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. 2021 Jan:53:56-62.e2.
doi: 10.1016/j.annepidem.2020.08.016. Epub 2020 Sep 11.

Regional variation in COVID-19 disparities: connections with immigrant and Latinx communities in U.S. counties

Kate Strully  1 , Tse-Chuan Yang  2 , Han Liu  2
Affiliations

Regional variation in COVID-19 disparities: connections with immigrant and Latinx communities in U.S. counties

Kate Strully et al. Ann Epidemiol. 2021 Jan.

Abstract

Purpose: To evaluate associations between counties' COVID-19 cases and racial-ethnic and nativity composition, considering heterogeneity across Latin American-origin subgroups and regions of the United States.

Methods: Using county-level data and multilevel negative binomial models, we evaluate associations between COVID-19 cases and percentages of residents that are foreign-born, Latinx, Black, or Asian, presenting estimates for all counties combined and stratifying across regions. Given varying risk factors among Latinx, we also evaluate associations for percentages of residents from specific Latin American-origin groups.

Results: Percentage of foreign-born residents is positively associated with COVID-19 case rate (IRR = 1.106; 95% CI: 1.074-1.139). Adjusted associations for percentage Latinx are nonsignificant for all counties combined, but this obscures heterogeneity. Counties with more Central Americans have higher case rates (IRR = 1.130; 95% CI: 1.067-1.197). And, in the Northeast and Midwest, counties with more Puerto Ricans have higher case rates. Associations with percentage Asians are nonsignificant after adjusting for percentage foreign-born. With the confirmation of prior evidence, the percentage of Black residents is positively and robustly associated with COVID-19 case rate (IRR = 1.031; 95% CI: 1.025-1.036).

Conclusions: Counties with more immigrants, as well as more Central American or Black residents, have more COVID-19 cases. In the Northeast and Midwest, counties with more Puerto Rican residents also have more COVID-19 cases.

Keywords: COVID-19; Disparities; Immigrant communities; Latinx communities.

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Figures

Fig. 1
Fig. 1
Maps of continuous U.S. counties reflecting (A) regions, (B) COVID-19 rates per 10,000 as of May 28, 2020, (C) percentages of Latinx residents, and (D) foreign-born residents.
See this image and copyright information in PMC

References

    1. Yancy C.W. COVID-19 and African Americans. JAMA. 2020;323(19):1891–1892. - PubMed
    1. CDC COVID-19 provisional counts - weekly updates by select demographic and geographic characteristics. 2020. https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm
    1. Owen W.F., Carmona R., Pomeroy C. Failing Another National Stress Test on Health Disparities. JAMA. 2020;323(19):1905–1906. - PubMed
    1. Garg S. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 — COVID-NET, 14 States, March 1–30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:458–464. - PMC - PubMed
    1. Rosenberg E.S., Tesoriero J.M., Rosenthal E.M., Chung R., Barranco M.A., Styer L.M. Cumulative incidence and diagnosis of SARS-CoV-2 infection in New York. Ann Epidemiol. 2020;48:23–29. - PMC - PubMed

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