Racial and Ethnic Disparities in COVID-19 Infection and Mortality in the United States: A state-wise update

ObjectivesTo evaluate COVID-19 infection and mortality in ethnic and racial sub-groups across all states in the United States. MethodsPublicly available data from "The COVID Tracking Project at The Atlantic" was accessed between 09/09/2020 and 09/14/2020. For each state and the District of Columbia, % infection, % death, % population proportion for subgroups of race (African American (AA), Asian, American Indian or Alaska Native, (AI/AN) and White), and ethnicity (Hispanic/Latino, and non-Hispanic), were recorded. Absolute and relative excess infection (AEI and REI) and mortality (AEM and REM) were computed as absolute and relative difference between % infection or % mortality and % population proportion for each state. Median (IQR) REI is provided below. ResultsThe Hispanic population had a median of 158% higher COVID-19 infection relative to their % population proportion (median REI 158%, [IQR: 100% to 200%]). This was followed by AA, with 50% higher COVID-19 infection relative to their % population proportion (median REI, 50% [IQR 25% to 100%]). The AA population had the most disproportionate mortality with a median of 46% higher mortality than % population proportion, (median REM 46% [IQR, 18% to 66%]). Disproportionate impact of COVID-19 was also seen in AI/AN and Asian population with [≥]100% excess infections than % population proportion seen in 35 states for Hispanic, 14 states for AA, 9 states for AIAN, and 7 states for Asian populations. There was no disproportionate impact in the white population in any state. ConclusionsRacial/ethnic minorities (AA, Hispanic, AIAN and Asian populations) are disproportionately affected by COVID 19 infection and mortality across the nation. These findings underscore the potential role of social determinants of health in explaining the disparate impact of SARS-CoV-2 on vulnerable demographic groups, as well as the opportunity to improve outcomes in chronically marginalized populations.