Racial Disparities in COVID-19 and Excess Mortality in Minnesota.
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ABSTRACT:
SUBMITTER: Wrigley-Field E
PROVIDER: S-EPMC7780067 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The impact of the coronavirus disease 2019 (COVID-19) pandemic has been starkly unequal across race and ethnicity. We examined the geographic variation in excess all-cause mortality by race and ethnicity to better understand the impact of the pandemic. We used individual-level administrative data on the US population between January 2011 and April 2020 to estimate the geographic variation in excess all-cause mortality by race and Hispanic origin. All-cause mortality allows a better understanding of the overall impact of the pandemic than mortality attributable to COVID-19 directly. Nationwide, adjusted excess all-cause mortality during that period was 6.8 per 10,000 for Black people, 4.3 for Hispanic people, 2.7 for Asian people, and 1.5 for White people. Nationwide averages mask substantial geographic variation. For example, despite similar excess White mortality, Michigan and Louisiana had markedly different excess Black mortality, as did Pennsylvania compared with Rhode Island. Wisconsin experienced no significant White excess mortality but had significant Black excess mortality. Further work understanding the causes of geographic variation in racial and ethnic disparities-the relevant roles of social and environmental factors relative to comorbidities and of the direct and indirect health effects of the pandemic-is crucial for effective policy making.
| S-EPMC7996479 | biostudies-literature
Project description:IntroductionRecent research underscores the exceptionally young age distribution of COVID-19 deaths in the U.S. compared with that of international peers. This paper characterizes how high levels of COVID-19 mortality at midlife ages (45-64 years) are deeply intertwined with continuing racial inequity in COVID-19 mortality.MethodsMortality data from Minnesota in 2020-2022 were analyzed in June 2022. Death certificate data (COVID-19 deaths N=12,771) and published vaccination rates in Minnesota allow vaccination and mortality rates to be observed with greater age and temporal precision than national data.ResultsBlack, Hispanic, and Asian adults aged <65 years were all more highly vaccinated than White populations of the same ages during most of Minnesota's substantial and sustained Delta surge and all the subsequent Omicron surges. However, White mortality rates were lower than those of all other groups. These disparities were extreme; at midlife ages (ages 45-64 years), during the Omicron period, more highly vaccinated populations had COVID-19 mortality that was 164% (Asian-American), 115% (Hispanic), or 208% (Black) of White COVID-19 mortality at these ages. In Black, Indigenous, and People of Color populations as a whole, COVID-19 mortality at ages 55-64 years was greater than White mortality at 10 years older.ConclusionsThis discrepancy between vaccination and mortality patterning by race/ethnicity suggests that if the current period is a pandemic of the unvaccinated, it also remains a pandemic of the disadvantaged in ways that can decouple from vaccination rates. This result implies an urgent need to center health equity in the development of COVID-19 policy measures.
| S-EPMC9622467 | biostudies-literature
Project description:BackgroundBlack populations in the United States are being disproportionately affected by the COVID-19 pandemic, but the increased mortality burden after accounting for health and other demographic characteristics is not well understood. We examined characteristics of individuals who died from COVID-19 in Michigan by race stratified by their age, sex and comorbidity prevalence to illustrate and understand this disparity in mortality risk.MethodsWe evaluate COVID-19 mortality in Michigan by demographic and health characteristics, using individual-level linked death certificate and surveillance data collected by the Michigan Department of Health and Human Services from March 16 to October 26, 2020. We identified differences in demographics and comorbidity prevalence across race among individuals who died from COVID-19 and calculated mortality rates by age, sex, race, and number of comorbidities.FindingsAmong the 6,065 COVID-19 related deaths in Michigan, Black individuals are experiencing 3·6 times the mortality rate of White individuals (p<0.001), with a mortality rate for Black individuals under 65 years without comorbidities that is 12·6 times that of their White counterparts (p<0.001). After accounting for age, race, sex, and number of comorbidities, we find that Black individuals in all strata are at higher risk of COVID-19 mortality than their White counterparts.InterpretationOur findings demonstrate that Black populations are disproportionately burdened by COVID-19 mortality, even after accounting for demographic and underlying health characteristics. We highlight how disparities across race, which result from systemic racism, are compounded in crises.FundingASP, AP and APG were funded by NSF Expeditions grant 1918784, NIH grant 1R01AI151176-01, NSF Rapid Response Research for COVID-19 grant RAPID-2027755, and the Notsew Orm Sands Foundation. MCF was supported by NIH grant K01AI141576.
| S-EPMC7933264 | biostudies-literature
Project description:High COVID-19 mortality among Black communities heightened the pandemic's devastation. In the state of Louisiana, the racial disparity associated with COVID-19 mortality was significant; Black Americans accounted for 50% of known COVID-19-related deaths while representing only 32% of the state's population. In this paper, we argue that structural racism resulted in a synergistic framework of cumulatively negative determinants of health that ultimately affected COVID-19 deaths in Louisiana Black communities. We identify the spatial distribution of social, environmental, and economic stressors across Louisiana parishes using hot spot analysis to develop aggregate stressors. Further, we examine the correlation between stressors, cumulative health risks, COVID-19 mortality, and the size of Black populations throughout Louisiana. We hypothesized that parishes with larger Black populations (percentages) would have larger stressor values and higher cumulative health risks as well as increased COVID-19 mortality rates. Our results suggest two categories of parishes. The first group has moderate levels of aggregate stress, high population densities, predominately Black populations, and high COVID-19 mortality. The second group of parishes has high aggregate stress, lower population densities, predominantly Black populations, and initially low COVID-19 mortality that increased over time. Our results suggest that structural racism and inequities led to severe disparities in initial COVID-19 effects among highly populated Black Louisiana communities and that as the virus moved into less densely populated Black communities, similar trends emerged.
| S-EPMC9271191 | biostudies-literature
Project description:ObjectiveTo investigate the patterns and demographic features of cardiovascular disease (CVD) death and subtypes myocardial infarction (MI), stroke, and heart failure in the pre-COVID-19 era (2018-2019) vs during the COVID-19 pandemic (2020-2021) in the United States.MethodsIn this cross-sectional study, we used the US Multiple Cause of Death files for 2018 to 2021 to examine the trend of excess cause-specific deaths using International Classification of Diseases, Tenth Revision codes for CVD (I00 to I99), MI (I21 and I22), stroke (I60 to I69), and heart failure (I42 and I50). Our primary outcome was excess mortality from CVD and its 3 subtypes (MI, stroke, and heart failure) between prepandemic (2018-2019) and pandemic (2020-2021) years. We performed a subgroup analysis on race and month-to-month and year-to-year variation using χ2 analysis to test statistical significance.ResultsOverall, 3,598,352 CVD deaths were analyzed during the study period. There was a 6.7% excess CVD mortality, 2.5% MI mortality, and 8.5% stroke mortality during the COVID-19 pandemic (2020-2021) compared with the prepandemic era (2018-2019). Black individuals had higher excess CVD mortality (13.8%) than White individuals (5.1%; P<.001). This remained consistent across subtypes of CVD, including MI (9.6% vs 1.0%; P<.001), stroke (14.5% vs 6.9%; P<.001), and heart failure (5.1% vs -1.2%; P<.001).ConclusionThere has been a significant rise in CVD and subtype-specific mortality during the COVID-19 pandemic that has been persistent despite 2 years since the onset of the pandemic. Excess CVD mortality has disproportionately affected Black compared with White individuals. Further studies targeting and eliminating health care disparities are necessary.
| S-EPMC9300586 | biostudies-literature
Project description:This research brief provides one of the first examinations of the impact of COVID-19 mortality on immigrant communities in the United States. In the absence of national data, we examine COVID-19 deaths in Minnesota, historically one of the major U.S. refugee destinations, using individual-level death certificates obtained from the Minnesota Department of Health Office of Vital Records. Minnesota's foreign-born crude COVID-19 death rates were similar to rates for the US-born, but COVID-19 death rates adjusted for age and gender were twice as high among the foreign-born. Among foreign-born Latinos, in particular, COVID-19 mortality was concentrated in relatively younger, prime working age men. Moreover, the place-based and temporal patterns of COVID-19 mortality were quite distinct, with the majority of US-born mortality concentrated in long-term care facilities and late in 2020, and foreign-born mortality occurring outside of residential institutions and earlier in the pandemic. The disparate impacts of COVID-19 for foreign-born Minnesotans demonstrate the need for targeted public health planning and intervention in immigrant communities.Supplementary informationThe online version contains supplementary material available at 10.1007/s11113-021-09668-1.
| S-EPMC8326639 | biostudies-literature
Project description:Racial disparities are apparent in the impact of coronavirus disease 2019 (COVID-19) in the United States, yet the factors contributing to racial inequities in COVID-19 mortality remain controversial. To better understand these factors, we investigated racial disparities in COVID-19 mortality among America's essential workers. Data from the American Community Survey and Current Population Survey was used to examine the correlation between the prevalence of COVID-19 deaths and occupational differences across racial/ethnic groups and states. COVID-19 mortality was higher among non-Hispanic (NH) Blacks compared with NH Whites, due to more NH Blacks holding essential-worker positions. Vulnerability to coronavirus exposure was increased among NH Blacks, who disproportionately occupied the top nine essential occupations. As COVID-19 death rates continue to rise, existing structural inequalities continue to shape racial disparities in this pandemic. Policies mandating the disaggregation of state-level data by race/ethnicity are vital to ensure equitable and evidence-based response and recovery efforts.
| S-EPMC7436547 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic has magnified existing health disparities for marginalized populations in the United States (U.S.), particularly among Black Americans. Social determinants of health are powerful drivers of health outcomes that could influence COVID-19 racial disparities.MethodsWe collected data from publicly available databases on COVID-19 death rates through October 28, 2020, clinical covariates, and social determinants of health indicators at the U.S. county level. We utilized negative binomial regression to assess the association between social determinants of health and COVID-19 mortality focusing on racial disparities in mortality.ResultsCounties with higher death rates had a higher proportion of Black residents and greater levels of adverse social determinants of health. A one percentage point increase in percent Black residents, percent uninsured adults, percent low birthweight, percent adults without high school diploma, incarceration rate, and percent households without internet in a county increased COVID-19 death rates by 0.9% (95% CI 0.5%-1.3%), 1.9% (95% CI 1.1%-2.7%), 7.6% (95% CI 4.4%-11.0%), 3.5% (95% CI 2.5%-4.5%), 5.4% (95% CI 1.3%-9.7%), and 3.4% (95% CI 2.5%-4.2%), respectively. Counties in the lowest quintile of a measure of economic privilege had an increased COVID-19 death rates of 67.5% (95% CI 35.9%-106.6%). Multivariate regression and subgroup analyses suggested that adverse social determinants of health may partially explain racial disparities in COVID-19 mortality.ConclusionsThis study demonstrates that social determinants of health contribute to COVID-19 mortality for Black Americans at the county level, highlighting the need for public health policies that address racial disparities in health outcomes.
| S-EPMC7785288 | biostudies-literature
Project description:ObjectiveTo evaluate the race-stratified state-level prevalence of health determinants and the racial disparities in coronavirus disease 2019 (COVID-19) cumulative incidence and mortality in the United States.Patients and methodsThe age-adjusted race-stratified prevalence of comorbidities (hypertension, diabetes, dyslipidemia, and obesity), preexisting medical conditions (pulmonary disease, heart disease, stroke, kidney disease, and malignant neoplasm), poor health behaviors (smoking, alcohol abuse, and physical inactivity), and adverse socioeconomic factors (education, household income, and health insurance) was computed in 435,139 American adult participants from the 2017 Behavioral Risk Factor Surveillance System survey. Correlation was assessed between health determinants and the race-stratified COVID-19 crude mortality rate and infection-fatality ratio computed from respective state public health departments in 47 states.ResultsBlacks had a higher prevalence of comorbidities (63.3%; 95% CI, 62.4% to 64.2% vs 55.1%; 95% CI, 54.7% to 55.5%) and adverse socioeconomic factors (47.0%; 95% CI, 46.0% to 47.9% vs 30.9%; 95% CI, 30.6% to 31.3%) than did whites. The prevalence of preexisting medical conditions was similar in blacks (30.4%; 95% CI, 28.8% to 32.1%) and whites (30.8%; 95% CI, 30.2% to 31.4%). The prevalence of poor health behaviors was higher in whites (57.2%; 95% CI, 56.3% to 58.0%) than in blacks (50.2%; 95% CI,46.2% to 54.2%). Comorbidities and adverse socioeconomic factors were highest in the southern region, and poor health behaviors were highest in the western region. The cumulative incidence rate (per 100,000 persons) was 3-fold higher in blacks (1546.4) than in whites (540.4). The crude mortality rate (per 100,000 persons) was 2-fold higher in blacks (83.2) than in whites (33.2). However, the infection-fatality ratio (per 100 cases) was similar in whites (6.2) and blacks (5.4). Within racial groups, the geographic distribution of health determinants did not correlate with the state-level COVID-19 mortality and infection-fatality ratio (P>.05 for all).ConclusionRacial disparities in COVID-19 are largely driven by the higher cumulative incidence of infection in blacks. There is a discordance between the geographic dispersion of COVID-19 mortality and the regional distribution of health determinants.
| S-EPMC7538135 | biostudies-literature
Project description: Not available
| S-EPMC9910840 | biostudies-literature