April 14, 2021

The racial and ethnic disparities among Covid-19 hospitalizations and ED visits, charted

Daily Briefing

    CDC on Monday released two studies that examined racial and ethnic disparities among Covid-19 hospitalizations and ED visits, finding that racial and ethnic minorities were significantly more likely to be hospitalized with or visit the ED with Covid-19.

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    Hospitalization rate disparities

    For the first study, researchers examined administrative discharge data from March 2020 to December 2020 in all four census regions in the United States. The researchers then calculated the percentage of hospitalized patients during that time period who had Covid-19, broken down by racial and ethnic groups.

    In total, about 8% of hospitalized patients in the data had Covid-19—but the numbers varied significantly by geography and among racial and ethnic groups. Specifically, the researchers found that in every region, the percentage of hospitalized patients who had Covid-19 was highest among Hispanic or Latino patients.

    In the Northeast, 14% of hospitalized Hispanic or Latino patients had Covid-19—the highest rate among any race or ethnicity in any census region in the United States, according to the study. By comparison, only about 7% of hospitalized white patients in the Northeast had Covid-19.

    The researchers found that racial and ethnic disparities among Covid-19 hospitalizations were starkest between May 2020 and July 2020, then subsided over the course of the epidemic as hospitalization rates among non-Hispanic white people increased. However, the researchers noted that disparities were still evident as of December 2020, particularly for Hispanic patients in the West.

    The researchers identified two factors driving the disparities: an increased risk of coronavirus exposure among racial and ethnic minority groups—including due to occupational and housing conditions, as well as socioeconomic status—and a higher risk of severe Covid-19 among those groups.

    ED visit rate disparities

    For the second study, researchers looked at ED visits in 13 states between October 2020 and December 2020 and, for each racial or ethnic group, calculated the number of Covid-19 ED visits per 100,000 people.

    According to the researchers, during the study period, Hispanic and American Indian or Alaska Native people were nearly twice as likely to visit the ED with Covid-19 as white people, and Black people were 1.4 times more likely.

    Overall, Hispanic people were most likely to visit the ED with Covid-19, at 588 ED visits per 100,000 people. In comparison, among non-Hispanic white patients, the rate was 333 per 100,000.

    The researchers noted several limitations to their study, including that their data was limited to 13 states. In addition, the researchers noted that white people represent a larger share of the population in those 13 states than in the national population.

    According to the researchers, racial and ethnic disparities in ED visits were likely driven by systemic inequities that affect the health of these populations, including more limited access to quality health care and more representation in jobs deemed as "essential" that come with less flexibility to work remotely or take time off.

    "Racism and discrimination shape these factors that influence health risks; racism, rather than a person's race or ethnicity, is a key driver of these health inequities," they wrote. Looking ahead, they said their findings could help inform vaccine prioritization and other resources for disproportionately affected areas.

    Walensky: 'We must do better'

    CDC Director Rochelle Walensky said on Monday that the studies emphasize "the critical need and an important opportunity to address health equity as a core element in all of our public health efforts," especially in vaccination efforts. "We must acknowledge the disparities that exist and commit to an equitable distribution of vaccines, particularly to those communities that have been hardest hit by the virus," she said.

    Walensky added the disparities found in the studies "were not caused by the [epidemic], but they were certainly exacerbated by [it]. The Covid-19 [epidemic] and its disproportional impact on communities of color is just the most recent and glaring example of health inequities that threaten the health of our nation."

    According to Walensky, CDC is pushing for more vaccinations in disproportionately affected areas, including providing more funds for community health workers, vaccine access and uptake, and testing efforts in high-risk, underserved neighborhoods. In addition, the agency recently established a new Racism and Health website.

    She noted that Black people currently make up around 12% of the population in the United States, but they comprise just 8.4% of those who have received at least one dose of a Covid-19 vaccine. Meanwhile, Hispanic or Latino people make up 18% of the U.S. population but just 10.7% of those who have received a vaccine.

    "We must do better and we will do better," Walensky said (Treisman, NPR, 4/12; Thomas, CNN, 4/12).

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