Elsevier

Annals of Epidemiology

Volume 48, August 2020, Pages 9-14
Annals of Epidemiology

Original article
Assessing racial and ethnic disparities using a COVID-19 outcomes continuum for New York State

https://doi.org/10.1016/j.annepidem.2020.06.010Get rights and content

Abstract

Purpose

Heightened COVID-19 mortality among Black non-Hispanic and Hispanic communities (relative to white non-Hispanic) is well established. This study aims to estimate the relative contributions to fatality disparities in terms of differences in SARS-CoV-2 infections, diagnoses, and disease severity.

Methods

We constructed COVID-19 outcome continua (similar to the HIV care continuum) for white non-Hispanic, Black non-Hispanic, and Hispanic adults in New York State. For each stage in the COVID-19 outcome continua (population, infection experience, diagnosis, hospitalization, fatality), we synthesized the most recent publicly available data. We described each continuum using overall percentages, fatality rates, and relative changes between stages, with comparisons between race and ethnicity using risk ratios.

Results

Estimated per-population COVID-19 fatality rates were 0.03%, 0.18%, and 0.12% for white non-Hispanic, Black non-Hispanic, and Hispanic adults, respectively. The 3.48-fold disparity for Hispanic, relative to white, communities was explained by differences in infection experience, whereas the 5.38-fold disparity for non-Hispanic Black, relative to white, communities was primarily driven by differences in both infection experience and in the need for hospitalization, given infection.

Conclusions

These findings suggest the most impactful stages on which to intervene with programs and policies to build COVID-19 health equity.

Keywords

Coronavirus
Infectious diseases
Epidemiology
Surveillance
Epidemics
Race factors

Cited by (0)

Author contribution: D.R.H.: Writing – original draft, Writing – review & editing, Formal analysis. M.A.B.: Writing – original draft, Writing – review & editing, Formal analysis. J.M.T.: Writing – review & editing. D.S.B.: Writing – review & editing. E.S.R.: Methodology, Writing – original draft, Writing – review & editing, Formal analysis.

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