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Dynamics of racial disparities in all-cause mortality during the COVID-19 pandemic

Author

Listed:
  • Hélène E. Aschmann

    (a Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158;)

  • Alicia R. Riley

    (b Department of Sociology, University of California, Santa Cruz, Santa Cruz, CA 95064;)

  • Ruijia Chen

    (a Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158;)

  • Yea-Hung Chen

    (a Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158;)

  • Kirsten Bibbins-Domingo

    (a Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158;)

  • Andrew C. Stokes

    (c Department of Global Health, Boston University School of Public Health, Boston, MA 02118;)

  • M. Maria Glymour

    (a Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158;)

  • Mathew V. Kiang

    (d Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA 94304)

Abstract
As research documenting disparate impacts of COVID-19 by race and ethnicity grows, little attention has been given to dynamics in mortality disparities during the pandemic and whether changes in disparities persist. We estimate age-standardized monthly all-cause mortality in the United States from January 2018 through February 2022 for seven racial/ethnic populations. Using joinpoint regression, we quantify trends in race-specific rate ratios relative to non-Hispanic White mortality to examine the magnitude of pandemic-related shifts in mortality disparities. Prepandemic disparities were stable from January 2018 through February 2020. With the start of the pandemic, relative mortality disadvantages increased for American Indian or Alaska Native (AIAN), Native Hawaiian or other Pacific Islander (NHOPI), and Black individuals, and relative mortality advantages decreased for Asian and Hispanic groups. Rate ratios generally increased during COVID-19 surges, with different patterns in the summer 2021 and winter 2021/2022 surges, when disparities approached prepandemic levels for Asian and Black individuals. However, two populations below age 65 fared worse than White individuals during these surges. For AIAN people, the observed rate ratio reached 2.25 (95% CI = 2.14, 2.37) in October 2021 vs. a prepandemic mean of 1.74 (95% CI = 1.62, 1.86), and for NHOPI people, the observed rate ratio reached 2.12 (95% CI = 1.92, 2.33) in August 2021 vs. a prepandemic mean of 1.31 (95% CI = 1.13, 1.49). Our results highlight the dynamic nature of racial/ethnic disparities in mortality and raise alarm about the exacerbation of mortality inequities for Indigenous groups due to the pandemic.

Suggested Citation

  • Hélène E. Aschmann & Alicia R. Riley & Ruijia Chen & Yea-Hung Chen & Kirsten Bibbins-Domingo & Andrew C. Stokes & M. Maria Glymour & Mathew V. Kiang, 2022. "Dynamics of racial disparities in all-cause mortality during the COVID-19 pandemic," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 119(40), pages 2210941119-, October.
    • Handle: RePEc:nas:journl:v:119:y:2022:p:e2210941119
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