Excess deaths disproportionally occurred among Black, American Indian/Alaskan Native, and Latino males and females during the 2020 COVID-19 pandemic

1. Excess deaths disproportionally occurred among Black, American Indian/Alaskan Native, and Latino males and females during the 2020 COVID-19 pandemic

Abstract: https://www.acpjournals.org/doi/10.7326/M21-2134     

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A large study of surveillance data found that excess deaths during the 2020 COVID-19 pandemic disproportionately occurred among Black, American Indian (AI)/Alaskan Native (AN), and Latino males and females in the U.S., compared to White and Asian males and females. According to the authors, these overwhelming disparities highlight the urgent need to address long-standing structural inequities affecting health and longevity. The findings are published in Annals of Internal Medicine.

Researchers from the National Cancer Institute, the National Institute for Minority Health and Health Disparities, and the Pacific Institute for Research and Evaluation, used data from the CDC National Center for Health Statistics to estimate deaths by month, year, sex, age group, race/ethnicity, and cause from March 1, 2020 (the first full month of the COVID-19 pandemic in the U.S.) to December 31, 2020. They found that compared with the number expected, based on 2019 data, 477,200 excess deaths occurred during the study period: 74% from COVID-19. The remaining fraction were attributed to causes including diabetes, heart disease, cerebrovascular disease, and Alzheimer disease. Black, AI/AN, and Latino males and females had more than double the number of excess deaths than White and Asian males and females, after standardizing by population size.

According to the authors, differences in COVID-19 risk, hospitalization, and death by race/ethnicity can be attributed to structural and social determinants of health with established and deep roots in structural racism. Studies have shown that Black and Latino persons are more likely to have occupational exposure to COVID-19, live in multigenerational households and/or more densely populated neighborhoods, and have less access to health care and private transportation, compared to White persons. Prior to a successful mass-vaccination program, AI/AN reservation–based communities were at further risk for infection due to a lack of infrastructure and chronically underfunded health care facilities.

The authors suggest that equitable vaccine distribution is needed to prevent further exacerbation of racial/ethnic disparities in COVID-19 risk and mortality. Inequities need to be addressed with urgency and cultural competence, as has been done by tribal communities.