Racial and Ethnic Disparities in COVID-19 Outcomes: Social Determination of Health

Abstract

As of 18 October 2020, over 39.5 million cases of coronavirus disease 2019 (COVID-19) and 1.1 million associated deaths have been reported worldwide. It is crucial to understand the effect of social determination of health on novel COVID-19 outcomes in order to establish health justice. There is an imperative need, for policy makers at all levels, to consider socioeconomic and racial and ethnic disparities in pandemic planning. Cross-sectional analysis from COVID Boston University's Center for Antiracist Research COVID Racial Data Tracker was performed to evaluate the racial and ethnic distribution of COVID-19 outcomes relative to representation in the United States. Representation quotients (RQs) were calculated to assess for disparity using state-level data from the American Community Survey (ACS). We found that on a national level, Hispanic/Latinx, American Indian/Alaskan Native, Native Hawaiian/Pacific Islanders, and Black people had RQs > 1, indicating that these groups are over-represented in COVID-19 incidence. Dramatic racial and ethnic variances in state-level incidence and mortality RQs were also observed. This study investigates pandemic disparities and examines some factors which inform the social determination of health. These findings are key for developing effective public policy and allocating resources to effectively decrease health disparities. Protective standards, stay-at-home orders, and essential worker guidelines must be tailored to address the social determination of health in order to mitigate health injustices, as identified by COVID-19 incidence and mortality RQs.

Keywords: COVID-19 pandemic; disadvantaged populations; gender; intersectionality; occupational risk; poverty; race; social determination of health.

Figure 1

Choropleth Maps of COVID-19 Incidence RQ by State among (A): White people; (B): Black people; (C): Latinx people; (D): Asian people; (E): AIAN; (F): NHPI.

Figure 2

Choropleth Maps of COVID-19 Death RQ by State among (A): White people; (B): Black people; (C): Latinx people; (D): Asian people; (E): AIAN; (F): NHPI.