Increased COVID-19 mortality among immigrants compared with US-born individuals: a cross-sectional analysis of 2020 mortality data

A M Bacong¹, R Chu², A Le³, V Bui⁴, N E Wang⁵, L P Palaniappan⁶

Affiliations

¹ Stanford University School of Medicine, Department of Medicine, Division of Cardiovascular Medicine, Stanford, CA, USA; Stanford University Center for Asian Health Research and Education, Stanford, CA, USA. Electronic address: abacong@stanford.edu.
² Stanford University Center for Asian Health Research and Education, Stanford, CA, USA; University of California, Los Angeles Fielding School of Public Health, Department of Community Health Sciences, Los Angeles, CA, USA; Asian American Studies Department, University of California, Los Angeles, Los Angeles, CA, USA.
³ University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
⁴ University of California, Berkeley School of Public Health, Berkeley, CA, USA.
⁵ Stanford University Center for Asian Health Research and Education, Stanford, CA, USA; Stanford University School of Medicine, Department of Medicine, Division of Emergency Medicine, Stanford, CA, USA.
⁶ Stanford University School of Medicine, Department of Medicine, Division of Cardiovascular Medicine, Stanford, CA, USA; Stanford University Center for Asian Health Research and Education, Stanford, CA, USA.

PMID: 38703491
PMCID: PMC11488693
DOI: 10.1016/j.puhe.2024.03.016

Observational Study

Increased COVID-19 mortality among immigrants compared with US-born individuals: a cross-sectional analysis of 2020 mortality data

A M Bacong et al. Public Health. 2024 Jun.

. 2024 Jun:231:173-178.

doi: 10.1016/j.puhe.2024.03.016. Epub 2024 May 3.

Authors

A M Bacong¹, R Chu², A Le³, V Bui⁴, N E Wang⁵, L P Palaniappan⁶

Affiliations

¹ Stanford University School of Medicine, Department of Medicine, Division of Cardiovascular Medicine, Stanford, CA, USA; Stanford University Center for Asian Health Research and Education, Stanford, CA, USA. Electronic address: abacong@stanford.edu.
² Stanford University Center for Asian Health Research and Education, Stanford, CA, USA; University of California, Los Angeles Fielding School of Public Health, Department of Community Health Sciences, Los Angeles, CA, USA; Asian American Studies Department, University of California, Los Angeles, Los Angeles, CA, USA.
³ University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
⁴ University of California, Berkeley School of Public Health, Berkeley, CA, USA.
⁵ Stanford University Center for Asian Health Research and Education, Stanford, CA, USA; Stanford University School of Medicine, Department of Medicine, Division of Emergency Medicine, Stanford, CA, USA.
⁶ Stanford University School of Medicine, Department of Medicine, Division of Cardiovascular Medicine, Stanford, CA, USA; Stanford University Center for Asian Health Research and Education, Stanford, CA, USA.

PMID: 38703491
PMCID: PMC11488693
DOI: 10.1016/j.puhe.2024.03.016

Abstract

Objective: Multiple studies have shown that racially minoritized groups had disproportionate COVID-19 mortality relative to non-Hispanic White individuals. However, there is little known regarding mortality by immigrant status nationally in the United States, despite being another vulnerable population.

Study design: This was an observational cross-sectional study using mortality vital statistics system data to calculate proportionate mortality ratios (PMRs) and mortality rates due to COVID-19 as the underlying cause.

Methods: Rates were compared by decedents' identified race, ethnicity (Hispanic vs non-Hispanic), and immigrant (immigrants vs US born) status. Asian race was further disaggregated into "Asian Indian," "Chinese," "Filipino," "Japanese," "Korean," and "Vietnamese."

Results: Of the over 3.4 million people who died in 2020, 10.4% of all deaths were attributed to COVID-19 as the underlying cause (n = 351,530). More than double (18.9%, n = 81,815) the percentage of immigrants who died of COVID-19 compared with US-born decedents (9.1%, n = 269,715). PMRs due to COVID-19 were higher among immigrants compared with US-born individuals for non-Hispanic White, non-Hispanic Black, Hispanic, and most disaggregated Asian groups. Among disaggregated Asian immigrants, age- and sex-adjusted PMR due to COVID-19 ranged from 1.58 times greater mortality among Filipino immigrants (95% confidence interval [CI]: 1.53, 1.64) to 0.77 times greater mortality among Japanese immigrants (95% CI: 0.68, 0.86). Age-adjusted mortality rates were also higher among immigrant individuals compared with US-born people.

Conclusions: Immigrant individuals experienced greater mortality due to COVID-19 compared with their US-born counterparts. As COVID-19 becomes more endemic, greater clinical and public health efforts are needed to reduce disparities in mortality among immigrants compared with their US-born counterparts.

Keywords: Asian American; COVID-19; Health disparities; Hispanic; Mortality.

PubMed Disclaimer

References

1. Rossen LM, Ahmad FB, Anderson RN, et al. Disparities in Excess Mortality Associated with COVID-19 - United States, 2020. MMWR Morb Mortal Wkly Rep. Aug 20 2021;70(33):1114–1119. doi:10.15585/mmwr.mm7033a2 - DOI - PMC - PubMed
1. Bassett MT, Chen JT, Krieger N. Variation in racial/ethnic disparities in COVID-19 mortality by age in the United States: A cross-sectional study. PLOS Medicine. 2020;17(10):e1003402. doi:10.1371/journal.pmed.1003402 - DOI - PMC - PubMed
1. Rossen LM, Branum AM, Ahmad FB, Sutton P, Anderson RN. Excess Deaths Associated with COVID-19, by Age and Race and Ethnicity - United States, January 26-October 3, 2020. MMWR Morb Mortal Wkly Rep. Oct 23 2020;69(42):1522–1527. doi:10.15585/mmwr.mm6942e2 - DOI - PMC - PubMed
1. Subica AM, Aitaoto N, Li Q, et al. Assessing the Impact of COVID-19 on the Health of Native Hawaiian/Pacific Islander People in the United States, 2021. Public Health Reports. 2023;138(1):164–173. doi:10.1177/00333549221123579 - DOI - PMC - PubMed
1. Magesh S, John D, Li WT, et al. Disparities in COVID-19 Outcomes by Race, Ethnicity, and Socioeconomic Status: A Systematic Review and Meta-analysis. JAMA Network Open. 2021;4(11):e2134147–e2134147. doi:10.1001/jamanetworkopen.2021.34147 - DOI - PMC - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Increased COVID-19 mortality among immigrants compared with US-born individuals: a cross-sectional analysis of 2020 mortality data

Affiliations

Increased COVID-19 mortality among immigrants compared with US-born individuals: a cross-sectional analysis of 2020 mortality data

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Supplementary concepts

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials