Excess mortality among Latino people in California during the COVID-19 pandemic

Abstract

Latino people in the US are experiencing higher excess deaths during the COVID-19 pandemic than any other racial/ethnic group, but it is unclear which sociodemographic subgroups within this diverse population are most affected. Such information is necessary to target policies that prevent further excess mortality and reduce inequities. Using death certificate data for January 1, 2016 through February 29, 2020 and time-series models, we estimated the expected weekly deaths among Latino people in California from March 1 through October 3, 2020. We quantified excess mortality as observed minus expected deaths and risk ratios (RR) as the ratio of observed to expected deaths. We considered subgroups categorized by age, sex, nativity, country of birth, educational attainment, occupation, and combinations of these factors. Our results indicate that during the first seven months of the pandemic, Latino deaths in California exceeded expected deaths by 10,316, a 31% increase. Excess death rates were greatest for individuals born in Mexico (RR 1.44; 95% PI, 1.41, 1.48) or a Central American country (RR 1.49; 95% PI, 1.37, 1.64), with less than a high school degree (RR 1.41; 95% PI, 1.35, 1.46), or in food-and-agriculture (RR 1.60; 95% PI, 1.48, 1.74) or manufacturing occupations (RR 1.59; 95% PI, 1.50, 1.69). Immigrant disadvantages in excess death were magnified among working-age Latinos in essential occupations. In sum, the COVID-19 pandemic has disproportionately impacted mortality among Latino immigrants, especially those in unprotected essential jobs. Interventions to reduce these inequities should include targeted vaccination, workplace safety enforcement, and expanded access to medical care and economic support.

Occupation and Educational Attainment Characteristics Associated With COVID-19 Mortality by Race and Ethnicity in California

“…We considered US born vs born outside of the US status because, compared with US born individuals, individuals born outside of the US are more likely to hold essential jobs and have experienced higher COVID-19 mortality in California. 21 Individuals born outside of the US who are undocumented may encounter labor market discrimination or have less power to select or negotiate for safe working conditions. Place of residence may affect both the occupations available and COVID-19 mortality, 22 and was grouped into 10 California regions (eTable 1 in the Supplement ).…”

“…Moreover, structural racism affects the educational opportunities that determine job opportunities 19 and shapes capacities of employees to negotiate for sick leave, access to protective equipment, and other workplace safety conditions. 20 COVID-19 mortality differs by education within occupational strata, 21 but the joint role of education and occupation in racial and ethnic inequities in COVID-19 mortality is unknown.…”

Neoliberal disease: COVID-19, co-pathogenesis and global health insecurities

“…Thus in the UK the government has reported disproportionate death rates and hospitalizations in Black, Asian and Minority Ethnic populations (ONS.GOV.UK, 2021). And in the US the embodiment of inequality in increased risk is especially pronounced in much higher death rates from COVID faced by indigenous, African American and LatinX communities – with hospitalizations being over four times higher than that of white Americans for LatinX and African Americans, and African Americans dying at over double the per capita rate of white Americans, and at still higher rates when deaths of middle-aged cohorts are compared (CDC, 2021; Ford Riley, et al, 2021; Webb et al , 2020).…”

Addressing racial/ethnic inequities in vaccine hesitancy and uptake: lessons learned from the California alliance against COVID-19

“…The COVID-19 pandemic has brought new attention to long-standing inequities faced by racial/ethnic minority populations and other underserved and socioeconomically disadvantaged groups. Not only have these communities borne the brunt of the pandemic in terms of negative health impacts (Iyanda et al, 2021 ; Nana-Sinkam et al, 2021 ; Riley et al, 2021 ), but complexities brought about by lack of access to essential medical resources and lack of trust of the scientific establishment due to institutional untrustworthiness and historical social injustices have made effective outreach and dissemination of evidence-based information about the pandemic difficult (Sy et al, 2020 ; Wilkins, 2018 ). Increased politicization of science and media has only added to the lack of trust in scientific information and resulted in uneven messaging and vaccination program implementation in different local communities.…”

“…Black, Indigenous, Latino/x, and other communities of color have been disproportionately impacted by the COVID-19 pandemic, especially in terms of number of cases and fatalities (Boserup et al, 2020 ; Centers for Disease Control and Prevention [CDC], 2021 ; Iyanda et al, 2021 ; Riley et al, 2021 ). Factors rooted in inequities and social determinants of health and their intersection have played a large role in the heightened risk faced by these communities, among them lack of access to health care and stigma and stereotypes about poor hygiene and carrying disease.…”