Abstract
Objectives: To describe variations in coronavirus disease 2019 (COVID-19) diagnosis by zip code race and ethnicity in Indiana.Methods: Cross-sectional evaluation of subjects with SARS-CoV-2 at Indiana University Health. We performed two separate analyses, first evaluating likelihood of COVID-19 diagnosis by race (Caucasian, African American, Asian, or other) and ethnicity (Hispanic vs. non-Hispanic) in the cohort encompassing the entire state of Indiana. Subsequently, patient data was geolocated with zip codes in Marion County and the immediate surrounding counties, and descriptive statistical analyses were used to calculate the number of COVID-19 cases per 10,000 persons for each of these zip codes.Results: Indiana had a total of 3,892 positive COVID-19 cases from January 1 to April 30, 2020. The odds of testing positive for COVID-19 were four-fold higher in African Americans than non-African Americans (OR 4.58, 95% CI 4.25–4.94, P < 0.0001). Increased COVID-19 cases per 10,000 persons were seen in zip codes with higher percentage of African American (median infection rate of 17.4 per 10,000 population in zip codes above median % African American compared to 6.7 per 10,000 population in zip codes below median % African American, with an overall median infection rate 9.9 per 10,000 population, P < 0.0001) or Hispanic residents (median infection rate of 15.9 per 10,000 population in zip codes above median % Hispanic compared to 7.0 per 10,000 population in zip codes below median % Hispanic, overall median infection rate 9.6 per 10,000 population, P < 0.0001).Conclusions: Individuals from zip codes with higher percentages of African American, Hispanic, foreign-born, and/or residents living in poverty are disproportionately affected by COVID-19. Urgent work is needed to understand and address the disproportionate burden of COVID-19 in minority communities and when economic disparities are present.
Highlights
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a global pandemic
Growing attention is being focused on disparities in race and ethnicity, as preliminary data suggests that African American individuals and Hispanic individuals may have a disproportionate burden of COVID-19
In the larger statewide cohort, 1,024 (33%) COVID-19positive individuals were African American and 507 (16%) were Hispanic. This is disparate from the proportion of the Indiana population that these groups constitute, as African Americans and Hispanics make up 8.8% and 4.5% of the Indiana state population, respectively [3]
Summary
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a global pandemic. COVID-19 by Zipcode, Race, Ethnicity determinants of health (SDH), which are reflected in geographic locations and are associated with increased COVID-19 disease burden in African American and Hispanic minority populations [3]. The most pervasive disparities in COVID-19 diagnosis have been seen in African American and Hispanic individuals, studies have to date only focused on single studies of dense urban areas [1]. Severe COVID-19 presentations occur more frequently in those with chronic diseases and minority populations, most notably African American and/or Hispanic individuals [2]. Growing attention is being focused on disparities in race and ethnicity, as preliminary data suggests that African American individuals and Hispanic individuals may have a disproportionate burden of COVID-19
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