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Census tract socioeconomic indicators and COVID-19-associated hospitalization rates-COVID-NET surveillance areas in
Jonathan M Wortham1,2, Seth A Meador1, James L Hadler3
1CDC COVID-NET Team, Atlanta, GA, United States of America.
Insights
COVID-19 hospitalizations disproportionately affected racial and ethnic minorities, particularly in high-poverty areas. Public health efforts must prioritize these vulnerable groups for mitigation and vaccination.
Area of Science:
- Epidemiology
- Public Health
- Health Disparities
Background:
- Studies indicated higher COVID-19 hospitalization rates among racial and ethnic minorities.
- Understanding these disparities is crucial for effective public health interventions.
Purpose of the Study:
- To quantify the association between race/ethnicity, socioeconomic status, and COVID-19 hospitalization rates.
- To inform public health strategies for vulnerable populations.
Main Methods:
- Utilized data from the COVID-19-associated Hospitalization Surveillance Network (COVID-NET).
- Analyzed hospitalization rates by race/ethnicity and census tract socioeconomic indicators (poverty levels).
- Calculated age-adjusted hospitalization rates.
Main Results:
- Overall hospitalization rates were higher in high-poverty census tracts.
- COVID-19 hospitalization rates were elevated for Black and Hispanic individuals, irrespective of poverty level.
- Specific rates detailed for White, Black, and Hispanic persons across different poverty strata.
Conclusions:
- High-poverty areas and racial/ethnic minority groups face elevated COVID-19 hospitalization risks.
- Public health interventions, including mitigation and vaccination campaigns, must target these disparities.
- Addressing the needs of minority groups and those in high-poverty areas is essential.
Objectives:
Some studies suggested more COVID-19-associated hospitalizations among racial and ethnic minorities. To inform public health practice, the COVID-19-associated Hospitalization Surveillance Network (COVID-NET) quantified associations between race/ethnicity, census tract socioeconomic indicators, and COVID-19-associated hospitalization rates.
Methods:
Using data from COVID-NET population-based surveillance reported during March 1-April 30, 2020 along with socioeconomic and denominator data from the US Census Bureau, we calculated COVID-19-associated hospitalization rates by racial/ethnic and census tract-level socioeconomic strata.
Results:
Among 16,000 COVID-19-associated hospitalizations, 34.8% occurred among non-Hispanic White (White) persons, 36.3% among non-Hispanic Black (Black) persons, and 18.2% among Hispanic or Latino (Hispanic) persons. Age-adjusted COVID-19-associated hospitalization rate were 151.6 (95% Confidence Interval (CI): 147.1-156.1) in census tracts with >15.2%-83.2% of persons living below the federal poverty level (high-poverty census tracts) and 75.5 (95% CI: 72.9-78.1) in census tracts with 0%-4.9% of persons living below the federal poverty level (low-poverty census tracts). Among White, Black, and Hispanic persons living in high-poverty census tracts, age-adjusted hospitalization rates were 120.3 (95% CI: 112.3-128.2), 252.2 (95% CI: 241.4-263.0), and 341.1 (95% CI: 317.3-365.0), respectively, compared with 58.2 (95% CI: 55.4-61.1), 304.0 (95%: 282.4-325.6), and 540.3 (95% CI: 477.0-603.6), respectively, in low-poverty census tracts.
Conclusions:
Overall, COVID-19-associated hospitalization rates were highest in high-poverty census tracts, but rates among Black and Hispanic persons were high regardless of poverty level. Public health practitioners must ensure mitigation measures and vaccination campaigns address needs of racial/ethnic minority groups and people living in high-poverty census tracts.
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