Abstract

BackgroundHealth disparities are prevalent in many areas of medicine. We aimed to investigate the impact of the COVID-19 pandemic on racial/ethnic groups in the United States (US) and to assess the effects of social distancing, social vulnerability metrics, and medical disparities.MethodsA cross-sectional study was conducted utilizing data from the COVID-19 Tracking Project and the Centers for Disease Control and Prevention (CDC). Demographic data were obtained from the US Census Bureau, social vulnerability data were obtained from the CDC, social distancing data were obtained from Unacast, and medical disparities data from the Center for Medicare and Medicaid Services. A comparison of proportions by Fisher’s exact test was used to evaluate differences between death rates stratified by age. Negative binomial regression analysis was used to predict COVID-19 deaths based on social distancing scores, social vulnerability metrics, and medical disparities.ResultsCOVID-19 cumulative infection and death rates were higher among minority racial/ethnic groups than whites across many states. Older age was also associated with increased cumulative death rates across all racial/ethnic groups on a national level, and many minority racial/ethnic groups experienced significantly greater cumulative death rates than whites within age groups ≥ 35 years. All studied racial/ethnic groups experienced higher hospitalization rates than whites. Older persons (≥ 65 years) also experienced more COVID-19 deaths associated with comorbidities than younger individuals. Social distancing factors, several measures of social vulnerability, and select medical disparities were identified as being predictive of county-level COVID-19 deaths.ConclusionCOVID-19 has disproportionately impacted many racial/ethnic minority communities across the country, warranting further research and intervention.

Highlights

  • The initial outbreak of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred during December 2019 in Wuhan, China.[1]

  • Asians were most affected compared to whites in South Dakota (5656 cases/100 000; rate 14.7 times higher than whites), while AIAN individuals were most affected compared to whites in New Mexico (3396 cases/100 000; rate 26.1 times higher than whites)

  • Native Hawaiian and Pacific Islanders (NHPIs) individuals were most affected compared to whites in Arkansas (22 989 cases/100 000; rate 36.1 times higher than whites) (Supplementary Table 1)

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Summary

Introduction

The initial outbreak of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred during December 2019 in Wuhan, China.[1]. Severe disease can occur in healthy individuals of all ages; older persons with preexisting comorbidities and racial/ethnic minority groups appear to be most at risk.[7,8] For instance, a report published by the. Health disparities are prevalent in many areas of medicine. We aimed to investigate the impact of the COVID-19 pandemic on racial/ethnic groups in the United States (US) and to assess the effects of social distancing, social vulnerability metrics, and medical disparities

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