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Racial Disparities During Pandemic

 Increased Racial Disparities in Excess Death During the Pandemic
    While racial disparities have always been an issue in the United States, the recent COVID-19 pandemic has greatly amplified these disparities. During the beginning of the pandemic, studies found that although African Americans make up less than 20% of the population, they had the second highest rate of hospitalization (33%) in the US. (See Who's at Risk) Similar trends were also found for Hispanic communities. However, more data has been released now that a year and a half of the pandemic has gone by, and researchers have re-examined the effects of COVID-19 on racial disparities. A study published on October 5, 2021 in the Annals of Internal Medicine focuses on deaths both indirectly and directly caused by COVID-19 between racial/ethnic groups.

Study Introduction

    Data of both COVID-19 and non-COVID-19 deaths during March to December 2020 were collected by researchers from the Centers for Disease Control and Prevention and U.S. Census Bureau. A total of 2.88 million deaths were recorded between March and December 2020. Compared with the number of expected deaths based on 2019 data, 477,200 excess deaths occurred in 2020 (22.9% increase). Of these excess deaths, 74% were attributed to COVID-19. 

Study Results

   Researchers analyzed racial and ethnic disparities in excess deaths attributed to COVID-19 and non-COVID-19 causes. They calculated that excess deaths per 10,000 persons in 2020 caused by COVID-19 were 2 to 3 times higher among Native American, Black, and Latino/a males and females than among White and Asian males and females. Meanwhile, excess death rates were 15% higher in 2019 and 32% higher in 2020 among Black females compared to White females. Although excess deaths were higher among males than females within each racial group, Native American, Black, and Latina females still had higher death rates than White and Asian males.


    Non-Covid-19 caused excess deaths made up 22.6% of total excess deaths among Whites, 29.7% among Blacks, 22.8% among Latinos, 25.8% among Asians, and 30.9% among Native Americans. Excess deaths per 10,000 persons due to non-COVID-19 causes were 3-4 times higher among Black and Native Americans compared to Whites and 2 times higher among Latinos compared with Whites. Even more surprising, non-COVID-19 death rates were 9 times higher among Black males aged 75 years or older compared to their White counterparts. Most excess deaths due to non-COVID-19 causes included Alzheimer disease, heart disease, cerebrovascular disease, diabetes and cancer. These underlying conditions were also more prevalent among Blacks, Native Americans, and Latinos than their respective White and Asian counterparts.


Discussion

     It's clear that the pandemic has widened racial/ethnic disparities in mortality between 2019 and 2020. Although the life expectancy gap between racial groups had been shrinking up until 2019, the pandemic has rapidly reversed the gains that were made. There are several factors that explain why Blacks, Latinos, and Native Americans are disproportionately affected during the pandemic. First, many people of color are considered essential workers and have a greater exposure to COVID-19 and thus, a higher risk of contracting the virus and dying from COVID-19. Second, many Black, Latino and Native American adults have a higher underlying burden of pre-existing conditions such as hypertension and obesity which put them at high risk for COVID-19 and non-COVID-19 hospitalization and death.  Finally, people of color in the United States face economic inequality, resulting in overrepresentation in essential and low-paid jobs and making it difficult for them obtain the resources needed to stay safe compared to their White counterparts. 

    These findings highlight the urge to address the nation's long-standing racial inequities because the pandemic has shown us that these inequities can really be a matter of life or death.  

Sources

1. Shiels, Meredith S., et al. “Racial and Ethnic Disparities in Excess Deaths during the Covid-19 Pandemic, March to December 2020.” Annals of Internal Medicine, 5 Oct. 2021, https://doi.org/10.7326/m21-2134.

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