Associations of COVID-19 Hospitalizations, ICU Admissions, and Mortality with Black and White Race and Their Mediation by Air Pollution and Other Risk Factors in the Louisiana Industrial Corridor, March 2020–August 2021

Qingzhao Yu, Wentao Cao, Diana Hamer, Norman Urbanek, Susanne Straif-Bourgeois, Stephania A. Cormier, Tekeda Ferguson and Jennifer Richmond-Bryant ()
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Qingzhao Yu: Biostatistics Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
Wentao Cao: Biostatistics Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
Diana Hamer: Division of Academic Affairs, Our Lady of the Lake Regional Medical Center, Baton Rouge, LA 70808, USA
Norman Urbanek: Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA
Susanne Straif-Bourgeois: Epidemiology Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
Stephania A. Cormier: Department of Biological Sciences, Louisiana State University, Baton Rouge, LA 70803, USA
Tekeda Ferguson: Epidemiology Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
Jennifer Richmond-Bryant: Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA

IJERPH, 2023, vol. 20, issue 5, 1-14

Abstract: Louisiana ranks among the bottom five states for air pollution and mortality. Our objective was to investigate associations between race and Coronavirus Disease 2019 (COVID-19) hospitalizations, intensive care unit (ICU) admissions, and mortality over time and determine which air pollutants and other characteristics may mediate COVID-19-associated outcomes. In our cross-sectional study, we analyzed hospitalizations, ICU admissions, and mortality among positive SARS-CoV-2 cases within a healthcare system around the Louisiana Industrial Corridor over four waves of the pandemic from 1 March 2020 to 31 August 2021. Associations between race and each outcome were tested, and multiple mediation analysis was performed to test if other demographic, socioeconomic, or air pollution variables mediate the race–outcome relationships after adjusting for all available confounders. Race was associated with each outcome over the study duration and during most waves. Early in the pandemic, hospitalization, ICU admission, and mortality rates were greater among Black patients, but as the pandemic progressed, these rates became greater in White patients. However, Black patients were disproportionately represented in these measures. Our findings imply that air pollution might contribute to the disproportionate share of COVID-19 hospitalizations and mortality among Black residents in Louisiana.

Keywords: COVID-19; SARS-CoV-2; coronavirus; hazardous air pollutants; HAPs; racial disparities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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