tetano
Editor, Senior Moderator
PLoS One
. 2022 Jan 28;17(1):e0260262.
doi: 10.1371/journal.pone.0260262. eCollection 2022.
Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates
Karen E Joynt Maddox[SUP] 1 2 3 [/SUP], Mat Reidhead[SUP] 3 [/SUP], Joshua Grotzinger[SUP] 3 [/SUP], Timothy McBride[SUP] 2 4 [/SUP], Aaloke Mody[SUP] 5 [/SUP], Elna Nagasako[SUP] 6 [/SUP], Will Ross[SUP] 7 [/SUP], Joseph T Steensma[SUP] 4 [/SUP], Abigail R Barker[SUP] 2 4 [/SUP]
Affiliations
Abstract
Background: Racial inequities in Coronavirus 2019 (COVID-19) have been reported over the course of the pandemic, with Black, Hispanic/Latinx, and Native American individuals suffering higher case rates and more fatalities than their White counterparts.
Methods: We used a unique statewide dataset of confirmed COVID-19 cases across Missouri, linked with historical statewide hospital data. We examined differences by race and ethnicity in raw population-based case and mortality rates. We used patient-level regression analyses to calculate the odds of mortality based on race and ethnicity, controlling for comorbidities and other risk factors.
Results: As of September 10, 2020 there were 73,635 confirmed COVID-19 cases in the State of Missouri. Among the 64,526 case records (87.7% of all cases) that merged with prior demographic and health care utilization data, 12,946 (20.1%) were Non-Hispanic (NH) Black, 44,550 (69.0%) were NH White, 3,822 (5.9%) were NH Other/Unknown race, and 3,208 (5.0%) were Hispanic. Raw cumulative case rates for NH Black individuals were 1,713 per 100,000 population, compared with 2,095 for NH Other/Unknown, 903 for NH White, and 1,218 for Hispanic. Cumulative COVID-19-related death rates for NH Black individuals were 58.3 per 100,000 population, compared with 38.9 for NH Other/Unknown, 19.4 for NH White, and 14.8 for Hispanic. In a model that included insurance source, history of a social determinant billing code in the patient's claims, census block travel change, population density, Area Deprivation Index, and clinical comorbidities, NH Black race (OR 1.75, 1.51-2.04, p<0.001) and NH Other/Unknown race (OR 1.83, 1.36-2.46, p<0.001) remained strongly associated with mortality.
Conclusions: In Missouri, COVID-19 case rates and mortality rates were markedly higher among NH Black and NH Other/Unknown race than among NH White residents, even after accounting for social and clinical risk, population density, and travel patterns during COVID-19.
. 2022 Jan 28;17(1):e0260262.
doi: 10.1371/journal.pone.0260262. eCollection 2022.
Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates
Karen E Joynt Maddox[SUP] 1 2 3 [/SUP], Mat Reidhead[SUP] 3 [/SUP], Joshua Grotzinger[SUP] 3 [/SUP], Timothy McBride[SUP] 2 4 [/SUP], Aaloke Mody[SUP] 5 [/SUP], Elna Nagasako[SUP] 6 [/SUP], Will Ross[SUP] 7 [/SUP], Joseph T Steensma[SUP] 4 [/SUP], Abigail R Barker[SUP] 2 4 [/SUP]
Affiliations
- PMID: 35089919
- DOI: 10.1371/journal.pone.0260262
Abstract
Background: Racial inequities in Coronavirus 2019 (COVID-19) have been reported over the course of the pandemic, with Black, Hispanic/Latinx, and Native American individuals suffering higher case rates and more fatalities than their White counterparts.
Methods: We used a unique statewide dataset of confirmed COVID-19 cases across Missouri, linked with historical statewide hospital data. We examined differences by race and ethnicity in raw population-based case and mortality rates. We used patient-level regression analyses to calculate the odds of mortality based on race and ethnicity, controlling for comorbidities and other risk factors.
Results: As of September 10, 2020 there were 73,635 confirmed COVID-19 cases in the State of Missouri. Among the 64,526 case records (87.7% of all cases) that merged with prior demographic and health care utilization data, 12,946 (20.1%) were Non-Hispanic (NH) Black, 44,550 (69.0%) were NH White, 3,822 (5.9%) were NH Other/Unknown race, and 3,208 (5.0%) were Hispanic. Raw cumulative case rates for NH Black individuals were 1,713 per 100,000 population, compared with 2,095 for NH Other/Unknown, 903 for NH White, and 1,218 for Hispanic. Cumulative COVID-19-related death rates for NH Black individuals were 58.3 per 100,000 population, compared with 38.9 for NH Other/Unknown, 19.4 for NH White, and 14.8 for Hispanic. In a model that included insurance source, history of a social determinant billing code in the patient's claims, census block travel change, population density, Area Deprivation Index, and clinical comorbidities, NH Black race (OR 1.75, 1.51-2.04, p<0.001) and NH Other/Unknown race (OR 1.83, 1.36-2.46, p<0.001) remained strongly associated with mortality.
Conclusions: In Missouri, COVID-19 case rates and mortality rates were markedly higher among NH Black and NH Other/Unknown race than among NH White residents, even after accounting for social and clinical risk, population density, and travel patterns during COVID-19.