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Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates

BACKGROUND: Racial inequities in Coronavirus 2019 (COVID-19) have been reported over the course of the pandemic, with Black, Hispanic/Latinx, and Native American individuals suffering higher case rates and more fatalities than their White counterparts. METHODS: We used a unique statewide dataset of...

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Autores principales: Joynt Maddox, Karen E., Reidhead, Mat, Grotzinger, Joshua, McBride, Timothy, Mody, Aaloke, Nagasako, Elna, Ross, Will, Steensma, Joseph T., Barker, Abigail R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797246/
https://www.ncbi.nlm.nih.gov/pubmed/35089919
http://dx.doi.org/10.1371/journal.pone.0260262
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author Joynt Maddox, Karen E.
Reidhead, Mat
Grotzinger, Joshua
McBride, Timothy
Mody, Aaloke
Nagasako, Elna
Ross, Will
Steensma, Joseph T.
Barker, Abigail R.
author_facet Joynt Maddox, Karen E.
Reidhead, Mat
Grotzinger, Joshua
McBride, Timothy
Mody, Aaloke
Nagasako, Elna
Ross, Will
Steensma, Joseph T.
Barker, Abigail R.
author_sort Joynt Maddox, Karen E.
collection PubMed
description BACKGROUND: Racial inequities in Coronavirus 2019 (COVID-19) have been reported over the course of the pandemic, with Black, Hispanic/Latinx, and Native American individuals suffering higher case rates and more fatalities than their White counterparts. METHODS: We used a unique statewide dataset of confirmed COVID-19 cases across Missouri, linked with historical statewide hospital data. We examined differences by race and ethnicity in raw population-based case and mortality rates. We used patient-level regression analyses to calculate the odds of mortality based on race and ethnicity, controlling for comorbidities and other risk factors. RESULTS: As of September 10, 2020 there were 73,635 confirmed COVID-19 cases in the State of Missouri. Among the 64,526 case records (87.7% of all cases) that merged with prior demographic and health care utilization data, 12,946 (20.1%) were Non-Hispanic (NH) Black, 44,550 (69.0%) were NH White, 3,822 (5.9%) were NH Other/Unknown race, and 3,208 (5.0%) were Hispanic. Raw cumulative case rates for NH Black individuals were 1,713 per 100,000 population, compared with 2,095 for NH Other/Unknown, 903 for NH White, and 1,218 for Hispanic. Cumulative COVID-19-related death rates for NH Black individuals were 58.3 per 100,000 population, compared with 38.9 for NH Other/Unknown, 19.4 for NH White, and 14.8 for Hispanic. In a model that included insurance source, history of a social determinant billing code in the patient’s claims, census block travel change, population density, Area Deprivation Index, and clinical comorbidities, NH Black race (OR 1.75, 1.51–2.04, p<0.001) and NH Other/Unknown race (OR 1.83, 1.36–2.46, p<0.001) remained strongly associated with mortality. CONCLUSIONS: In Missouri, COVID-19 case rates and mortality rates were markedly higher among NH Black and NH Other/Unknown race than among NH White residents, even after accounting for social and clinical risk, population density, and travel patterns during COVID-19.
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spelling pubmed-87972462022-01-29 Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates Joynt Maddox, Karen E. Reidhead, Mat Grotzinger, Joshua McBride, Timothy Mody, Aaloke Nagasako, Elna Ross, Will Steensma, Joseph T. Barker, Abigail R. PLoS One Research Article BACKGROUND: Racial inequities in Coronavirus 2019 (COVID-19) have been reported over the course of the pandemic, with Black, Hispanic/Latinx, and Native American individuals suffering higher case rates and more fatalities than their White counterparts. METHODS: We used a unique statewide dataset of confirmed COVID-19 cases across Missouri, linked with historical statewide hospital data. We examined differences by race and ethnicity in raw population-based case and mortality rates. We used patient-level regression analyses to calculate the odds of mortality based on race and ethnicity, controlling for comorbidities and other risk factors. RESULTS: As of September 10, 2020 there were 73,635 confirmed COVID-19 cases in the State of Missouri. Among the 64,526 case records (87.7% of all cases) that merged with prior demographic and health care utilization data, 12,946 (20.1%) were Non-Hispanic (NH) Black, 44,550 (69.0%) were NH White, 3,822 (5.9%) were NH Other/Unknown race, and 3,208 (5.0%) were Hispanic. Raw cumulative case rates for NH Black individuals were 1,713 per 100,000 population, compared with 2,095 for NH Other/Unknown, 903 for NH White, and 1,218 for Hispanic. Cumulative COVID-19-related death rates for NH Black individuals were 58.3 per 100,000 population, compared with 38.9 for NH Other/Unknown, 19.4 for NH White, and 14.8 for Hispanic. In a model that included insurance source, history of a social determinant billing code in the patient’s claims, census block travel change, population density, Area Deprivation Index, and clinical comorbidities, NH Black race (OR 1.75, 1.51–2.04, p<0.001) and NH Other/Unknown race (OR 1.83, 1.36–2.46, p<0.001) remained strongly associated with mortality. CONCLUSIONS: In Missouri, COVID-19 case rates and mortality rates were markedly higher among NH Black and NH Other/Unknown race than among NH White residents, even after accounting for social and clinical risk, population density, and travel patterns during COVID-19. Public Library of Science 2022-01-28 /pmc/articles/PMC8797246/ /pubmed/35089919 http://dx.doi.org/10.1371/journal.pone.0260262 Text en © 2022 Joynt Maddox et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Joynt Maddox, Karen E.
Reidhead, Mat
Grotzinger, Joshua
McBride, Timothy
Mody, Aaloke
Nagasako, Elna
Ross, Will
Steensma, Joseph T.
Barker, Abigail R.
Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates
title Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates
title_full Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates
title_fullStr Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates
title_full_unstemmed Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates
title_short Understanding contributors to racial and ethnic inequities in COVID-19 incidence and mortality rates
title_sort understanding contributors to racial and ethnic inequities in covid-19 incidence and mortality rates
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797246/
https://www.ncbi.nlm.nih.gov/pubmed/35089919
http://dx.doi.org/10.1371/journal.pone.0260262
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