Disproportionate Impact of COVID-19 Pandemic on Racial and Ethnic Minorities

Abstract

Background Health disparities are prevalent in many areas of medicine. We aimed to investigate the impact of the COVID-19 pandemic on racial/ethnic groups in the United States (US) and to assess the effects of social distancing, social vulnerability metrics, and medical disparities. Methods A cross-sectional study was conducted utilizing data from the COVID-19 Tracking Project and the Centers for Disease Control and Prevention (CDC). Demographic data were obtained from the US Census Bureau, social vulnerability data were obtained from the CDC, social distancing data were obtained from Unacast, and medical disparities data from the Center for Medicare and Medicaid Services. A comparison of proportions by Fisher’s exact test was used to evaluate differences between death rates stratified by age. Negative binomial regression analysis was used to predict COVID-19 deaths based on social distancing scores, social vulnerability metrics, and medical disparities. Results COVID-19 cumulative infection and death rates were higher among minority racial/ethnic groups than whites across many states. Older age was also associated with increased cumulative death rates across all racial/ethnic groups on a national level, and many minority racial/ethnic groups experienced significantly greater cumulative death rates than whites within age groups ≥ 35 years. All studied racial/ethnic groups experienced higher hospitalization rates than whites. Older persons (≥ 65 years) also experienced more COVID-19 deaths associated with comorbidities than younger individuals. Social distancing factors, several measures of social vulnerability, and select medical disparities were identified as being predictive of county-level COVID-19 deaths. Conclusion COVID-19 has disproportionately impacted many racial/ethnic minority communities across the country, warranting further research and intervention.

Actual Racial/Ethnic Disparities in COVID-19 Mortality for the Non-Hispanic Black Compared to Non-Hispanic White Population in 35 US States and Their Association with Structural Racism

“…The importance of direct age standardization in examining racial/ethnic disparities in COVID-19 mortality is illustrated by a comparison of our estimate of the Black-White death rate ratio in Minnesota (3.2) to that in previous studies. Two studies that relied upon crude death rates reported ratios of 1.45 [40] and 1.7 [38], and one study that relied upon indirectly age-adjusted death rates reported a ratio of 1.4 [39]. The COVID Racial Data Tracker (as of February 2021), which relies upon crude death rate estimates, reported no racial/ ethnic disparity between non-Hispanic Black and non-Hispanic White COVID-19 mortality rates in Minnesota [34].…”

“…Several previous studies have examined racial disparities in COVID-19 mortality using crude death rates [35][36][37][38]. Two studies reported national, race-specific COVID-19 mortality rates without age adjustment [35,36].…”

“…Two studies reported national, race-specific COVID-19 mortality rates without age adjustment [35,36]. Two presented statespecific estimates of the crude COVID-19 mortality rate by racial/ethnic group [37,38]. We are aware of only three papers that have calculated age-adjusted, race/ethnicity-specific COVID-19 death rates [2,39,40].…”

Loneliness and symptom burden in oncology patients during the COVID‐19 pandemic

“…Although lower income levels were associated with loneliness in our sample, overall the patients were White, well-educated, and reported an annual income of >$60,000. Given the racial/ethnic disparities associated with the COVID-19 pandemic, [40][41][42] future studies need to evaluate the relationships between loneliness and additional social determinants of health (eg, availability of technology and level of interpersonal and community violence) among both socioeconomically advantaged and socioeconomically disadvantaged individuals. Given the lack of information on the total number of patients who received the survey, as well as Cancer Month 0, 2021 on the characteristics of the patients who chose not to complete the survey, our findings may not generalize to all patients with cancer.…”

COVID-19 fatalities by zip codes and socioeconomic indicators across various U.S. regions

“…Our results varied slightly from other studies. Another study found the Northeast exhibited the largest CFR (5.9%), then the Midwest (5.6%), West (5.1%) and South (5.05%) [ 28 ]. One possible explanation of this inconsistency is the ZCs representing the West region reside within metropolitan areas, where larger population densities can facilitate increased spread and elevated CFRs.…”