[CDC] Studies Confirm Racial, Ethnic Disparities In COVID-19 Hospitalizations And Visits

2021/04/14 Leave a comment

More evidence:

Days after declaring racism a serious public health threat, the Centers for Disease Control and Prevention released a pair of studies further quantifying the disproportionate impact of COVID-19 on communities of color.

The studies, published Monday in Morbidity and Mortality Weekly Report, examine trends in racial and ethnic disparities in hospitalizations and emergency room visits associated with COVID-19 in 2020.

CDC Director Rochelle Walensky said at a regular White House COVID-19 Response Team briefing that the new literature underscores the need to prioritize health equity, including in the country’s accelerating vaccine rollout.

“These disparities were not caused by the pandemic, but they were certainly exacerbated by [it],” Walensky said. “The COVID-19 pandemic and its disproportional impact on communities of color is just the most recent and glaring example of health inequities that threaten the health of our nation.”

After assessing administrative discharge data from March to December 2020, the CDC found that the proportion of hospitalized patients with COVID-19 was highest for Hispanic and Latino patients in all four census regions of the U.S.

Racial and ethnic disparities were most pronounced between May and July, it said, and declined over the course of the pandemic as hospitalizations increased among non-Hispanic white people. But such disparities persisted across the country as of December, most notably among Hispanic patients in the West.

The findings build on earlier studies about racial and ethnic disparities in COVID-19 hospitalizations by showing how they shifted over time and between regions.

Researchers point to two driving factors for the disproportionate hospitalizations among these minority groups: a higher risk of exposure to the virus and a higher risk for severe disease. They said differences in exposure risk associated with occupational and housing conditions, as well as socioeconomic status, are likely behind the demographic patterns they observed.

“Identification of the specific social determinants of health (e.g., access to health care, occupation and job conditions, housing instability, and transportation challenges) that contribute to geographic and temporal differences in racial and ethnic disparities in COVID-19 infection and poor health outcomes is critical,” they said, adding that a better understanding of these factors at the local level can help tailor strategies to prevent illness and allocate resources.

The second study examined COVID-19-related emergency department visits in 13 states between October and December, and found similar disparities between racial and ethnic groups.

During that period, Hispanic and American Indian or Alaska Native people were 1.7 times more likely to seek care than white people, and Black individuals 1.4 times more likely.

Researchers noted that these racial and ethnic groups are also impacted by long-standing and systemic inequities that affect their health, such as limited access to quality health care and disproportionate representation in “essential” jobs with less flexibility to take leave or work remotely.

“Racism and discrimination shape these factors that influence health risks; racism, rather than a person’s race or ethnicity, is a key driver of these health inequities,” they explained.

Such inequities can increase the risk of exposure and delayed medical attention, further heightening the risks for severe disease outcomes and the need to seek emergency care.

Looking ahead, researchers said their findings could be used to prioritize vaccines and other resources for disproportionately affected communities in an effort to reduce the need for emergency care. Walensky also emphasized the implications of the new studies on and beyond the country’s pandemic response.

“This information and the ongoing surveillance data we see daily from states across the country underscore the critical need and an important opportunity to address health equity as a core element in all of our public health efforts,” she said.

A renewed push to address such inequity is now underway at the CDC, which late last week declared racism a “serious public health threat that directly affects the well-being of millions of Americans.”

Walensky has directed the agency’s departments to develop interventions and measure health outcomes in the next year. It’s also provided $3 billion to support efforts to expand equity and access to vaccines, in addition to $2.25 billion previously allocated for COVID-19 testing in high-risk and underserved communities. The CDC has also launched a Racism and Health web portal to promote education and dialogue on the subject.

One area of particular focus is making sure the distribution of COVID-19 vaccines across the U.S. reaches the communities that have been hit hardest.

Data so far indicate that Black individuals make up roughly 12% of the country’s population but just 8.4% of those who have received at least one dose, Walensky said. And while 18% of the country identifies as Hispanic or Latino, she said, they make up only 10.7% of those who have been vaccinated.

Officials at Monday’s briefing highlighted further progress in the race to get shots into arms, noting that 120 million Americans have been vaccinated — 46% of adults have had at least one dose and 28% are fully vaccinated. And in exactly one week, all adults will be eligible to sign up for an appointment.

“This means that there has never been a better time than now for seniors and those eligible to get their shots,” said Andy Slavitt, senior advisor on the White House COVID-19 Response Team. “Make an appointment today. And if you have someone in your life, particularly a senior, who has not gotten a shot yet, reach out and see what help they need.”

Source: Studies Confirm Racial, Ethnic Disparities In COVID-19 Hospitalizations And Visits

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CDC Director Designates Racism a ‘Serious Public Health Threat’

2021/04/10 Leave a comment

Of note:

Racism is a scourge in American society. It’s also a serious public health threat, according to the director of the Centers for Disease Control and Prevention.

In a statement released Thursday, Dr. Rochelle Walensky pointed to the disproportionate impact of COVID-19 on communities of color, as seen in case numbers, deaths and social consequence.

“Yet, the disparities seen over the past year were not a result of COVID-19,” Walensky said. “Instead, the pandemic illuminated inequities that have existed for generations and revealed for all of America a known, but often unaddressed, epidemic impacting public health: racism.”

As Pandemic Deaths Add Up, Racial Disparities Persist — And In Some Cases Worsen

 

 

“What we know is this: racism is a serious public health threat that directly affects the well-being of millions of Americans,” she added. “As a result, it affects the health of our entire nation. Racism is not just the discrimination against one group based on the color of their skin or their race or ethnicity, but the structural barriers that impact racial and ethnic groups differently to influence where a person lives, where they work, where their children play, and where they worship and gather in community. These social determinants of health have life-long negative effects on the mental and physical health of individuals in communities of color.”

The result, she says, are stark health disparities that have mounted over generations.

So what does it mean for the agency? Walensky has charged all of the offices and centers under the CDC to develop interventions and measurable health outcomes in the next year, addressing racism in their respective areas. And she’s made clear that is a priority for the entire CDC.

The CDC also launched a new web portal, Racism and Health, that’s designed to be a hub for public and scientific information and discourse on the subject.

The site notes that racism, in both its structural and interpersonal forms, has a negative effect on mental and physical health.

And Walensky isn’t trying to avoid hard conversations.

“The word racism is intentional in this [initiative] for the CDC,” she told Timemagazine. “This is not just about the color of your skin but also about where you live, where you work, where your children play, where you pray, how you get to work, the jobs you have. All of these things feed into people’s health and their opportunities for health.”

The CDC committed to continuing to study how racism affects health, and propose and implement solutions accordingly. It will expand its investments in minority and other disproportionately affected communities to create “durable infrastructure” to address disparities.

“It has to be baked into the cake,” Walensky told Time. “It’s got to be part of what everybody is doing.”

Source: CDC Director Designates Racism a ‘Serious Public Health Threat’

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CDC: COVID-19 Was 3rd Leading Cause Of Death In 2020, People Of Color Hit Hardest

2021/04/02 Leave a comment

More confirmation of COVID-19 racial disparities:

COVID-19 was the third-underlying cause of death in 2020 after heart disease and cancer, the Centers for Disease Control and Prevention confirmed on Wednesday.

A pair of reports published in the CDC’s Morbidity and Mortality WeeklyReport sheds new light on the approximately 375,000 U.S. deaths attributed to COVID-19 last year, and highlights the pandemic’s disproportionate impact on communities of color — a point CDC Director Rochelle Walensky emphasized at a White House COVID-19 Response Team briefing on Wednesday.

She said deaths related to COVID-19 were higher among American Indian and Alaskan Native persons, Hispanics, Blacks and Native Hawaiian and Pacific Islander persons than whites. She added that “among nearly all of these ethnic and racial minority groups, the COVID-19 related deaths were more than double the death rate of non-Hispanic white persons.”

“The data should serve again as a catalyst for each of us [to] continue to do our part to drive down cases and reduce the spread of COVID-19, and get people vaccinated as soon as possible,” she said.

The reports examine data from U.S. death certificates and the National Vital Statistics System to draw conclusions about the accuracy of the country’s mortality surveillance and shifts in mortality trends.

One found that the age-adjusted death rate rose by 15.9% in 2020, its first increase in three years.

Overall death rates were highest among Black and American Indian/Alaska Native people, and higher for elderly people than younger people, according to the report. Age-adjusted death rates were higher among males than females.

COVID-19 was reported as either the underlying cause of death or a contributing cause of death for some 11.3% of U.S. fatalities, and replaced suicide as one of the top 10 leading causes of death.

Similarly, COVID-19 death rates were highest among individuals ages 85 and older, with the age-adjusted death rate higher among males than females. The COVID-19 death rate was highest among Hispanic and American Indian/ Alaska Native people.

Researchers emphasized that these death estimates are provisional, as the final annual mortality data for a given year are typically released 11 months after the year ends. Still, they said early estimates can give researchers and policymakers an early indication of changing trends and other “actionable information.”

“These data can guide public health policies and interventions aimed at reducing numbers of deaths that are directly or indirectly associated with the COVID-19 pandemic and among persons most affected, including those who are older, male, or from disproportionately affected racial/ethnic minority groups,” they added.

The other study examined 378,048 death certificates from 2020 that listed COVID-19 as a cause of death. Researchers said their findings “support the accuracy of COVID-19 mortality surveillance” using official death certificates, noting the importance of high-quality documentation and countering concerns about deaths being improperly attributed to the pandemic.

Among the death certificates reviewed, just 5.5% listed COVID-19 and no other conditions. Among those that included at least one other condition, 97% had either a co-occurring diagnosis of a “plausible chain-of-event” condition such as pneumonia or respiratory failure, a “significant contributing” condition such as hypertension or diabetes, or both.

“Continued messaging and training for professionals who complete death certificates remains important as the pandemic progresses,” researchers said. “Accurate mortality surveillance is critical for understanding the impact of variants of SARS-CoV-2, the virus that causes COVID-19, and of COVID-19 vaccination and for guiding public health action.”

Officials at the Wednesday briefing continued to call on Americans to practice mitigation measures and do their part to keep themselves and others safe, noting that COVID-19 cases continue to rise even as the country’s vaccine rollout accelerates.

The 7-day average of new cases is just under 62,000 cases per day, Walensky said, marking a nearly 12% increase from the previous 7-day period. Hospitalizations are also up at about 4,900 admissions per day, she added, with the 7-day average of deaths remaining slightly above 900 per day.

Dr. Celine Gounder, an infectious disease specialist at New York University who served as a COVID-19 adviser on the Biden transition team, told NPR’s Morning Edition on Wednesday that she remains concerned about the rate of new infections, even as the country has made considerable progress with its vaccination rollout.

She compared vaccines to a raincoat and an umbrella, noting they provide protection during a rainstorm but not in a hurricane

“And we’re really still in a COVID hurricane,” Gounder said. “Transmission rates are extremely high. And so even if you’ve been vaccinated, you really do need to continue to be careful, avoid crowds and wear masks in public.”

Source: CDC: COVID-19 Was 3rd Leading Cause Of Death In 2020, People Of Color Hit Hardest

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Children Can Get Severe COVID-19, CDC Says — Especially Black And Hispanic Children

2020/08/10 Leave a comment

Another example of racial disparities. While the study did not include socioeconomic factors, these likely explain part of the differences:

While most children who catch the coronavirus have either no symptoms or mild ones, they are still at risk of developing “severe” symptoms requiring admission to an intensive care unit, the Centers for Disease Control and Prevention said in a new report released Friday.

Hispanic and Black children in particular were much more likely to require hospitalization for COVID-19, with Hispanic children about eight times as likely as white children to be hospitalized, while Black children were five times as likely.

Despite persistent rumors that children are “almost immune” from the virus, the analysis of 576 children hospitalized for the virus across 14 states found that one out of three was admitted to the ICU — similar to the rate among adults. Almost 1 in 5 of those were infants younger than 3 months. The most common symptoms included fever and chills, inability to eat, nausea and vomiting.

The findings come as school districts across the country are figuring out how to educate the nation’s children while still protecting kids, teachers and family members from the ravages of the virus. The American Federation of Teachers has said it considers in-person schooling to be safe only when fewer than 5% of coronavirus tests in an area are positive.

Researchers don’t fully understand why some racial groups are hospitalized at higher rates than others. But the CDC’s findings are consistent with other studies, the authors of the report said, citing a recent analysis from the Baltimore-District of Columbia region that found that Hispanics had more COVID-19 infections than other groups.

“It has been hypothesized that Hispanic adults might be at increased risk for SARS-CoV-2 infection because they are overrepresented in frontline (e.g., essential and direct-service) occupations with decreased opportunities for social distancing, which might also affect children living in those households,” the CDC researchers wrote.

Underlying medical conditions might have contributed to the children’s hospitalization, researchers wrote, noting that Hispanic and Black children are more likely to suffer from conditions like obesity.

If there’s any good news, it’s that even among children hospitalized with severe COVID-19 complications, the fatality rate remains low, researchers said.

A separate study in the journal Pediatrics also found racial and socioeconomic disparities in children and young adults tested for COVID-19 in Washington, D.C. Hispanic children were more than six times as likely as white children to test positive for the virus; Black children were over four times as likely.

Ultimately, the CDC concluded, it’s crucial to continue prevention efforts wherever children gather, specifically citing schools and child care centers.

Source: Children Can Get Severe COVID-19, CDC Says — Especially Black And Hispanic Children

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Coronavirus Is Hitting Black and Hispanic Americans Harder. CDC Data Shows How Much.

2020/06/17 Leave a comment

Yet more evidence (and waiting for Canada to catch up with such data):

In a new, massive federal survey of novel coronavirus cases in the United States, a report by the Centers for Disease Control and Prevention offers an in-depth breakdown by gender, race, ethnicity, and health factors.

Among 1,320,488 laboratory-confirmed COVID-19 cases considered by the CDC between January 22 and May 30, 2020—of which only 45 percent had race or ethnicity data—33 percent were Hispanic or Latino of any race and 22 percent of infections were among Black Americans, the Morbidity and Mortality Weekly Report released Monday found. For context, those communities account for about 18 percent and 13 percent of the U.S. population, respectively.

The numbers amount to the best evidence yet that the deadly pandemic has had an outsized impact on communities of color.

“These findings suggest that persons in these groups … are disproportionately affected by the COVID-19 pandemic,” the report said, calling them consistent with previously reported data “that found higher proportions of Black and Hispanic persons among hospitalized COVID-19 patients.”

Of the 287,320 cases with data on underlying health conditions, the most common were cardiovascular disease at 32 percent, diabetes at 30 percent, and chronic lung disease at 18 percent.

Even as officials nationwide have forged ahead with re-openings, more than a dozen states—including Arizona, Arkansas, Oklahoma, North Carolina, South Carolina, California, Florida, and Texas—hit new daily COVID-19 case tally records in recent weeks. As the CDC put it in Monday’s report: “The COVID-19 pandemic is an ongoing public health crisis in the United States that continues to affect all populations and result in severe outcomes, including death.”

And as ProPublica previously reported, environmental, economic, and political factors have for years put Black Americans at higher risk of chronic conditions that overlap with COVID-19 risks, including asthma, heart disease, and diabetes.

Communities of color in every state have had a unique experience of the contagion, and these numbers suggest the outbreak is reflecting glaring health-care inequalities that no vaccine or treatment can cure.

Source: Coronavirus Is Hitting Black and Hispanic Americans Harder. CDC Data Shows How Much.

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