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Published on: April 9, 2021
Racial and Ethnic Disparities in COVID-19: Evidence from Six Large Cities
Joseph Benitez1, Charles Courtemanche2, Aaron Yelowitz2
1Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY 40536 USA.
Insights
Racial and ethnic disparities in coronavirus disease 2019 (COVID-19) cases are significant in the USA. Higher COVID-19 case rates, not higher fatality rates, explain the disproportionate impact on Black and Hispanic communities.
Area of Science:
- Public Health
- Epidemiology
- Health Disparities
Background:
- The coronavirus pandemic (COVID-19) has disproportionately affected racial and ethnic minority groups in the USA.
- Understanding the drivers of these disparities is crucial for effective public health interventions.
Purpose of the Study:
- To examine racial and ethnic disparities in confirmed COVID-19 cases and fatalities at the ZIP code level across six diverse US cities.
- To identify factors contributing to these disparities, controlling for a wide range of demographic, socioeconomic, and health-related variables.
Main Methods:
- Analysis of COVID-19 data linked to demographic, socioeconomic, housing, occupation, transportation, healthcare access, long-run opportunity, human mobility, and population health data.
- ZIP code-level analysis across Atlanta, Baltimore, Chicago, New York City, San Diego, and St. Louis.
- Examination of COVID-19 fatalities in Chicago and New York City.
Main Results:
- ZIP codes with higher proportions of Black and Hispanic residents showed statistically significant increases in COVID-19 cases per capita.
- Hispanic residents had a larger disparity in cases compared to Black residents.
- While some disparities were explained by factors like long-run opportunity and human mobility, most remained unexplained.
- Higher COVID-19 case rates, rather than higher fatality rates, accounted for the majority of observed disparities in fatalities in Chicago and New York City.
Conclusions:
- Significant racial and ethnic disparities exist in COVID-19 incidence across US cities.
- These disparities are largely driven by higher case rates in Black and Hispanic communities, not necessarily higher individual fatality risk.
- Further research is needed to understand the unexplained factors contributing to these disparities.
Abstract:
As of June 2020, the coronavirus pandemic has led to more than 2.3 million confirmed infections and 121 thousand fatalities in the USA, with starkly different incidence by race and ethnicity. Our study examines racial and ethnic disparities in confirmed COVID-19 cases across six diverse cities-Atlanta, Baltimore, Chicago, New York City, San Diego, and St. Louis-at the ZIP code level (covering 436 "neighborhoods" with a population of 17.7 million). Our analysis links these outcomes to six separate data sources to control for demographics; housing; socioeconomic status; occupation; transportation modes; health care access; long-run opportunity, as measured by income mobility and incarceration rates; human mobility; and underlying population health. We find that the proportions of Black and Hispanic residents in a ZIP code are both positively and statistically significantly associated with COVID-19 cases per capita. The magnitudes are sizeable for both Black and Hispanic, but even larger for Hispanic. Although some of these disparities can be explained by differences in long-run opportunity, human mobility, and demographics, most of the disparities remain unexplained even after including an extensive list of covariates related to possible mechanisms. For two cities-Chicago and New York-we also examine COVID-19 fatalities, finding that differences in confirmed COVID-19 cases explain the majority of the observed disparities in fatalities. In other words, the higher death toll of COVID-19 in predominantly Black and Hispanic communities mostly reflects higher case rates, rather than higher fatality rates for confirmed cases.
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