Racial and Ethnic Disparities in COVID-19 Incidence by Age, Sex, and Period Among Persons Aged <25 Years — 16 U.S. Jurisdictions, January 1–December 31, 2020

Abstract

The COVID-19 pandemic has disproportionately affected racial and ethnic minority groups in the United States. Whereas racial and ethnic disparities in severe COVID-19-associated outcomes, including mortality, have been documented (1-3), less is known about populationbased disparities in infection with SARS-CoV-2, the virus that causes COVID-19. In addition, although persons aged <30 years account for approximately one third of reported infections, § there is limited information on racial and ethnic disparities in infection among young persons over time and by sex and age. Based on 689,672 U.S. COVID-19 cases reported to CDC's case-based surveillance system by jurisdictional health departments, racial and ethnic disparities in COVID-19 incidence among persons aged <25 years in 16 U.S. jurisdictions ¶ were described by age group and sex and across three periods during January 1-December 31, 2020. During January-April, COVID-19 incidence was substantially higher among most racial and ethnic minority groups compared with that among non-Hispanic White (White) persons (rate ratio [RR] range = 1.09-4.62). During May-August, the RR increased from 2.49 to 4.57 among non-Hispanic Native Hawaiian and Pacific Islander (NH/PI) persons but decreased among other racial and ethnic minority groups (RR range = 0.52-2.82). Decreases in disparities were observed during September-December (RR range = 0.37-1.69); these decreases were largely because of a greater increase in incidence among White persons, rather than a decline in incidence among racial and ethnic minority groups. NH/PI,

Racial and ethnic disparities for SARS-CoV-2 positivity in the United States: a generalizing pandemic

“…This attenuation in disparities appears to be due, at least in part, to a stronger relative increase in the test positivity percentage among White individuals over time rather than a decline in test positivity among racial and ethnic minority groups, which is likely driven by the pandemic generalizing from diverse metropolitan areas to less diverse rural areas. 4,5,8 Our findings on disparities for testing positive among Black and Hispanic individuals in the first months of the pandemic have been demonstrated previously. [1][2][3][4][5] This study extended previously published models to evaluate patterns in disparities over the first full year of the pandemic.…”

“…[4][5][6][7] Recently, additional analyses have suggested that racial and ethnic disparities may be changing over time as outbreaks spread from racially and ethnically diverse metropolitan centers to more rural and less diverse areas. 4,5,8 In this report, we updated our previous analyses 4,5 to evaluate changes in disparities for testing positive with SARS-CoV-2 over the first full year of the pandemic and by geographic region in the largest integrated healthcare system in the United States.…”

Emergency Department Visits for COVID-19 by Race and Ethnicity — 13 States, October–December 2020

“…Fifth, in NSSP, Native Hawaiian and Other Pacific Islander (NH/PI) and Asian are separate categories. However, these groups were combined in the population estimates used, so these groups were combined into A/PI for this analysis, likely masking previously reported COVID-19 disparities among NH/PI persons (3). Race/ethnicity-specific estimates for non-Hispanic persons of multiple and other races were not calculated because population denominators were unavailable.…”

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“…This slight underrepresentation might be because of several factors including disparities in access to health care and testing [26]. However, Hispanic or Latino ethnicity was associated with increased odds of hospitalization, consistent with reports highlighting the disproportionate impact of COVID-19 on the Hispanic or Latino population in the United States [27,28].…”