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Measuring the missing: greater racial and ethnic disparities in COVID-19 burden after accounting for missing race/ethnicity data

Black, Hispanic, and Indigenous persons in the United States have an increased risk of SARS-CoV-2 infection and death from COVID-19, due to persistent social inequities. The magnitude of the disparity is unclear, however, because race/ethnicity information is often missing in surveillance data. In t...

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Detalles Bibliográficos
Autores principales: Labgold, Katie, Hamid, Sarah, Shah, Sarita, Gandhi, Neel R., Chamberlain, Allison, Khan, Fazle, Khan, Shamimul, Smith, Sasha, Williams, Steve, Lash, Timothy L., Collin, Lindsay J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cold Spring Harbor Laboratory 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536882/
https://www.ncbi.nlm.nih.gov/pubmed/33024980
http://dx.doi.org/10.1101/2020.09.30.20203315
Descripción
Sumario:Black, Hispanic, and Indigenous persons in the United States have an increased risk of SARS-CoV-2 infection and death from COVID-19, due to persistent social inequities. The magnitude of the disparity is unclear, however, because race/ethnicity information is often missing in surveillance data. In this study, we quantified the burden of SARS-CoV-2 infection, hospitalization, and case fatality rates in an urban county by racial/ethnic group using combined race/ethnicity imputation and quantitative bias-adjustment for misclassification. After bias-adjustment, the magnitude of the absolute racial/ethnic disparity, measured as the difference in infection rates between classified Black and Hispanic persons compared to classified White persons, increased 1.3-fold and 1.6-fold respectively. These results highlight that complete case analyses may underestimate absolute disparities in infection rates. Collecting race/ethnicity information at time of testing is optimal. However, when data are missing, combined imputation and bias-adjustment improves estimates of the racial/ethnic disparities in the COVID-19 burden.