Black–White Risk Differentials in COVID-19 (SARS-COV2) Transmission, Mortality and Case Fatality in the United States: Translational Epidemiologic Perspective and Challenges

Laurens Holmes, Michael Enwere, Janille Williams, Benjamin Ogundele, Prachi Chavan, Tatiana Piccoli, Chinacherem Chinaka, Camillia Comeaux, Lavisha Pelaez, Osatohamwen Okundaye, Leslie Stalnaker, Fanta Kalle, Keeti Deepika, Glen Philipcien, Maura Poleon, Gbadebo Ogungbade, Hikma Elmi, Valescia John and Kirk W. Dabney
Additional contact information
Laurens Holmes: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Michael Enwere: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Janille Williams: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Benjamin Ogundele: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Prachi Chavan: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Tatiana Piccoli: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Chinacherem Chinaka: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Camillia Comeaux: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Lavisha Pelaez: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Osatohamwen Okundaye: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Leslie Stalnaker: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Fanta Kalle: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Keeti Deepika: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Glen Philipcien: Emergency Department, Victoria Hospital, Castries, St. Lucia
Maura Poleon: School of Nursing, Florida International University, Miami, FL 33139, USA
Gbadebo Ogungbade: Global Health Services Initiatives Incorporated, Arlington, TX 76014 USA
Hikma Elmi: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Valescia John: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
Kirk W. Dabney: Nemours Children’s Healthcare System, Wilmington, DE 19803, USA

IJERPH, 2020, vol. 17, issue 12, 1-18

Abstract: Background: Social and health inequities predispose vulnerable populations to adverse morbidity and mortality outcomes of epidemics and pandemics. While racial disparities in cumulative incidence (CmI) and mortality from the influenza pandemics of 1918 and 2009 implicated Blacks with survival disadvantage relative to Whites in the United States, COVID-19 currently indicates comparable disparities. We aimed to: (a) assess COVID-19 CmI by race, (b) determine the Black–White case fatality (CF) and risk differentials, and (c) apply explanatory model for mortality risk differentials. Methods: COVID-19 data on confirmed cases and deaths by selective states health departments were assessed using a cross-sectional ecologic design. Chi-square was used for CF independence, while binomial regression model for the Black–White risk differentials. Results: The COVID-19 mortality CmI indicated Blacks/AA with 34% of the total mortality in the United States, albeit their 13% population size. The COVID-19 CF was higher among Blacks/AA relative to Whites; Maryland, (2.7% vs. 2.5%), Wisconsin (7.4% vs. 4.8%), Illinois (4.8% vs. 4.2%), Chicago (5.9% vs. 3.2%), Detroit (Michigan), 7.2% and St. John the Baptist Parish (Louisiana), 7.9%. Blacks/AA compared to Whites in Michigan were 15% more likely to die, CmI risk ratio (CmIRR) = 1.15, 95% CI, 1.01–1.32. Blacks/AA relative to Whites in Illinois were 13% more likely to die, CmIRR = 1.13, 95% CI, 0.93–1.39, while Blacks/AA compared to Whites in Wisconsin were 51% more likely to die, CmIRR = 1.51, 95% CI, 1.10–2.10. In Chicago, Blacks/AA were more than twice as likely to die, CmIRR = 2.24, 95% CI, 1.36–3.88. Conclusion: Substantial racial/ethnic disparities are observed in COVID-19 CF and mortality with Blacks/AA disproportionately affected across the United States.

Keywords: COVID-19 (SARS-COV2); race/ethnicity; case fatality; mortality; health disparities; United States (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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