Black–White Risk Differentials in COVID-19 (SARS-COV2) Transmission, Mortality and Case Fatality in the United States: Translational Epidemiologic Perspective and Challenges
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Author
Holmes, LaurensEnwere, Michael
Williams, Janille
Ogundele, Benjamin
Chavan, Prachi
Piccoli, Tatiana
Chinaka, Chinacherem
Comeaux, Camillia
Pelaez, Lavisha
Okundaye, Osatohamwen
Stalnaker, Leslie
Kalle, Fanta
Deepika, Keeti
Philipcien, Glen
Poleon, Maura
Ogungbade, Gbadebo
Elmi, Hikma
John, Valescia
Dabney, Kirk W.
Journal title
International Journal of Environmental Research and Public HealthDate Published
2020-06-17Publication Volume
17Publication Issue
12Publication Begin page
4322
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Background: Social and health inequities predispose vulnerable populations to adverse morbidity and mortality outcomes of epidemics and pandemics. While racial disparities in cumulative incidence (CmI) and mortality from the influenza pandemics of 1918 and 2009 implicated Blacks with survival disadvantage relative to Whites in the United States, COVID-19 currently indicates comparable disparities. We aimed to: (a) assess COVID-19 CmI by race, (b) determine the Black-White case fatality (CF) and risk differentials, and (c) apply explanatory model for mortality risk differentials. Methods: COVID-19 data on confirmed cases and deaths by selective states health departments were assessed using a cross-sectional ecologic design. Chi-square was used for CF independence, while binomial regression model for the Black-White risk differentials. Results: The COVID-19 mortality CmI indicated Blacks/AA with 34% of the total mortality in the United States, albeit their 13% population size. The COVID-19 CF was higher among Blacks/AA relative to Whites; Maryland, (2.7% vs. 2.5%), Wisconsin (7.4% vs. 4.8%), Illinois (4.8% vs. 4.2%), Chicago (5.9% vs. 3.2%), Detroit (Michigan), 7.2% and St. John the Baptist Parish (Louisiana), 7.9%. Blacks/AA compared to Whites in Michigan were 15% more likely to die, CmI risk ratio (CmIRR) = 1.15, 95% CI, 1.01-1.32. Blacks/AA relative to Whites in Illinois were 13% more likely to die, CmIRR = 1.13, 95% CI, 0.93-1.39, while Blacks/AA compared to Whites in Wisconsin were 51% more likely to die, CmIRR = 1.51, 95% CI, 1.10-2.10. In Chicago, Blacks/AA were more than twice as likely to die, CmIRR = 2.24, 95% CI, 1.36-3.88. Conclusion: Substantial racial/ethnic disparities are observed in COVID-19 CF and mortality with Blacks/AA disproportionately affected across the United States.Citation
Holmes L Jr, Enwere M, Williams J, Ogundele B, Chavan P, Piccoli T, Chinacherem C, Comeaux C, Pelaez L, Okundaye O, Stalnaker L, Kalle F, Deepika K, Philipcien G, Poleon M, Ogungbade G, Elmi H, John V, Dabney KW. Black-White Risk Differentials in COVID-19 (SARS-COV2) Transmission, Mortality and Case Fatality in the United States: Translational Epidemiologic Perspective and Challenges. Int J Environ Res Public Health. 2020 Jun 17;17(12):4322. doi: 10.3390/ijerph17124322. PMID: 32560363; PMCID: PMC7345143.DOI
10.3390/ijerph17124322ae974a485f413a2113503eed53cd6c53
10.3390/ijerph17124322
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