The Magnitude of Black/Hispanic Disparity in COVID-19 Mortality Across United States Counties During the First Waves of the COVID-19 Pandemic

• Published in: International journal of public health Vol. 66; p. 1604004
• Main Authors: Im, Cindy, Munasinghe, Lalani L, Martínez, José M, Letsou, William, Bagherzadeh-Khiabani, Farideh, Marin, Soudabeh, Yasui, Yutaka
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media SA 22.09.2021; Frontiers Media S.A
• Subjects: Adolescent; Adult; African Americans - statistics & numerical data; Age; Aged; Aged, 80 and over; Child; Child, Preschool; Classification schemes; Coronaviruses; COVID-19; COVID-19 - ethnology; COVID-19 - mortality; Cultural differences; FDA approval; health disparities; Health Status Disparities; Hispanic or Latino - statistics & numerical data; Hispanic people; Humans; Middle Aged; Mortality; Pandemics; Population; Poverty; Public health; Public Health Archive; race/ethnicity; SARS-CoV-2; Socioeconomic Factors; United States - epidemiology; Urbanization; Young Adult; United States; United States > US; COVID-19; mortality; SARS-CoV-2; health disparities; public health; race/ethnicity
• ISSN: 1661-8564; 1661-8556; 1661-8564
• DOI: 10.3389/ijph.2021.1604004

To quantify the Black/Hispanic disparity in COVID-19 mortality in the United States (US). COVID-19 deaths in all US counties nationwide were analyzed to estimate COVID-19 mortality rate ratios by county-level proportions of Black/Hispanic residents, using mixed-effects Poisson regression. Excess COVID-19 mortality counts, relative to predicted under a counterfactual scenario of no racial/ethnic disparity gradient, were estimated. County-level COVID-19 mortality rates increased monotonically with county-level proportions of Black and Hispanic residents, up to 5.4-fold (≥43% Black) and 11.6-fold (≥55% Hispanic) higher compared to counties with <5% Black and <15% Hispanic residents, respectively, controlling for county-level poverty, age, and urbanization level. Had this disparity gradient not existed, the US COVID-19 death count would have been 92.1% lower (177,672 fewer deaths), making the rate comparable to other high-income countries with substantially lower COVID-19 death counts. During the first 8 months of the SARS-CoV-2 pandemic, the US experienced the highest number of COVID-19 deaths. This COVID-19 mortality burden is strongly associated with county-level racial/ethnic diversity, explaining most US COVID-19 deaths.