RESUMEN
Although non-Hispanic American Indian and Alaska Native (AI/AN) persons account for 0.7% of the U.S. population,* a recent analysis reported that 1.3% of coronavirus disease 2019 (COVID-19) cases reported to CDC with known race and ethnicity were among AI/AN persons (1). To assess the impact of COVID-19 among the AI/AN population, reports of laboratory-confirmed COVID-19 cases during January 22-July 3, 2020 were analyzed. The analysis was limited to 23 states§ with >70% complete race/ethnicity information and five or more laboratory-confirmed COVID-19 cases among both AI/AN persons (alone or in combination with other races and ethnicities) and non-Hispanic white (white) persons. Among 424,899 COVID-19 cases reported by these states, 340,059 (80%) had complete race/ethnicity information; among these 340,059 cases, 9,072 (2.7%) occurred among AI/AN persons, and 138,960 (40.9%) among white persons. Among 340,059 cases with complete patient race/ethnicity data, the cumulative incidence among AI/AN persons in these 23 states was 594 per 100,000 AI/AN population (95% confidence interval [CI] = 203-1,740), compared with 169 per 100,000 white population (95% CI = 137-209) (rate ratio [RR] = 3.5; 95% CI = 1.2-10.1). AI/AN persons with COVID-19 were younger (median age = 40 years; interquartile range [IQR] = 26-56 years) than were white persons (median age = 51 years; IQR = 32-67 years). More complete case report data and timely, culturally responsive, and evidence-based public health efforts that leverage the strengths of AI/AN communities are needed to decrease COVID-19 transmission and improve patient outcomes.
Asunto(s)
/estadística & datos numéricos , Infecciones por Coronavirus/etnología , Disparidades en el Estado de Salud , Indígenas Norteamericanos/estadística & datos numéricos , Neumonía Viral/etnología , Adolescente , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , COVID-19 , Prueba de COVID-19 , Niño , Preescolar , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , SARS-CoV-2 , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Estados Unidos/epidemiología , Adulto JovenRESUMEN
INTRODUCTION: In the US people of color are disproportionately affected by pedestrian crashes. The purpose of this study was to examine the potential for racial bias in driver yielding behaviors at midblock crosswalks in low and high income neighborhoods located in the sprawling metropolitan area of Las Vegas, NV. METHODS: Participants (1 white, 1 black female) crossed at a midblock crosswalk on a multilane road in a low income and a high income neighborhood. Trained observers recorded (1) number of cars that passed in the nearest lane before yielding while the pedestrian waited near the crosswalk at the curb (2) number of cars that passed through the crosswalk with the pedestrian in the same half of the roadway. RESULTS: The first car in the nearest lane yielded to the pedestrian while they waited at the curb 51.5% of the time at the high income and 70.7% of the time at the low income crosswalk. Two way ANOVAs found an interaction effect between income and race on yielding behaviors. Simple effects for income revealed that at the high income crosswalk, drivers were less likely to yield to the white pedestrian while she waited at the curb (F(1,122)=11.18;p=0.001), and were less likely to yield to the black pedestrian while she was in the same half of the roadway at the high income crosswalk (F(1,124)=4.40;p=0.04). Simple effects for race showed significantly more cars passed through the crosswalk while the black pedestrian was in the roadway compared to the white pedestrian at the high income crosswalk (F(1,124)=6.62;p=0.01). CONCLUSIONS: Bias in driver yielding behavior may be one influencing factor in higher rates of pedestrian crashes for people of color.