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. 2020 Dec;86(12):1615-1622.
doi: 10.1177/0003134820973356. Epub 2020 Nov 24.

Disproportionate Impact of COVID-19 Pandemic on Racial and Ethnic Minorities

Brad Boserup  1 , Mark McKenney  1   2 , Adel Elkbuli  1
Affiliations

Disproportionate Impact of COVID-19 Pandemic on Racial and Ethnic Minorities

Brad Boserup et al. Am Surg. 2020 Dec.

Expression of concern in

  • Expression of Concern.
    [No authors listed] [No authors listed] Am Surg. 2025 Mar;91(3):464-472. doi: 10.1177/00031348241305412. Epub 2025 Jan 10. Am Surg. 2025. PMID: 39791244 Free PMC article. No abstract available.

Abstract

Background: Health disparities are prevalent in many areas of medicine. We aimed to investigate the impact of the COVID-19 pandemic on racial/ethnic groups in the United States (US) and to assess the effects of social distancing, social vulnerability metrics, and medical disparities.

Methods: A cross-sectional study was conducted utilizing data from the COVID-19 Tracking Project and the Centers for Disease Control and Prevention (CDC). Demographic data were obtained from the US Census Bureau, social vulnerability data were obtained from the CDC, social distancing data were obtained from Unacast, and medical disparities data from the Center for Medicare and Medicaid Services. A comparison of proportions by Fisher's exact test was used to evaluate differences between death rates stratified by age. Negative binomial regression analysis was used to predict COVID-19 deaths based on social distancing scores, social vulnerability metrics, and medical disparities.

Results: COVID-19 cumulative infection and death rates were higher among minority racial/ethnic groups than whites across many states. Older age was also associated with increased cumulative death rates across all racial/ethnic groups on a national level, and many minority racial/ethnic groups experienced significantly greater cumulative death rates than whites within age groups ≥ 35 years. All studied racial/ethnic groups experienced higher hospitalization rates than whites. Older persons (≥ 65 years) also experienced more COVID-19 deaths associated with comorbidities than younger individuals. Social distancing factors, several measures of social vulnerability, and select medical disparities were identified as being predictive of county-level COVID-19 deaths.

Conclusion: COVID-19 has disproportionately impacted many racial/ethnic minority communities across the country, warranting further research and intervention.

Keywords: COVID-19; health disparities; racial disparities; social determinants of health.

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Figures

Figure 1.
Figure 1.
Cumulative crude COVID-19 death rates (per 100 000 population) according to age, race, and ethnicity (data recorded by the Centers for Disease Control from the week of February 1, 2020-the week of July 11, 2020). Asterisks indicate a significant difference in comparison to whites within each age group studied. Significance was determined via a simple comparison of proportions by Fisher’s exact test. *P < .01; **P < .001.
Figure 2.
Figure 2.
Cumulative crude laboratory-confirmed COVID-19-associated hospitalizations rates (data represent the 14 states in the COVID-NET network and were recorded from March 1, 2020-July 11, 2020). The dashed lines represent hospitalization rates (per 100 000 population) according to age, race, and ethnicity while the bar graph represents hospitalization rate ratios according to age, race, and ethnicity. Rate ratios are the ratio of racial/ethnic cumulative crude COVID-19-associated hospitalizations rates to age-matched white cumulative crude COVID-19-associated hospitalizations rates.
Figure 3.
Figure 3.
Cumulative COVID-19 deaths according to comorbidity and age (data were collected by the Centers for Disease Control and Prevention from February 1, 2020-July 11, 2020).
See this image and copyright information in PMC

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