Racial Disparities In Excess All-Cause Mortality During The Early COVID-19 Pandemic Varied Substantially Across States

Polyakova, Maria; Udalova, Victoria; Kocks, Geoffrey; Genadek, Katie R.; Finlay, Keith; Finkelstein, Amy

doi:10.1377/hlthaff.2020.02142

Cited by 70 publications

(47 citation statements)

References 11 publications

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“…Further applying such an intersectional approach, we stratified COVID-19 and excess deaths by race, ethnicity, and sex to examine the disparate impacts of COVID-19 in Colorado. Early in the pandemic, the CDPHE published a press release [35] acknowledging the disparities in SARS-CoV-2 infection and mortality, especially with respect to race and ethnicity [36]. Our study confirmed their preliminary observations: Black and Hispanic White males -representing 32% of the population [37]were most afflicted, with 232 and 186 estimated excess deaths per 100k respectively, from March to September 2020.…”

Section: Discussionsupporting

confidence: 84%

“…Additionally, we showed that all-cause mortality disproportionately affected younger adults, as measured by the ratio of deaths in 2020 to the average of the five previous years. In other words, although the level of excess deaths in Colorado was larger among older populations in absolute value, as observed across the country [40,41] during the first COVID-19 wave, working age adults (35)(36)(37)(38)(39)(40)(41)(42)(43)(44) experienced the highest all-cause mortality ratio (1.4 times more deaths in 2020, as compared to the five previous years). For comparison, all-cause mortality among older populations (aged 75+) was 1.2 times higher than in 2015 to 2019.…”

Section: Discussionmentioning

confidence: 80%

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Evaluation of County-Level Heterogeneity in Excess Mortality in Colorado from March to September 2020

Chandra

Charpignon

et al. 2021

Preprint

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Importance: Tracking the direct and indirect impact of the coronavirus disease 2019 (COVID-19) pandemic on all-cause mortality in the United States has been hindered by the lack of testing and by reporting delays. Evaluating excess mortality, or the number of deaths above what is expected in a given time period, provides critical insights into the true burden of the COVID-19 pandemic caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Stratifying mortality data by demographics such as age, sex, race, ethnicity, and geography helps quantify how subgroups of the population have been differentially affected. Similarly, stratifying mortality data by cause of death reveals the public health effects of the pandemic in terms of other acute and chronic diseases. Objective: To provide stratified estimates of excess mortality in Colorado from March to September 2020. Design, Setting, and Population: This study evaluated the number of excess deaths both directly due to SARS-CoV-2 infection and from all other causes between March and September 2020 at the county level in Colorado. Data were obtained from the Vital Statistics Program at the Colorado Department of Public Health and Environment. These estimates of excess mortality were derived by comparing population- adjusted mortality rates in 2020 with rates in the same months from 2015 to 2019. Results: We found evidence of excess mortality in Colorado between March and September 2020. Two peaks in excess deaths from all causes were recorded in the state, one mid-April and the other at the end of June. Since the first documented SARS-CoV-2 infection on March 5th, we estimated that the excess mortality rate in Colorado was two times higher than the officially reported COVID-19 mortality rate. State-level cumulative excess mortality from all causes reached 71 excess deaths per 100k residents (~4000 excess deaths in the state); in contrast, 35 deaths per 100k directly due to SARS-CoV-2 were recorded in the same period (~1980 deaths. Excess mortality occurred in 52 of 64 counties, accounting for 99% of the state's population. Most excess deaths recorded from March to September 2020 were associated with acute events (estimated at 44 excess deaths per 100k residents and at 9 after excluding deaths directly due to SARS-CoV-2) rather than with chronic conditions (~21 excess deaths per 100k). Among Coloradans aged 14-44, 1.4 times more deaths occurred in those months than during the same period in the five previous years. Hispanic White males died of COVID-19 at the highest rate during this time (~90 deaths from COVID-19 per 100k residents); however, Non-Hispanic Black/African American males were the most affected in terms of overall excess mortality (~204 excess deaths per 100k). Beyond inequalities in COVID-19 mortality per se, these findings signal considerable regional and racial-ethnic disparities in excess all-cause mortality that need to be addressed for a just recovery and in future public health crises.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 80%

Evaluation of County-Level Heterogeneity in Excess Mortality in Colorado from March to September 2020

Chandra

Charpignon

et al. 2021

Preprint

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“…Following Polyakova et al (2020Polyakova et al ( , 2021, we estimate excess mortality as the deviation from a linear mortality trend. Figure 3 plots all-cause mortality rates among all Americans for each year from 2011 to 2020, using death data from the National Center for Health Statistics and population estimates from the American Community Survey (National Center for Health Statistics 2021a, United States Census Bureau 2020a).…”

Section: Excess Deaths: a Summary Of Covid-19's Mortality Effectsmentioning

confidence: 99%

The Great Unequalizer: Initial Health Effects of COVID-19 in the United States

Alsan¹,

Chandra²,

Simon

2021

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Skinner provided helpful comments. We thank Erik Hurst, Heidi Williams, and Timothy Taylor for very useful comments and suggestions on a previous draft of the paper. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.

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“…Relatedly, a different study used Social Security data and finds that excess all-cause mortality was highest in Black people and lowest for White people. There was also significant variation by state in the disparities of excess death by race (Polyakova et al 2021). Finally, a U.S. study using mortality data from the National Vital Statistics System found that the largest increases in excess death by October 2020 were found for those between the ages of 25 and 44 and among Hispanic or Latino persons (Rossen et al 2020).…”

Section: Literature Reviewmentioning

confidence: 96%

The Impact of the COVID-19 Pandemic and Policy Responses on Excess Mortality

Agrawal¹,

Cantor²,

Sood³

et al. 2021

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As a way of slowing COVID-19 transmission, many countries and U.S. states implemented shelter-in-place (SIP) policies. However, the effects of SIP policies on public health are a priori ambiguous as they might have unintended adverse effects on health. The effect of SIP policies on COVID-19 transmission and physical mobility is mixed. To understand the net effects of SIP policies, we measure the change in excess deaths following the implementation of SIP policies in 43 countries and all U.S. states. We use an event study framework to quantify changes in the number of excess deaths after the implementation of a SIP policy. We find that following the implementation of SIP policies, excess mortality increases. The increase in excess mortality is statistically significant in the immediate weeks following SIP implementation for the international comparison only and occurs despite the fact that there was a decline in the number of excess deaths prior to the implementation of the policy. At the U.S. state-level, excess mortality increases in the immediate weeks following SIP introduction and then trends below zero following 20 weeks of SIP implementation. We failed to find that countries or U.S. states that implemented SIP policies earlier, and in which SIP policies had longer to operate, had lower excess deaths than countries/U.S. states that were slower to implement SIP policies. We also failed to observe differences in excess death trends before and after the implementation of SIP policies based on pre-SIP COVID-19 death rates.

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Racial Disparities In Excess All-Cause Mortality During The Early COVID-19 Pandemic Varied Substantially Across States

Cited by 70 publications

References 11 publications

Evaluation of County-Level Heterogeneity in Excess Mortality in Colorado from March to September 2020

Evaluation of County-Level Heterogeneity in Excess Mortality in Colorado from March to September 2020

The Great Unequalizer: Initial Health Effects of COVID-19 in the United States

The Impact of the COVID-19 Pandemic and Policy Responses on Excess Mortality

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