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Use of Zip Code Based Aggregate Indicators to Assess Race Disparities in COVID-19
Kevin D Long1, Steven M Albert2
1University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA.
Objective:
In the first six months of the pandemic, information on race and ethnicity was missing for half of the US COVID-19 cases. Combining case ascertainment with census-based zip code indicators may identify COVID-19 race-ethnicity disparities in the absence of individual-level data.
Design:
Ecological retrospective study for the period March-July 2020.
Setting:
Population-based investigation, Allegheny County, Pennsylvania.
Participants:
All COVID-19 cases, adjusted for zip code area population, in the early period of the pandemic.
Main Outcome Measures:
Monthly COVID-19 incidence and requests for human services by zip code level indicators of race-ethnicity and poverty.
Results:
In the early period of the pandemic, COVID-19 incidence was higher in zip codes with a greater proportion of racial and ethnic minorities. Zip codes with the highest quartile of minority residents (>25.1% of population) had a COVID-19 incidence of 60.1 (95% CI: 51.7-68.5) per 10,000 in this period; zip codes with the lowest quartile of minority residents (<6.3%) had an incidence of 31.3 (95% CI: 14.4-48.2). Requests for human services during this period (volume of 211 calls and county services) confirm these disparities.
Conclusion:
Use of census-defined race-ethnicity proportions by zip code offers a way to identify disparities when individual race-ethnicity data are unavailable.
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