COVID-19 and racial disparities

Abstract

To the Editor: Epidemiologic evidence of age- and sex-related differences for COVID-19 suggest that males and older adults with underlying health conditions including hypertension, obesity, chronic lung disease, diabetes, and cardiovascular disease have increased vulnerability to COVID-19.1Garg S. Kim L. Whitaker M. et al.Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019—COVID-NET, 14 states, March 1–30, 2020.MMWR Morb Mortal Wkly Rep. 2020; 69: 458-464Crossref PubMed Scopus (3) Google Scholar To date, the literature is very limited on data exploring racial disparities.1Garg S. Kim L. Whitaker M. et al.Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019—COVID-NET, 14 states, March 1–30, 2020.MMWR Morb Mortal Wkly Rep. 2020; 69: 458-464Crossref PubMed Scopus (3) Google Scholar On April 8, 2020, the Centers for Disease Control and Prevention published surveillance data of laboratory-confirmed COVID-19–associated hospitalizations in 14 US states.1Garg S. Kim L. Whitaker M. et al.Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019—COVID-NET, 14 states, March 1–30, 2020.MMWR Morb Mortal Wkly Rep. 2020; 69: 458-464Crossref PubMed Scopus (3) Google Scholar Although 18% of individuals in the catchment population were African American, among those with data on race/ethnicity (n = 580), 33.1% were African American, suggesting that African Americans may be disproportionately affected by COVID-19.1Garg S. Kim L. Whitaker M. et al.Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019—COVID-NET, 14 states, March 1–30, 2020.MMWR Morb Mortal Wkly Rep. 2020; 69: 458-464Crossref PubMed Scopus (3) Google Scholar These data are consistent with government statistics from cities in the United States showing similar racial disparities. In Chicago, Illinois, African Americans account for only 14.6% of the state's population; however, as of April 9, 2020, 51.5% of COVID-positive patients and 67.3% (n = 132) of those who died were African American.2City of Chicago. Latest data.https://www.chicago.gov/city/en/sites/covid-19/home/latest-data.htmlDate accessed: April 10, 2020Google Scholar Furthermore, in Michigan, although 33% of patients diagnosed with COVID-19 as of April 9, 2020, were African American, this population makes up only approximately 14.1% of the state population.3State of MichiganCoronavirus: Michigan data.https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.htmlDate accessed: April 10, 2020Google Scholar Ethnic minority groups may have greater risk of infection due to comorbidities, including hypertension in African American populations.4National Medical AssociationCOVID-19 underscores wealth and health disparities in the African American community. Available at:.https://www.nmanet.org/news/500673/COVID-19-Underscores-Wealth-and-Health-Disparities-in-the-African-American-Community.htmDate: 2020Date accessed: April 10, 2020Google Scholar Moreover, African Americans are more likely to live in densely populated neighbourhoods of lower socioeconomic status, which may lead to increased exposure from closer contact between individuals, less equitable health care access, and lower rates of COVID-19 testing. Additionally, the US Bureau of Labour Statistics reported that only 19.7% of African American employees can work from home, compared with 29.9% of white employees.5US Bureau of Labour StatisticsEconomic news release.https://www.bls.gov/news.release/flex2.t01.htmDate: 2019Date accessed: April 10, 2020Google Scholar African Americans may be more likely to work in occupations included in the essential workforce, such as transportation and food service. Moreover, on April 8, 2020, Oliver Brooks, the President of the National Medical Association representing African American physicians and their patients in the United States, stated, “Many of these jobs also do not provide healthcare coverage, so we are underinsured or uninsured during a health crisis. When adding the underlying health risk factors of heart disease, diabetes, and asthma, the African American population is at the epicenter of this current health crisis.”4National Medical AssociationCOVID-19 underscores wealth and health disparities in the African American community. Available at:.https://www.nmanet.org/news/500673/COVID-19-Underscores-Wealth-and-Health-Disparities-in-the-African-American-Community.htmDate: 2020Date accessed: April 10, 2020Google Scholar To gain a thorough understanding of the epidemiology of COVID-19 and to ensure targeted health education and equitable allocation of health care system resources for more vulnerable populations, studies on the race-specific prevalence of COVID-19 and outcomes are crucial. We call for higher-priority assessment of racial and ethnic disparities in COVID-19, which may reduce morbidity and mortality among African Americans. As Brooks stated, “There is still time, but time is running out.”4National Medical AssociationCOVID-19 underscores wealth and health disparities in the African American community. Available at:.https://www.nmanet.org/news/500673/COVID-19-Underscores-Wealth-and-Health-Disparities-in-the-African-American-Community.htmDate: 2020Date accessed: April 10, 2020Google Scholar Exploring the risk of severe COVID-19 infection in patients with hidradenitis suppurativaJournal of the American Academy of DermatologyVol. 83Issue 2PreviewTo the Editor: The recent letter by Shah et al1 highlighting the epidemiology of COVID-19 infection and the impact on African American populations captivated our attention. As the world continues to battle this global pandemic, it is important that we acknowledge vulnerable populations and address the needs in these populations to minimize mortality and morbidity. As Shah et al1 noted, ethnic minority groups may have a greater risk of infection due to comorbidities. Full-Text PDF