Significant mortality rate variation associated with race in the United States

1. Age-specific mortality rates varied significantly by race in the context of COVID-19 infection.

2. Higher mortality rates were observed for Blacks, Hispanics, American Indians, and Asians, relative to Whites.

Evidence Rating Level: 3 (Average)

The United States has faced the omnipresent reality of racial health disparities, with COVID-19 opening the door to bring these issues to the forefront. Non-Hispanic White individuals are being impacted at a significantly reduced rate compared to underrepresented minorities. This cross-sectional study drew data from the US Census between February 1, 2020 and July 22, 2020 to investigate age-specific variations in COVID-19 mortality rates stratified by racial group. The number of deaths related to COVID-19 by race were 68,377 for Whites, 29,476 for Blacks, 23,256 for Hispanics, 1,143 for American Indians/Alaskan Natives, and 6,468 for Asians/Pacific Islanders. Relative to White individuals, the age-standardized rate ratios were calculated for Blacks (RR = 3.6, 95% CI 3.5 to 3.8, p<.001), Hispanics (RR = 2.8, 95% CI 2.7 to 3.0, p<.001), American Indians/Alaskan Natives (RR = 2.2, 95% CI 1.8 to 2.6, p<.001), and Asians/Pacific Islanders (RR = 1.6, 95% CI 1.4 to 1.7, p<.001). For persons between the ages of 35 and 44 years, rate ratios relative to Whites were quite high, with Blacks being 9.0 (95% CI 7.9 to 10.0, p<.001) and Hispanics being 7.0 (95% CI 5.8 to 8.7, p<.001). American Indians/Alaskan Natives demonstrated similarly high rate ratios through 74 years of age. Age-standardized rates alone would not result in these findings. However, this study suggests that there is substantial variation by race in age-specific mortality rates amidst COVID-19. Further research should exercise caution in the use of age standardization when working within age strata.

Click to read the study in PLOS Medicine

Image: PD

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