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Racial and Ethnic Disparities in COVID-19 Infection and Hospitalization in the Active Component US Military
John M Young1, Shauna L Stahlman1, Shawn S Clausen1
1John M. Young and James D. Mancuso are with the Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD. Shauna L. Stahlman, Shawn S. Clausen, and Mark L. Bova are with the Epidemiology and Analysis Section of the Armed Forces Health Surveillance Division at the Defense Health Agency, Silver Spring, MD. Note. The opinions and assertions expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Department of Defense or the US government.
Racial and ethnic disparities in COVID-19 infection and hospitalization were found in the US military. These health inequities persist despite universal healthcare access, indicating a need for targeted interventions.
Area of Science:
- Public Health
- Epidemiology
- Health Disparities
Background:
- The COVID-19 pandemic highlighted existing health disparities in civilian populations.
- Understanding similar disparities within the US military is crucial for ensuring health equity.
Purpose of the Study:
- To assess racial and ethnic disparities in COVID-19 testing, infection, and hospitalization among active-duty US military personnel.
- To investigate factors contributing to these disparities.
Main Methods:
- Retrospective cohort study analyzing calendar year 2020 data.
- Calculated incidence rates of COVID-19 testing, infection, and hospitalization.
- Utilized adjusted risk ratios (ARR) to compare risk across racial and ethnic groups.
Main Results:
- Testing rates for COVID-19 were similar across racial and ethnic groups.
- Non-Hispanic Blacks and Hispanics exhibited a higher risk of infection (ARR=1.25-1.26) and hospitalization (ARR=1.21-1.28) compared to Whites.
- Overall incidence: 61.3 tests/100 population/year, 10.4% positive tests, 1.1% hospitalization rate among infected.
Conclusions:
- Racial and ethnic disparities in COVID-19 infection and hospitalization exist within the US military.
- Universal healthcare access and similar testing rates did not eliminate these disparities.
- Interventions must address patient, provider, healthcare system, and societal factors to promote health equity.
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