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. 2022 Feb 18;19(4):2368.
doi: 10.3390/ijerph19042368.

Disparities in Excess, All-Cause Mortality among Black, Hispanic, and White Veterans at the U.S. Department of Veterans Affairs during the COVID-19 Pandemic

Lilia R Lukowsky  1 , Claudia Der-Martirosian  1 , Aram Dobalian  1   2
Affiliations

Disparities in Excess, All-Cause Mortality among Black, Hispanic, and White Veterans at the U.S. Department of Veterans Affairs during the COVID-19 Pandemic

Lilia R Lukowsky et al. Int J Environ Res Public Health. .

Abstract

Background: From 2019 to 2020, all-cause mortality in the U.S. increased, with most of the rise attributed to COVID-19. No studies have examined the racial disparities in all-cause mortality among U.S. veterans receiving medical care (VA users) at the U.S. Department of Veterans Affairs (VA) during the pandemic.

Methods: In the present paper, we conduct a longitudinal study examining the differences in mortality among White, Black, and Hispanic veterans, aged 45 years and older, during the first, full year of the pandemic (March 2020-February 2021). We calculated the Standardized Mortality Rates (SMRs) per 100,000 VA users for each racial and ethnic group by age and gender.

Results: The highest percentage increase between the number of deaths occurred between pre- and post-pandemic years (March 2020-February 2021 vs. March 2019-February 2020). For Hispanics, the all-cause mortality increased by 34%, while for Blacks, it increased by 32%. At the same time, we observed that an 18% increase in all-cause mortality occurred among Whites.

Conclusion: Blacks and Hispanics were disproportionately affected by the COVID-19 pandemic, leading both directly and indirectly to higher all-cause mortality among these groups compared to Whites. Disparities in the all-cause mortality rates varied over time and across groups. Additional research is needed to examine which factors may account for the observed changes over time. Understanding those factors will permit the development of strategies to mitigate these disparities.

Keywords: COVID-19; all-cause mortality; pandemic; racial disparities; veterans.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Monthly standardized mortality rates, among White, Black, and Hispanic VA users over 45 years old, between March 2018 and February 2020.
Figure 2
Figure 2
Excess of all-cause monthly deaths as a difference between observed and expected monthly death counts, standardizing by age and gender, among VA users aged 45 years or older by racial/ethnic group from March 2018 to February 2021.
Figure 3
Figure 3
Percent change between each month of period 3 and the average of number of deaths between periods 1 and 2 among VA users aged 45 years or older, between March 2018 and February 2021.
See this image and copyright information in PMC

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