National Disparities in COVID-19 Outcomes between Black and White Americans.
Adult
Black or African American
/ statistics & numerical data
Aged, 80 and over
COVID-19
/ mortality
Critical Care
/ statistics & numerical data
Female
Health Status Disparities
Healthcare Disparities
/ ethnology
Hospitalization
/ statistics & numerical data
Humans
Infant, Newborn
Male
Mortality
Outcome Assessment, Health Care
Severity of Illness Index
Social Determinants of Health
/ ethnology
Socioeconomic Factors
United States
/ epidemiology
White People
/ statistics & numerical data
Black health
Built environment
COVID-19
Disparities
Structural inequities
United States
Journal
Journal of the National Medical Association
ISSN: 1943-4693
Titre abrégé: J Natl Med Assoc
Pays: United States
ID NLM: 7503090
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
24
06
2020
accepted:
11
07
2020
pubmed:
12
8
2020
medline:
22
4
2021
entrez:
12
8
2020
Statut:
ppublish
Résumé
There is very limited comprehensive information on disparate outcomes of black and white patients with COVID-19 infection. Reports from cities and states have suggested a discordant impact on black Americans, but no nationwide study has yet been performed. We sought to understand the differential outcomes for black and white Americans infected with COVID-19. We obtained case-level data from the Centers for Disease Control and Prevention on 76,442 white and 48,338 non-Hispanic Black patients diagnosed with COVID-19, ages 0 to >80+, outlining information on hospitalization, ICU admission, ventilation, and death outcomes. Multivariate Poisson regressions were used to estimate the association of race, treating white as the reference group, controlling for sex, age group, and the presence of comorbidities. Black patients were generally younger than white, were more often female, and had larger numbers of comorbidities. Compared to white patients with COVID-19, black patients had 1.4 times the risk of hospitalization (RR 1.42, p < 0.001), and almost twice the risk of requiring ICU care (RR 1.68, p < 0.001) or ventilatory support (RR 1.81, p < 0.001) after adjusting for covariates. Black patients saw a 1.36 times increased risk of death (RR 1.36, p < 0.001) compared to white. Disparities between black and white outcomes increased with advanced age. Despite the initial descriptions of COVID-19 being a disease that affects all individuals, regardless of station, our data demonstrate the differential racial effects in the United States. This current pandemic reinforces the need to assess the unequal effects of crises on disadvantaged populations to promote population health.
Sections du résumé
BACKGROUND
BACKGROUND
There is very limited comprehensive information on disparate outcomes of black and white patients with COVID-19 infection. Reports from cities and states have suggested a discordant impact on black Americans, but no nationwide study has yet been performed. We sought to understand the differential outcomes for black and white Americans infected with COVID-19.
METHODS
METHODS
We obtained case-level data from the Centers for Disease Control and Prevention on 76,442 white and 48,338 non-Hispanic Black patients diagnosed with COVID-19, ages 0 to >80+, outlining information on hospitalization, ICU admission, ventilation, and death outcomes. Multivariate Poisson regressions were used to estimate the association of race, treating white as the reference group, controlling for sex, age group, and the presence of comorbidities.
RESULTS
RESULTS
Black patients were generally younger than white, were more often female, and had larger numbers of comorbidities. Compared to white patients with COVID-19, black patients had 1.4 times the risk of hospitalization (RR 1.42, p < 0.001), and almost twice the risk of requiring ICU care (RR 1.68, p < 0.001) or ventilatory support (RR 1.81, p < 0.001) after adjusting for covariates. Black patients saw a 1.36 times increased risk of death (RR 1.36, p < 0.001) compared to white. Disparities between black and white outcomes increased with advanced age.
CONCLUSION
CONCLUSIONS
Despite the initial descriptions of COVID-19 being a disease that affects all individuals, regardless of station, our data demonstrate the differential racial effects in the United States. This current pandemic reinforces the need to assess the unequal effects of crises on disadvantaged populations to promote population health.
Identifiants
pubmed: 32778445
pii: S0027-9684(20)30149-8
doi: 10.1016/j.jnma.2020.07.009
pmc: PMC7413663
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
125-132Informations de copyright
Copyright © 2020 National Medical Association. Published by Elsevier Inc. All rights reserved.
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