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. 2020 Dec;110(12):1850-1852.
doi: 10.2105/AJPH.2020.305913. Epub 2020 Oct 15.

COVID-19 and Overall Mortality Inequities in the Surge in Death Rates by Zip Code Characteristics: Massachusetts, January 1 to May 19, 2020

Nancy Krieger  1 , Pamela D Waterman  1 , Jarvis T Chen  1
Affiliations

COVID-19 and Overall Mortality Inequities in the Surge in Death Rates by Zip Code Characteristics: Massachusetts, January 1 to May 19, 2020

Nancy Krieger et al. Am J Public Health. 2020 Dec.

Abstract

Objectives. To address evidence gaps in COVID-19 mortality inequities resulting from inadequate race/ethnicity data and no socioeconomic data.Methods. We analyzed age-standardized death rates in Massachusetts by weekly time intervals, comparing rates for January 1 to May 19, 2020, with the corresponding historical average for 2015 to 2019 stratified by zip code social metrics.Results. At the surge peak (week 16, April 15-21), mortality rate ratios (comparing 2020 vs 2015-2019) were 2.2 (95% confidence interval [CI] = 1.4, 3.5) and 2.7 (95% CI = 1.4, 5.5) for the lowest and highest zip code tabulation area (ZCTA) poverty categories, respectively, with the 2020 peak mortality rate 1.1 (95% CI = 1.0, 1.3) times higher in the highest than the lowest poverty ZCTA. Similarly, rate ratios were significantly elevated for the highest versus lowest quintiles with respect to household crowding (1.7; 95% CI = 1.0, 2.9), racialized economic segregation (3.1; 95% CI = 1.8, 5.3), and percentage population of color (1.8; 95% CI = 1.6, 2.0).Conclusions. The COVID-19 mortality surge exhibited large inequities.Public Health Implications. Using zip code social metrics can guide equity-oriented COVID-19 prevention and mitigation efforts.

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Figures

FIGURE 1—
FIGURE 1—
Weekly Age-Standardized All-Cause Mortality Rates per 100 000 Person-Years in 2015–2019 vs 2020 by Massachusetts Zip Code Social Metrics for (a) Percentage Household Crowding and (b) Percentage Population of Color Note. For full figure showing all zip code social metrics used, see Figure A (available as a supplement to the online version of this article at https://www.ajph.org).
See this image and copyright information in PMC

References

    1. Krieger N, Gonsalves G, Bassett MT, Hanage W, Krumholz HM. The fierce urgency of now: closing glaring gaps in US surveillance data on COVID-19. Available at: https://www.healthaffairs.org/do/10.1377/hblog20200414.238084/full. Accessed July 29, 2020. - DOI
    1. Villarosa L. “A terrible price”: the deadly racial disparities of COVID-19 in America. Available at: https://www.nytimes.com/2020/04/29/magazine/racial-disparities-covid-19..... Accessed July 29, 2020.
    1. COVID Tracking Project. COVID racial data tracker. Available at: https://covidtracking.com/race. Accessed July 29, 2020.
    1. Leon DA, Shkolnikov VM, Smeeth L, Magnus P, Pecholdová M, Jarvis CI. COVID-19: a need for real-time monitoring of weekly excess deaths [letter] Lancet. 2020;395(10234):E81. doi: 10.1016/S0140-6736(20)30933-8. - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention. Preliminary estimate of excess mortality during the COVID-19 outbreak—New York City, March 11–May 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(19):603–605. doi: 10.15585/mmwr.mm6919e5. - DOI - PubMed

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