Background Current reporting of Covid-19 mortality data by race and ethnicity across the United States could bias our understanding of population-mortality disparities. Moreover, stark differences in age distribution by race and ethnicity groups are seldom accounted for in analyses.
Methods To address these gaps, we conducted a cross-sectional study using publicly-reported Covid-19 mortality data to assess the quality of race and ethnicity data (Black, Latinx, white), and estimated age-adjusted disparities using a random effects meta-analytic approach.
Results We found only 28 states, and NYC, reported race and ethnicity-stratified Covid-19 mortality along with large variation in the percent of missing race and ethnicity data by state. Aggregated relative risk of death estimates for Black compared to the white population was 3.57 (95% CI: 2.84-4.48). Similarly, Latinx population displayed 1.88 (95% CI: 1.61-2.19) times higher risk of death than white patients.
Discussion In states providing race and ethnicity data, we identified significant population-level Covid-19 mortality disparities. We demonstrated the importance of adjusting for age differences across population groups to prevent underestimating disparities in younger population groups. The availability of high-quality and comprehensive race and ethnicity data is necessary to address factors contributing to inequity in Covid-19 mortality.
Competing Interest StatementDr. Gross reported receiving research grants from the National Comprehensive Cancer Network (funded by Pfizer and Astra-Zeneca), funding from Johnson & Johnson to assist with developing new approaches to sharing clinical trial data (through the Yale Open Data Access Project), and funding from Flatiron, Inc for travel/speaking, outside the submitted work. No other disclosures were reported.
Funding StatementN/a
Author DeclarationsAll relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript.
Yes
All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.
Yes
FootnotesDr. Gross reported receiving research grants from the National Comprehensive Cancer Network (funded by Pfizer and Astra-Zeneca), funding from Johnson & Johnson to assist with developing new approaches to sharing clinical trial data (through the Yale Open Data Access Project), and funding from Flatiron, Inc for travel/speaking, outside the submitted work. No other disclosures were reported.
The Authors would like to acknowledge Pamela Soulos, Jessica Long, Sophia Mun, Maureen Canavan for their assistance in abstracting and curating the relevant data.
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