AUTHOR=Im Cindy , Munasinghe Lalani L. , Martínez José M. , Letsou William , Bagherzadeh-Khiabani Farideh , Marin Soudabeh , Yasui Yutaka 

TITLE=The Magnitude of Black/Hispanic Disparity in COVID-19 Mortality Across United States Counties During the First Waves of the COVID-19 Pandemic

JOURNAL=International Journal of Public Health

VOLUME=66

YEAR=2021

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2021.1604004

DOI=10.3389/ijph.2021.1604004

ISSN=1661-8564

ABSTRACT=<p><bold>Objectives:</bold> To quantify the Black/Hispanic disparity in COVID-19 mortality in the United States (US).</p><p><bold>Methods:</bold> COVID-19 deaths in all US counties nationwide were analyzed to estimate COVID-19 mortality rate ratios by county-level proportions of Black/Hispanic residents, using mixed-effects Poisson regression. Excess COVID-19 mortality counts, relative to predicted under a counterfactual scenario of no racial/ethnic disparity gradient, were estimated.</p><p><bold>Results:</bold> County-level COVID-19 mortality rates increased monotonically with county-level proportions of Black and Hispanic residents, up to 5.4-fold (≥43% Black) and 11.6-fold (≥55% Hispanic) higher compared to counties with &lt;5% Black and &lt;15% Hispanic residents, respectively, controlling for county-level poverty, age, and urbanization level. Had this disparity gradient not existed, the US COVID-19 death count would have been 92.1% lower (177,672 fewer deaths), making the rate comparable to other high-income countries with substantially lower COVID-19 death counts.</p><p><bold>Conclusion:</bold> During the first 8 months of the SARS-CoV-2 pandemic, the US experienced the highest number of COVID-19 deaths. This COVID-19 mortality burden is strongly associated with county-level racial/ethnic diversity, explaining most US COVID-19 deaths.</p>