Disparities in Excess, All-Cause Mortality among Black, Hispanic, and White Veterans at the U.S. Department of Veterans Affairs during the COVID-19 Pandemic.

Claudia Der-Martirosian,Lilia R Lukowsky,Aram Dobalian

doi:10.3390/ijerph19042368

Abstract

Background: From 2019 to 2020, all-cause mortality in the U.S. increased, with most of the rise attributed to COVID-19. No studies have examined the racial disparities in all-cause mortality among U.S. veterans receiving medical care (VA users) at the U.S. Department of Veterans Affairs (VA) during the pandemic. Methods: In the present paper, we conduct a longitudinal study examining the differences in mortality among White, Black, and Hispanic veterans, aged 45 years and older, during the first, full year of the pandemic (March 2020–February 2021). We calculated the Standardized Mortality Rates (SMRs) per 100,000 VA users for each racial and ethnic group by age and gender. Results: The highest percentage increase between the number of deaths occurred between pre- and post-pandemic years (March 2020–February 2021 vs. March 2019–February 2020). For Hispanics, the all-cause mortality increased by 34%, while for Blacks, it increased by 32%. At the same time, we observed that an 18% increase in all-cause mortality occurred among Whites. Conclusion: Blacks and Hispanics were disproportionately affected by the COVID-19 pandemic, leading both directly and indirectly to higher all-cause mortality among these groups compared to Whites. Disparities in the all-cause mortality rates varied over time and across groups. Additional research is needed to examine which factors may account for the observed changes over time. Understanding those factors will permit the development of strategies to mitigate these disparities.

Highlights

The COVID-19 pandemic led to an increase in all-cause mortality in both the U.S [1,2,3]and internationally [4]
During the early months of the pandemic, while Black and Hispanic veterans were more likely to test positive for COVID-19 and to be hospitalized with severe COVID-19 symptoms compared to White veterans, 30-day mortality rates for those who tested positive for COVID-19 were lower for these groups than among White veterans [10,11]
The largest change in all-cause mortality was observed between periods 2 and 3, resulting in a 34% increase in deaths among Hispanics and a 32% increase among Blacks

Summary

Introduction

The COVID-19 pandemic led to an increase in all-cause mortality in both the U.S [1,2,3]and internationally [4]. The COVID-19 pandemic led to an increase in all-cause mortality in both the U.S [1,2,3]. Examining the all-cause mortality allows for the estimation of both the direct and indirect effects of the pandemic. During the early months of the pandemic, while Black and Hispanic veterans were more likely to test positive for COVID-19 and to be hospitalized with severe COVID-19 symptoms compared to White veterans, 30-day mortality rates for those who tested positive for COVID-19 were lower for these groups than among White veterans [10,11]. Methods: In the present paper, we conduct a longitudinal study examining the differences in mortality among White, Black, and Hispanic veterans, aged 45 years and older, during the first, full year of the pandemic (March 2020–February 2021). Mortality Rates (SMRs) per 100,000 VA users for each racial and ethnic group by age and gender

Methods

Results

Discussion

Conclusion