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. 2021 Nov;61(5):644-651.
doi: 10.1016/j.amepre.2021.05.015. Epub 2021 Jul 16.

Racial and Ethnic Disparities in SARS-CoV-2 Testing and COVID-19 Outcomes in a Medicaid Managed Care Cohort

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Racial and Ethnic Disparities in SARS-CoV-2 Testing and COVID-19 Outcomes in a Medicaid Managed Care Cohort

Mireille Jacobson et al. Am J Prev Med. 2021 Nov.

Abstract

Introduction: Socioeconomic differences may confound racial and ethnic differences in SARS-CoV-2 testing and COVID-19 outcomes.

Methods: A retrospective cohort study was conducted of racial/ethnic differences in SARS-CoV-2 testing and positive tests and COVID-19 hospitalizations and deaths among adults impaneled at a Northern California regional medical center and enrolled in the county Medicaid managed care plan (N=84,346) as of March 1, 2020. Logistic regressions adjusted for demographics, comorbidities, and neighborhood characteristics.

Results: Nearly 30% of enrollees were ever tested for SARS-CoV-2, and 4% tested positive. A total of 19.7 per 10,000 were hospitalized for and 9.4 per 10,000 died of COVID-19. Those identified as Asian, Black, or of other/unknown race had lower testing rates, whereas those identified as Latino had higher testing rates than Whites. Enrollees of Asian or other/unknown race had slightly higher odds of a positive test, and Latinos had much higher odds of a positive test (OR=3.77, 95% CI=3.41, 4.17) than Whites. The odds of hospitalization (OR=2.85, 95% CI=1.85, 4.40) and death (OR=4.75, 95% CI=2.23, 10.12) were higher for Latino than for White patients, even after adjusting for demographics, comorbidities, and neighborhood characteristics.

Conclusions: In a Medicaid managed care population, where socioeconomic differences may be reduced, the odds of a positive SARS-CoV-2 test, COVID-19 hospitalization, and COVID-19 death were higher for Latino but not Black patients than for White patients. Racial/ethnic disparities depend on local context. The substantially higher risk facing Latinos should be a key consideration in California's strategies to mitigate disease transmission and harm.

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Figures

Figure 1
Figure 1
Unadjusted ORs and AORs of testing, positivity, and hospitalizations.

References

    1. Garg S, Kim L, Whitaker M, et al. Hospitalization rates and characteristicsof patients hospitalized with laboratory-confirmed coronavirus disease 2019 - COVID-NET, 14 states, March 1-30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):458–464. doi: 10.15585/mmwr.mm6915e3. - DOI - PMC - PubMed
    1. Killerby ME, Link-Gelles R, Haight SC, et al. Characteristics associated with hospitalization among patients with COVID-19 - metropolitan Atlanta, Georgia, March-April 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):790–794. doi: 10.15585/mmwr.mm6925e1. - DOI - PMC - PubMed
    1. Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus Disease 2019 case surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(24):759–765. doi: 10.15585/mmwr.mm6924e2. - DOI - PMC - PubMed
    1. Gold JAW, Wong KK, Szablewski CM, et al. Characteristics and clinical outcomes of adult patients hospitalized with COVID-19 - Georgia, March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(18):545–550. doi: 10.15585/mmwr.mm6918e1. - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention; 2021. Health equity considerations and racial and ethnic minority groups.https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-e... Updated February 12Accessed April 5, 2021.