scholarly journals Improved measurement of racial/ethnic disparities in COVID-19 mortality in the United States

2020 ◽  
Author(s):  
Joshua R. Goldstein ◽  
Serge Atherwood
Keyword(s):  
United States ◽  
New York ◽  
National Level ◽  
Ethnic Disparities ◽  
State Level ◽  
The United States ◽  
Estimation Methods ◽  
Death Rates ◽  
Population Distributions ◽  
Racial Ethnic

AbstractDifferent estimation methods produce diverging accounts of racial/ethnic disparities in COVID-19 mortality in the United States. The CDC’s decision to present the racial/ethnic distribution of COVID-19 deaths at the state level alongside re-weighted racial/ethnic population distributions—in effect, a geographic adjustment—makes it seem that Whites have the highest death rates. Age adjustment procedures used by others, including the New York City Department of Health and Mental Hygiene, lead to the opposite conclusion that Blacks and Hispanics are dying from COVID-19 at higher rates than Whites. In this paper, we use indirect standardization methods to adjust per-capita death rates for both age and geography simultaneously, avoiding the one-sided adjustment procedures currently in use. Using CDC data, we find age-and-place-adjusted COVID-19 death rates are 80% higher for Blacks and more than 50% higher for Hispanics, relative to Whites, on a national level, while there is almost no disparity for Asians. State-specific estimates show wide variation in mortality disparities. Comparison with non-epidemic mortality reveals potential roles for pre-existing health disparities and differential rates of infection and care.

scholarly journals Benchmarking COVID-19 Mortality in the United States

2020 ◽  
Author(s):  
Ruth Etzioni ◽  
Elan Markowitz ◽  
Ivor S. Douglas
Keyword(s):  
United States ◽  
Cumulative Incidence ◽  
Ethnic Disparities ◽  
The United States ◽  
Age Group ◽  
Effective Response ◽  
Death Rates ◽  
The Us ◽  
Hispanic Populations ◽  
Racial Ethnic

AbstractOn September 22nd the US officially recorded 200,000 COVID-19 deaths. It is unclear how many deaths might have been expected in the case of an early and effective response to the pandemic. We aim to provide a best-case estimate of COVID-19 deaths in the US by September 22nd using the experience of Germany as a benchmark. Our methods accommodate the differences in demographics between Germany and the US. We match cumulative incidence of COVID-19 deaths by age group in Germany to non-Hispanic whites in the US and project the implied number of deaths in this population and among the black and Hispanic populations under observed racial/ethnic disparities in cumulative COVID-19 mortality in the US. We estimate that if the US had been as successful as Germany in managing the pandemic we would have expected 22% of the deaths actually recorded. The number of deaths would have been lower by a further one-third if we could have eliminated racial/ethnic disparites in COVID-19 outcomes. We conclude that almost 80 percent of the COVID-19 deaths in the US by September 22nd could have been avoided with an early and effective response producing similar age-specific death rates among non-Hispanic whites as in Germany.

scholarly journals Exploring Changes in Racial/Ethnic Disparities of HIV Diagnosis Rates Under the “Ending the HIV Epidemic: A Plan for America” Initiative

2020 ◽  
Vol 135 (5) ◽  
pp. 685-690
Author(s):  
Donna Hubbard McCree ◽  
Harrell Chesson ◽  
Erin L.P. Bradley ◽  
Austin Williams ◽  
Zanetta Gant ◽  
...  
Keyword(s):  
United States ◽  
Rate Ratio ◽  
National Level ◽  
Ethnic Disparities ◽  
The United States ◽  
Potential Effect ◽  
Structural Factors ◽  
Hiv Diagnosis ◽  
Hiv Epidemic ◽  
Racial Ethnic

Objectives Racial/ethnic disparities in HIV diagnosis rates remain despite the availability of effective treatment and prevention tools in the United States. In 2019, President Trump announced the “Ending the HIV Epidemic: A Plan for America” (EHE) initiative to reduce new HIV infections in the United States at least 75% by 2025 and at least 90% by 2030. The objective of this study was to show the potential effect of the EHE initiative on racial/ethnic disparities in HIV diagnosis rates at the national level. Methods We used 2017 HIV diagnoses data from the Centers for Disease Control and Prevention National HIV Surveillance System. We developed a counterfactual scenario to determine changes in racial/ethnic disparities if the 2017 HIV diagnosis rates were reduced by 75% in the geographic regions targeted by the EHE initiative. We used 4 measures to calculate results: rate ratio, population-attributable proportion (PAP), Gini coefficient, and Index of Disparity. Results The relative measures of racial/ethnic disparity decreased by 9%-21% in the EHE scenario compared with the 2017 HIV diagnoses data. The largest decrease was in the Hispanic/Latino:white rate ratio (−20.6%) and in the black:white rate ratio (−18.2%). The PAP measure decreased by 11.5%. The absolute versions of the Index of Disparity (unweighted and weighted) were approximately 50% lower in the EHE scenario than in the 2017 HIV diagnoses data. Conclusions EHE efforts could reduce but will not eliminate racial/ethnic disparities in HIV diagnosis rates. Efforts to address racial/ethnic disparities should continue, and innovative approaches, specifically those that focus on social and structural factors, should be developed and implemented for populations that are disproportionately affected by HIV in the United States.

scholarly journals Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

2021 ◽  
Vol 18 (6) ◽  
pp. 2921
Author(s):  
Jay J. Xu ◽  
Jarvis T. Chen ◽  
Thomas R. Belin ◽  
Ronald S. Brookmeyer ◽  
Marc A. Suchard ◽  
...  
Keyword(s):  
United States ◽  
District Of Columbia ◽  
Ethnic Disparities ◽  
The United States ◽  
Attributable Mortality ◽  
Race Ethnicity ◽  
Using Data ◽  
Rate Ratios ◽  
Degree Of Association ◽  
Racial Ethnic

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

scholarly journals Racial/Ethnic Disparities in ART Adherence in the United States

2012 ◽  
Vol 60 (5) ◽  
pp. 466-472 ◽  
Author(s):  
Jane M. Simoni ◽  
David Huh ◽  
Ira B. Wilson ◽  
Jie Shen ◽  
Kathy Goggin ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Disparities ◽  
The United States ◽  
Art Adherence ◽  
Racial Ethnic

Infant Mortality among Adolescent Mothers in the United States: A 5-Year Analysis of Racial and Ethnic Disparities

2020 ◽  
Author(s):  
Matthew D. Moore ◽  
Anne E. Brisendine ◽  
Martha S. Wingate
Keyword(s):  
United States ◽  
Preterm Birth ◽  
Infant Mortality ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial And Ethnic Disparities ◽  
Postneonatal Mortality ◽  
Maternal Characteristics ◽  
Race Ethnicity ◽  
Racial Ethnic

Objective This study was aimed to examine differences in infant mortality outcomes across maternal age subgroups less than 20 years in the United States with a specific focus on racial and ethnic disparities. Study Design Using National Center for Health Statistics cohort-linked live birth–infant death files (2009-2013) in this cross-sectional study, we calculated descriptive statistics by age (<15, 15–17, and 18–19 years) and racial/ethnic subgroups (non-Hispanic white [NHW], non-Hispanic black [NHB], and Hispanic) for infant, neonatal, and postneonatal mortality. Adjusted odds ratios (aOR) were calculated by race/ethnicity and age. Preterm birth and other maternal characteristics were included as covariates. Results Disparities were greatest for mothers <15 and NHB mothers. The risk of infant mortality among mothers <15 years compared to 18 to 19 years was higher regardless of race/ethnicity (NHW: aOR = 1.40, 95% confidence interval [CI]: 1.06–1.85; NHB: aOR = 1.28, 95% CI: 1.04–1.56; Hispanic: aOR = 1.36, 95%CI: 1.07–1.74). Compared to NHW mothers, NHB mothers had a consistently higher risk of infant mortality (15–17 years: aOR = 1.12, 95% CI: 1.03–1.21; 18–19 years: aOR = 1.21, 95% CI: 1.15–1.27), while Hispanic mothers had a consistently lower risk (15–17 years: aOR = 0.72, 95% CI: 0.66–0.78; 18–19 years: aOR = 0.74, 95% CI: 0.70–0.78). Adjusting for preterm birth had a greater influence than maternal characteristics on observed group differences in mortality. For neonatal and postneonatal mortality, patterns of disparities based on age and race/ethnicity differed from those of overall infant mortality. Conclusion Although infants born to younger mothers were at increased risk of mortality, variations by race/ethnicity and timing of death existed. When adjusted for preterm birth, differences in risk across age subgroups declined and, for some racial/ethnic groups, disappeared. Key Points

Racial/Ethnic Disparities in Antenatal Depression in the United States: A Systematic Review

2016 ◽  
Vol 20 (9) ◽  
pp. 1780-1797 ◽  
Author(s):  
Soumyadeep Mukherjee ◽  
Mary Jo Trepka ◽  
Dudith Pierre-Victor ◽  
Raed Bahelah ◽  
Tenesha Avent
Keyword(s):  
United States ◽  
Systematic Review ◽  
Ethnic Disparities ◽  
The United States ◽  
Antenatal Depression ◽  
Racial Ethnic

scholarly journals Racial/ethnic disparities in sleep duration and sleep disturbances among pregnant and non‐pregnant women in the United States

2020 ◽  
Vol 29 (5) ◽  
Author(s):  
Lydia Feinstein ◽  
Ketrell L. McWhorter ◽  
Symielle A. Gaston ◽  
Wendy M. Troxel ◽  
Katherine M. Sharkey ◽  
...  
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Sleep Duration ◽  
Sleep Disturbances ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial Ethnic

scholarly journals Disproportionate Impact of COVID-19 Pandemic on Racial and Ethnic Minorities

2020 ◽  
pp. 000313482097335
Author(s):  
Brad Boserup ◽  
Mark McKenney ◽  
Adel Elkbuli
Keyword(s):  
Ethnic Groups ◽  
Social Vulnerability ◽  
Negative Binomial ◽  
Demographic Data ◽  
National Level ◽  
The United States ◽  
Death Rates ◽  
Social Distancing ◽  
The Impact ◽  
Racial Ethnic

Background Health disparities are prevalent in many areas of medicine. We aimed to investigate the impact of the COVID-19 pandemic on racial/ethnic groups in the United States (US) and to assess the effects of social distancing, social vulnerability metrics, and medical disparities. Methods A cross-sectional study was conducted utilizing data from the COVID-19 Tracking Project and the Centers for Disease Control and Prevention (CDC). Demographic data were obtained from the US Census Bureau, social vulnerability data were obtained from the CDC, social distancing data were obtained from Unacast, and medical disparities data from the Center for Medicare and Medicaid Services. A comparison of proportions by Fisher’s exact test was used to evaluate differences between death rates stratified by age. Negative binomial regression analysis was used to predict COVID-19 deaths based on social distancing scores, social vulnerability metrics, and medical disparities. Results COVID-19 cumulative infection and death rates were higher among minority racial/ethnic groups than whites across many states. Older age was also associated with increased cumulative death rates across all racial/ethnic groups on a national level, and many minority racial/ethnic groups experienced significantly greater cumulative death rates than whites within age groups ≥ 35 years. All studied racial/ethnic groups experienced higher hospitalization rates than whites. Older persons (≥ 65 years) also experienced more COVID-19 deaths associated with comorbidities than younger individuals. Social distancing factors, several measures of social vulnerability, and select medical disparities were identified as being predictive of county-level COVID-19 deaths. Conclusion COVID-19 has disproportionately impacted many racial/ethnic minority communities across the country, warranting further research and intervention.

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