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. 2020 Jul 6;19(1):114.
doi: 10.1186/s12939-020-01227-y.

Race, socioeconomic deprivation, and hospitalization for COVID-19 in English participants of a national biobank

Aniruddh P Patel  1   2   3 , Manish D Paranjpe  2   3 , Nina P Kathiresan  3   4 , Manuel A Rivas  5 , Amit V Khera  6   7   8
Affiliations

Race, socioeconomic deprivation, and hospitalization for COVID-19 in English participants of a national biobank

Aniruddh P Patel et al. Int J Equity Health. .

Abstract

Preliminary reports suggest that the Coronavirus Disease 2019 (COVID- 19) pandemic has led to disproportionate morbidity and mortality among historically disadvantaged populations. We investigate the racial and socioeconomic associations of COVID- 19 hospitalization among 418,794 participants of the UK Biobank, of whom 549 (0.13%) had been hospitalized. Both Black participants (odds ratio 3.7; 95%CI 2.5-5.3) and Asian participants (odds ratio 2.2; 95%CI 1.5-3.2) were at substantially increased risk as compared to White participants. We further observed a striking gradient in COVID- 19 hospitalization rates according to the Townsend Deprivation Index - a composite measure of socioeconomic deprivation - and household income. Adjusting for socioeconomic factors and cardiorespiratory comorbidities led to only modest attenuation of the increased risk in Black participants, adjusted odds ratio 2.4 (95%CI 1.5-3.7). These observations confirm and extend earlier preliminary and lay press reports of higher morbidity in non-White individuals in the context of a large population of participants in a national biobank. The extent to which this increased risk relates to variation in pre-existing comorbidities, differences in testing or hospitalization patterns, or additional disparities in social determinants of health warrants further study.

Keywords: COVID-19; Health disparity; Race; Socioeconomic deprivation.

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Conflict of interest statement

A.V.K. has served as a consultant to Sanofi, Medicines Company, Amgen, Maze Pharmaceuticals, Navitor Pharmaceuticals, and Color Genomics; received speaking fees from Illumina, the Novartis Institute for Biomedical Research; received sponsored research agreements from the Novartis Institute for Biomedical Research and IBM Research, and reports a patent related to a genetic risk predictor (20190017119). The remaining authors have no disclosures.

Figures

Fig. 1
Fig. 1
COVID-19 hospitalization rates by race and geographic region, Townsend Deprivation Index, and household income. a COVID-19 hospitalizations per 10,000 individuals stratified by self-reported race and geographic region grouped based on socio-demographic similarities. In all regions, significant differences in COVID-19 hospitalizations were observed between self-reported White, Asian and Black individuals (1-way ANOVA p < 0.001). b Mean COVID-19 hospitalizations per 10,000 individuals by deciles of the Townsend Deprivation Index. Townsend Deprivation Index was significantly associated with COVID-19 hospitalization in adjusted and unadjusted models (p < 0.001). c COVID-19 hospitalizations per 10,000 individuals by brackets of self-reported pre-tax household income. Pre-tax household income was significantly associated with COVID-19 hospitalization in an unadjusted model (p < 0.001)
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References

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