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. 2021 Jun;8(3):732-742.
doi: 10.1007/s40615-020-00833-4. Epub 2020 Sep 1.

Racial, Economic, and Health Inequality and COVID-19 Infection in the United States

Vida Abedi #  1   2 , Oluwaseyi Olulana #  3 , Venkatesh Avula  1 , Durgesh Chaudhary  4 , Ayesha Khan  4 , Shima Shahjouei  4 , Jiang Li  1 , Ramin Zand  5
Affiliations

Racial, Economic, and Health Inequality and COVID-19 Infection in the United States

Vida Abedi et al. J Racial Ethn Health Disparities. 2021 Jun.

Abstract

Objectives: There is preliminary evidence of racial and social economic disparities in the population infected by and dying from COVID-19. The goal of this study is to report the associations of COVID-19 with respect to race, health, and economic inequality in the United States.

Methods: We performed an ecological study of the associations between infection and mortality rate of COVID-19 and demographic, socioeconomic, and mobility variables from 369 counties (total population, 102,178,117 [median, 73,447; IQR, 30,761-256,098]) from the seven most affected states (Michigan, New York, New Jersey, Pennsylvania, California, Louisiana, Massachusetts).

Results: The risk factors for infection and mortality are different. Our analysis shows that counties with more diverse demographics, higher population, education, income levels, and lower disability rates were at a higher risk of COVID-19 infection. However, counties with higher proportion with disability and poverty rates had a higher death rate. African Americans were more vulnerable to COVID-19 than other ethnic groups (1981 African American infected cases versus 658 Whites per million). Data on mobility changes corroborate the impact of social distancing.

Conclusion: Our study provides evidence of racial, economic, and health inequality in the population infected by and dying from COVID-19. These observations might be due to the workforce of essential services, poverty, and access to care. Counties in more urban areas are probably better equipped at providing care. The lower rate of infection, but a higher death rate in counties with higher poverty and disability could be due to lower levels of mobility, but a higher rate of comorbidities and health care access.

Keywords: COVID-19; Ecological-based study; Economic inequality; Health status disparities; Healthcare disparities; Population-based analysis; Racial disparity; Socioeconomic factors; United States.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Population count, non-Hispanic White, and Median Income and the rate of COVID-19 and related death in the counties of the state of Pennsylvania, as of April 9, 2020
Fig. 2
Fig. 2
a Bivariate analysis of factors for mortality due to COVID-19. b Bivariate analysis of factors for infection by COVID-19
See this image and copyright information in PMC

Update of

References

    1. Branswell H, Joseph A. WHO declares the coronavirus outbreak a pandemic. n.d. Retrieved April 14, 2020, from https://www.statnews.com/2020/03/11/who-declares-the-coronavirus-outbrea...
    1. Lake MA. What we know so far: COVID-19 current clinical knowledge and research. Clin Med. 2020;20(2):124–127. doi: 10.7861/clinmed.2019-coron. - DOI - PMC - PubMed
    1. Garg S, Kim L, Whitaker M, O’Halloran A, Cummings C, Holstein R, et al. Hospitalization Rates and Characteristics of Patients Hospitalized with. 2020. MMWR:Morbidity and Mortality Weekly Report. 69(15):458–64. - PMC - PubMed
    1. JHU. Coronavirus COVID-19 global cases by the center for systems science and engineering [Internet]. Johns Hopkins Univ. 2020;Available from: https://coronavirus.jhu.edu/map.html
    1. Zhu L, She ZG, Cheng X, Qin JJ, Zhang XJ, Cai J, Lei F, Wang H, Xie J, Wang W, Li H. Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes. Cell Metabolism. 2020 May 1. https://www.cell.com/cell-metabolism/pdfExtended/S1550-4131(20)30238-2. - PMC - PubMed

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