with large percentages of Hispanic persons. During December 9-22, high COVID-19 incidence was reported by 3,114 (99.1%) counties, including >95% of those with large percentages of persons in each of the five racial and ethnic minority groups. The findings of this population-based analysis complement those of case-based analyses. In jurisdictions with substantial missing race and ethnicity information, this method could be applied to smaller geographic areas, to identify communities of color that might be experiencing high potential COVID-19 impact. As areas with high rates of new infection change over time, public health efforts can be tailored to the needs of communities of * Aggregate county-level case counts were downloaded through HHS Protect (accessed January 26, 2021).
Differential Impact of COVID-19 Risk Factors on Ethnicities in the United States
Frontiers in Public Health, 2021
The coronavirus disease (COVID-19) has revealed existing health inequalities in racial and ethnic minority groups in the US. This work investigates and quantifies the non-uniform effects of geographical location and other known risk factors on various ethnic groups during the COVID-19 pandemic at a national level. To quantify the geographical impact on various ethnic groups, we grouped all the states of the US. into four different regions (Northeast, Midwest, South, and West) and considered Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Hispanic, Non-Hispanic Asian (NHA) as ethnic groups of our interest. Our analysis showed that infection and mortality among NHB and Hispanics are considerably higher than NHW. In particular, the COVID-19 infection rate in the Hispanic community was significantly higher than their population share, a phenomenon we observed across all regions in the US but is most prominent in the West. To gauge the differential impact of comorbidities on differen...
Provisional COVID-19 Age-Adjusted Death Rates, by Race and Ethnicity — United States, 2020–2021
Morbidity and Mortality Weekly Report, 2022
On April 22, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Disparities in COVID-19 death rates by race and ethnicity have been reported in the United States (1,2). In response to these disparities, preventive, medical care, and social service assistance programs were implemented to lessen disparities in COVID-19 outcomes, including grants to support state, tribal, local, and territorial health department responses (3). The potential impact of such efforts on annual changes in racial and ethnic disparities in mortality rates that identify COVID-19 as the underlying cause of death has not been previously reported. This analysis used U.S. provisional mortality data from death certificates collected by CDC's National Vital Statistics System (NVSS) to estimate changes in COVID-19-related age-adjusted death rates (AADRs) by race and ethnicity during 2020-2021. Compared with non-Hispanic multiracial persons (the group with the lowest death rate), significant decreases in AADR ratios occurred during 2020-2021 among non-Hispanic American Indian or Alaska Native (AI/AN) persons (34.0%), non-Hispanic Asian (Asian) persons (37.6%), non-Hispanic Black or African American (Black) persons (40.2%), Hispanic persons (37.1%), and non-Hispanic White (White) persons (14%); a non-statistically significant 7.2% increase in AADR ratio occurred among non-Hispanic Native Hawaiian or other Pacific Islander (NH/OPI) persons. Despite reductions in AADR disparities from 2020 to 2021, large disparities in AADR by race and ethnicity remained in 2021. Providing effective preventive interventions, including vaccina tion and clinical care, to all communities in proportion to their need for these interventions is necessary to reduce racial and ethnic disparities in COVID-19 deaths. CDC WONDER* mortality data from 2020 (final) and 2021 (provisional) reported to NVSS as of February 6, 2022, was used to assess annual changes in COVID-19 deaths among U.S. residents of any age during January 2020-December 2021. Cause of death codes from the International Classification of Diseases, Tenth Revision (ICD-10) were used to classify diseases as underlying causes of death † (4). COVID-19 deaths were defined as deaths for which COVID-19 was listed on the death certificate as a confirmed or presumed underlying cause * https://wonder.cdc.gov/mcd-icd10-provisional.