Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 29;19(5):e0303667.
doi: 10.1371/journal.pone.0303667. eCollection 2024.

Association of race/ethnicity and severe housing problems with COVID-19 deaths in the United States: Analysis of the first three waves

Mumbi E Kimani  1   2 , Mare Sarr  3   4
Affiliations

Association of race/ethnicity and severe housing problems with COVID-19 deaths in the United States: Analysis of the first three waves

Mumbi E Kimani et al. PLoS One. .

Abstract

The objective of this study is to assess the associations of race/ethnicity and severe housing problems with COVID-19 death rates in the US throughout the first three waves of the COVID-19 pandemic in the US. We conducted a cross-sectional study using a negative binomial regression model to estimate factors associated with COVID-19 deaths in 3063 US counties between March 2020 and July 2021 by wave and pooled across all three waves. In Wave 1, counties with larger percentages of Black, Hispanic, American Indian and Alaska Native (AIAN), and Asian American and Pacific Islander (AAPI) residents experienced a greater risk of deaths per 100,000 residents of +22.82 (95% CI 15.09, 30.56), +7.50 (95% CI 1.74, 13.26), +13.52 (95% CI 8.07, 18.98), and +5.02 (95% CI 0.92, 9.12), respectively, relative to counties with larger White populations. By Wave 3, however, the mortality gap declined considerably in counties with large Black, AIAN and AAPI populations: +10.38 (95% CI 4.44, 16.32), +7.14 (95% CI 1.14, 13.15), and +3.72 (95% CI 0.81, 6.63), respectively. In contrast, the gap increased for counties with a large Hispanic population: +13 (95% CI 8.81, 17.20). Housing problems were an important predictor of COVID-19 deaths. However, while housing problems were associated with increased COVID-19 mortality in Wave 1, by Wave 3, they contributed to magnified mortality in counties with large racial/ethnic minority groups. Our study revealed that focusing on a wave-by-wave analysis is critical to better understand how the associations of race/ethnicity and housing conditions with deaths evolved throughout the first three COVID-19 waves in the US. COVID-19 mortality initially took hold in areas characterized by large racial/ethnic minority populations and poor housing conditions. Over time, as the virus spread to predominantly White counties, these disparities decreased substantially but remained sizable.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. COVID-19 deaths count.
Fig 2
Fig 2. Marginal effect of racial/ethnic composition–pooled sample.
Fig 3
Fig 3. Marginal effect of racial/ethnic composition–Wave 1.
Fig 4
Fig 4. Marginal effect of racial/ethnic composition–Wave 2.
Fig 5
Fig 5. Marginal effect of racial/ethnic composition–Wave 3.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Shaw M. Housing and Public Health. Annu Rev Public Health. 2004;25(1):397–418. doi: 10.1146/annurev.publhealth.25.101802.123036 - DOI - PubMed
    1. Dedman DJ, Gunnell D, Smith GD, Frankel S. Childhood housing conditions and later mortality in the Boyd Orr cohort. J Epidemiol Community Health. 2001. Jan 1;55(1):10–5. doi: 10.1136/jech.55.1.10 - DOI - PMC - PubMed
    1. Lanphear BP, Aligne CA, Auinger P, Weitzman M, Byrd RS. Residential Exposures Associated With Asthma in US Children. Pediatrics. 2001. Mar 1;107(3):505–11. doi: 10.1542/peds.107.3.505 - DOI - PubMed
    1. World Health Organization. WHO housing and health guidelines [Internet]. Geneva: World Health Organization; 2018. [cited 2023 Apr 29]. 149 p. Available from: https://apps.who.int/iris/handle/10665/276001.
    1. Ahmad K, Erqou S, Shah N, Nazir U, Morrison AR, Choudhary G, et al.. Association of poor housing conditions with COVID-19 incidence and mortality across US counties. PLOS ONE. 2020. Nov 2;15(11):e0241327. doi: 10.1371/journal.pone.0241327 - DOI - PMC - PubMed