Lessons Learned from Health Disparities in Coronavirus Disease-2019 in the United States

Abstract

In the United States, the coronavirus disease-2019 (COVID-19) pandemic has disproportionally affected Black, Latinx, and Indigenous populations, immigrants, and economically disadvantaged individuals. Such historically marginalized groups are more often employed in low-wage jobs without health insurance and have higher rates of infection, hospitalization, and death from COVID-19 than non-Latinx White individuals. Mistrust in the health care system, language barriers, and limited health literacy have hindered vaccination rates in minorities, further exacerbating health disparities rooted in structural, institutional, and socioeconomic inequities. In this article, we discuss the lessons learned over the last 2 years and how to mitigate health disparities moving forward.

Keywords: Black; Covid-19; Health disparities; Hispanic; Latino; Latinx; Race/ethnicity.

Fig. 1

Structural and social determinants of health contributing to the racial and ethnic disparities in the coronavirus disease (COVID-19) pandemic in the United States and proposed areas for action, as informed by the World Health Organization Conceptual Framework for Action. PPE, personal protective equipment.

Fig. 2

COVID-19 weekly cases per 100,000 population by race/ethnicity, United States, March 1, 2020-June 4, 2022. Percentage of cases reporting race, 63.1%. Demographic data for COVID-19 cases is based on a subset of individuals where state and territorial jurisdictions have reported case-level data to the CDC since January 21, 2020. Demographic data have varying degrees of missing data and are not generalizable to the entire population of individuals with COVID-19. All displayed counts include confirmed COVID-19 cases as reported by US states, US territories, New York City (NYC), and the District of Columbia from the previous day. Counts for certain jurisdictions also include probable COVID-19 cases. Case rates displayed for the week ending 08/07/2021 reflect a large data influx. The clinical dates for these data were not available. These data are provisional and will be updated as CDC receives additional information. AI/AN, American Indian/Alaska Native; NH, non-hispanic; PI, Pacific Islander.

Fig. 3

COVID-19 cases per capita between most and least socially disadvantaged counties. This data represents cases from the onset of the pandemic through April 19, 2020. The most vulnerable quartile of counties (n = 706, top) and the least vulnerable quartile of counties (n = 625, bottom), as indicated by the minority status and language domain of the US Centers for Disease Control’s Social Vulnerability Index. Counties without linked Federal Information Processing Standard code or reported COVID-19 cases were excluded. Darker shades represent counties with more cases per capita.

Fig. 4

Spanish-speaking mother at an English-speaking-only vaccination site.