COVID-19 Mortality by Race and Ethnicity in US Metropolitan and Nonmetropolitan Areas, March 2020 to February 2022.
JAMA Netw Open
; 6(5): e2311098, 2023 05 01.
Статья
в английский
| MEDLINE | ID: covidwho-2316762
ABSTRACT
Importance Prior research has established that Hispanic and non-Hispanic Black residents in the US experienced substantially higher COVID-19 mortality rates in 2020 than non-Hispanic White residents owing to structural racism. In 2021, these disparities decreased. Objective:
To assess to what extent national decreases in racial and ethnic disparities in COVID-19 mortality between the initial pandemic wave and subsequent Omicron wave reflect reductions in mortality vs other factors, such as the pandemic's changing geography. Design, Setting, andParticipants:
This cross-sectional study was conducted using data from the US Centers for Disease Control and Prevention for COVID-19 deaths from March 1, 2020, through February 28, 2022, among adults aged 25 years and older residing in the US. Deaths were examined by race and ethnicity across metropolitan and nonmetropolitan areas, and the national decrease in racial and ethnic disparities between initial and Omicron waves was decomposed. Data were analyzed from June 2021 through March 2023. Exposures Metropolitan vs nonmetropolitan areas and race and ethnicity. Main Outcomes andMeasures:
Age-standardized death rates.Results:
There were death certificates for 977â¯018 US adults aged 25 years and older (mean [SD] age, 73.6 [14.6] years; 435â¯943 female [44.6%]; 156â¯948 Hispanic [16.1%], 140â¯513 non-Hispanic Black [14.4%], and 629â¯578 non-Hispanic White [64.4%]) that included a mention of COVID-19. The proportion of COVID-19 deaths among adults residing in nonmetropolitan areas increased from 5944 of 110â¯526 deaths (5.4%) during the initial wave to a peak of 40â¯360 of 172â¯515 deaths (23.4%) during the Delta wave; the proportion was 45â¯183 of 210â¯554 deaths (21.5%) during the Omicron wave. The national disparity in age-standardized COVID-19 death rates per 100â¯000 person-years for non-Hispanic Black compared with non-Hispanic White adults decreased from 339 to 45 deaths from the initial to Omicron wave, or by 293 deaths. After standardizing for age and racial and ethnic differences by metropolitan vs nonmetropolitan residence, increases in death rates among non-Hispanic White adults explained 120 deaths/100â¯000 person-years of the decrease (40.7%); 58 deaths/100â¯000 person-years in the decrease (19.6%) were explained by shifts in mortality to nonmetropolitan areas, where a disproportionate share of non-Hispanic White adults reside. The remaining 116 deaths/100â¯000 person-years in the decrease (39.6%) were explained by decreases in death rates in non-Hispanic Black adults. Conclusions and Relevance This study found that most of the national decrease in racial and ethnic disparities in COVID-19 mortality between the initial and Omicron waves was explained by increased mortality among non-Hispanic White adults and changes in the geographic spread of the pandemic. These findings suggest that despite media reports of a decline in disparities, there is a continued need to prioritize racial health equity in the pandemic response.
Полный текст:
Имеется в наличии
Коллекция:
Международные базы данных
база данных:
MEDLINE
Основная тема:
COVID-19
Тип исследования:
Наблюдательное исследование
/
Прогностическое исследование
/
Рандомизированные контролируемые испытания
Темы:
Варианты
Пределы темы:
Взрослые
/
Пожилые
/
Женщины
/
Люди
/
Мужчины
/
Middle aged
Страна как тема:
Северная Америка
Язык:
английский
Журнал:
JAMA Netw Open
Год:
2023
Тип:
Статья
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