Confirmed: COVID-19 has outsized impact on Black and Hispanic populations

Black and Hispanic populations’ heightened risk of exposure and transmission is primary factor of impact

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Oregon Health & Science University

PORTLAND, Or.—A systematic review in the Annals of Internal Medicine, undertaken by researchers at Oregon Health & Science University (OHSU) and the VA Portland Health Care System, has confirmed data that have been reported in observational studies nationwide: Black and Hispanic populations have been disproportionately affected by COVID-19. 

“This is the first paper to comprehensively examine the literature about COVID-related health disparities and the factors leading to disparities in health outcomes. The information we’ve seen so far suggests the disparities were likely related to exposure-related factors rather than other factors, like underlying health issues,” noted senior author Devan Kansagara, M.D., staff physician in the Department of Hospital and Specialty Medicine at the Portland VA and an associate professor of medicine at OHSU School of Medicine. 

The study, funded by the U.S. Department of Veterans Affairs, examined 52 observational studies that have been conducted since the beginning of 2020. Researchers believe that these disparities are related to minority populations’ higher risk of exposure to SARS-CoV-2. 

“It’s likely rooted in social determinants of health and longstanding inequalities in terms of housing, transportation, occupation and access to health care,” added lead author Katherine Mackey, M.D., staff physician in the Department of Hospital and Specialty Medicine at the Portland VA and assistant professor of medicine at OHSU School of Medicine.

“Evidence suggests that African-American/Black populations disproportionately account for COVID-19 deaths compared with non-Hispanic White populations (Table 2) … Analysis of data from the CDC’s National Center for Health Statistics (NCHS) shows that African-American/Black populations experience approximately 15% excess deaths (defined as the percentage of COVID-19 deaths for a racial/ethnic group compared with the percentage of that racial/ethnic group in the population), and data from APM Research Lab show that African American/Black populations have 3.2 times the risk for mortality compared with White populations,” the article states.

“Evidence also suggests that Hispanic populations disproportionately account for COVID-19 deaths … Data from NCHS shows that Hispanic populations have approximately 21% excess deaths, and data from APM Research Lab shows that Hispanic populations have 3.2 times the mortality risk compared with non-Hispanic White persons.”

The review highlights that racial and ethnic minority populations are disproportionately harmed by the virus primarily because they are at heightened risk of being exposed in the first place. Underlying health conditions did not appear to be a factor driving higher rates of hospitalizations and deaths. 

Instead, the evidence suggests that disparities in housing, transportation and occupations are raising the risk of virus exposure and transmission. The researchers believe that they will gain additional clarity on the subject, as the pandemic continues and evidence builds.

“Increased susceptibility to COVID-19 does not seem to explain the observed disparities, but more evidence is needed to confirm this finding and evaluate the effects of health care access and exposure-related factors, such as population density,” concludes the article.

“We need to double down on efforts to reduce exposure to the virus in the first place among vulnerable populations,” Kansagara pointed out.

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