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Showing content from https://pubmed.ncbi.nlm.nih.gov/32560363/ below:

Black-White Risk Differentials in COVID-19 (SARS-COV2) Transmission, Mortality and Case Fatality in the United States: Translational Epidemiologic Perspective and Challenges

. 2020 Jun 17;17(12):4322. doi: 10.3390/ijerph17124322. Black-White Risk Differentials in COVID-19 (SARS-COV2) Transmission, Mortality and Case Fatality in the United States: Translational Epidemiologic Perspective and Challenges Laurens Holmes Jr^{1 2 3}, Michael Enwere^{1 4 5}, Benjamin Ogundele^{1 4}, Prachi Chavan^{1 4}, Tatiana Piccoli^{1 4}, Chinaka Chinacherem^{1 4}, Camillia Comeaux^{1 4}, Lavisha Pelaez^{1 4}, Osatohamwen Okundaye^{1 4}, Leslie Stalnaker^{1 4}, Fanta Kalle^{1 6}, Keeti Deepika^{1 4}, Glen Philipcien⁷, Maura Poleon⁸, Gbadebo Ogungbade⁹, Hikma Elmi^{1 4}, Valescia John^{1 4}, Kirk W Dabney^{1 3}

Affiliations

¹ Nemours Children's Healthcare System, Wilmington, DE 19803, USA.
² Biological Sciences Department, University of Delaware, Newark, DE 19716, USA.
³ Emergency Department, Thomas Jefferson University, College of population Health, Philadelphia, PA 19107, USA.
⁴ Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA.
⁵ Public Health Department, Walden University, Minneapolis, MN 55401, USA.
⁶ Edward Via College of Osteopathic Medicine, Auburn, AL 36832, USA.
⁷ Emergency Department, Victoria Hospital, Castries, St. Lucia.
⁸ School of Nursing, Florida International University, Miami, FL 33139, USA.
⁹ Global Health Services Initiatives Incorporated, Arlington, TX 76014 USA.

PMID: 32560363
PMCID: PMC7345143
DOI: 10.3390/ijerph17124322

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Black-White Risk Differentials in COVID-19 (SARS-COV2) Transmission, Mortality and Case Fatality in the United States: Translational Epidemiologic Perspective and Challenges

Laurens Holmes Jr et al. Int J Environ Res Public Health. 2020.

. 2020 Jun 17;17(12):4322. doi: 10.3390/ijerph17124322. Authors Laurens Holmes Jr^{1 2 3}, Michael Enwere^{1 4 5}, Janille Williams^{1 4}, Benjamin Ogundele^{1 4}, Prachi Chavan^{1 4}, Tatiana Piccoli^{1 4}, Chinaka Chinacherem^{1 4}, Camillia Comeaux^{1 4}, Lavisha Pelaez^{1 4}, Osatohamwen Okundaye^{1 4}, Leslie Stalnaker^{1 4}, Fanta Kalle^{1 6}, Keeti Deepika^{1 4}, Glen Philipcien⁷, Maura Poleon⁸, Gbadebo Ogungbade⁹, Hikma Elmi^{1 4}, Valescia John^{1 4}, Kirk W Dabney^{1 3} Affiliations

¹ Nemours Children's Healthcare System, Wilmington, DE 19803, USA.
² Biological Sciences Department, University of Delaware, Newark, DE 19716, USA.
³ Emergency Department, Thomas Jefferson University, College of population Health, Philadelphia, PA 19107, USA.
⁴ Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA.
⁵ Public Health Department, Walden University, Minneapolis, MN 55401, USA.
⁶ Edward Via College of Osteopathic Medicine, Auburn, AL 36832, USA.
⁷ Emergency Department, Victoria Hospital, Castries, St. Lucia.
⁸ School of Nursing, Florida International University, Miami, FL 33139, USA.
⁹ Global Health Services Initiatives Incorporated, Arlington, TX 76014 USA.

PMID: 32560363
PMCID: PMC7345143
DOI: 10.3390/ijerph17124322

Item in Clipboard

Abstract

Background: Social and health inequities predispose vulnerable populations to adverse morbidity and mortality outcomes of epidemics and pandemics. While racial disparities in cumulative incidence (CmI) and mortality from the influenza pandemics of 1918 and 2009 implicated Blacks with survival disadvantage relative to Whites in the United States, COVID-19 currently indicates comparable disparities. We aimed to: (a) assess COVID-19 CmI by race, (b) determine the Black-White case fatality (CF) and risk differentials, and (c) apply explanatory model for mortality risk differentials.

Methods: COVID-19 data on confirmed cases and deaths by selective states health departments were assessed using a cross-sectional ecologic design. Chi-square was used for CF independence, while binomial regression model for the Black-White risk differentials.

Results: The COVID-19 mortality CmI indicated Blacks/AA with 34% of the total mortality in the United States, albeit their 13% population size. The COVID-19 CF was higher among Blacks/AA relative to Whites; Maryland, (2.7% vs. 2.5%), Wisconsin (7.4% vs. 4.8%), Illinois (4.8% vs. 4.2%), Chicago (5.9% vs. 3.2%), Detroit (Michigan), 7.2% and St. John the Baptist Parish (Louisiana), 7.9%. Blacks/AA compared to Whites in Michigan were 15% more likely to die, CmI risk ratio (CmIRR) = 1.15, 95% CI, 1.01-1.32. Blacks/AA relative to Whites in Illinois were 13% more likely to die, CmIRR = 1.13, 95% CI, 0.93-1.39, while Blacks/AA compared to Whites in Wisconsin were 51% more likely to die, CmIRR = 1.51, 95% CI, 1.10-2.10. In Chicago, Blacks/AA were more than twice as likely to die, CmIRR = 2.24, 95% CI, 1.36-3.88.

Conclusion: Substantial racial/ethnic disparities are observed in COVID-19 CF and mortality with Blacks/AA disproportionately affected across the United States.

Keywords: COVID-19 (SARS-COV2); United States; case fatality; health disparities; mortality; race/ethnicity.

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Conflict of interest statement

All authors have declared no conflict of interest.

Figures
Figure 1

( A ) Frequency of…

Figure 1

( A ) Frequency of COVID-19 mortality by race in selected states, USA,…

Figure 1

(A) Frequency of COVID-19 mortality by race in selected states, USA, 9th April 2020. Notes. The COVID-19 mortality frequency reflects higher occurrence in Illinois, Louisiana, Michigan and North Carolina. (B) The frequency of COVID-19 mortality by race in selected cities and Milwaukee County, USA, 9th April 2020. The cities with the disproportionate burden of COVID-19 for Blacks are Chicago and Milwaukee city as well as the county.

Figure 2

Cumulative incidence of COVID-19 mortality…

Figure 2

Cumulative incidence of COVID-19 mortality in mid-west states, USA, 9th April 2020. Co…

Figure 2

Cumulative incidence of COVID-19 mortality in mid-west states, USA, 9th April 2020. Co = county; in the mid-west states with data on race, mortality cumulative incidence (CmI) was higher among Blacks/AA relative to Whites.

Figure 3

Disproportionate magnitude of COVID-19 mortality…

Figure 3

Disproportionate magnitude of COVID-19 mortality on Blacks/AA in selective states and county, 9–13th…

Figure 3

Disproportionate magnitude of COVID-19 mortality on Blacks/AA in selective states and county, 9–13th April 2020. Notes: The point estimates on the line indicates the burden of COVID-19 mortality in the Black/AA communities in these geographic locales. As per mid-April 2020, the COVID-19 disproportionate burden of dying was outstanding in Wisconsin, Michigan and Illinois (mid-western states).

Figure 4

Black–White risk differentials in COVID-19…

Figure 4

Black–White risk differentials in COVID-19 mortality in selected states and regions in the…

Figure 4

Black–White risk differentials in COVID-19 mortality in selected states and regions in the United States, April 2020. Notes: The solid line indicates the risk of dying from COVID-19 comparing Black/AA with their White counterparts. With Whites as the reference group, implying 1.0 as no risk. In Chicago with a risk ratio (RR) of dying for Blacks/AA estimated at 2.24 in this model, implying that for everyone death from COVID-19 among Whites in Chicago, more than 2 Blacks/AA experienced mortality from the COVID-19 pandemic.