Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• The COVID-19 public health emergency (PHE) highlighted significant racial and ethnic disparities in mortality.
• Understanding age-specific excess mortality is crucial for addressing downstream implications in minoritized populations.

Purpose of the Study:

• To characterize overall and age-specific all-cause excess mortality by race and ethnicity during the COVID-19 PHE.
• To assess if these disparities differed from prepandemic trends.

Main Methods:

• Cross-sectional study analyzing US death certificate data from March 2020 to May 2023.
• Examined all-cause excess mortality (observed-to-expected ratios) across racial and ethnic groups and age demographics.

Main Results:

• Over 1.38 million excess deaths occurred during the COVID-19 PHE, with American Indian/Alaska Native and Hispanic populations showing the highest ratios.
• Populations aged 25-64 years experienced the greatest relative increases in excess mortality.
• In individuals under 25, the Black population accounted for 51.1% of excess deaths, despite being 13.8% of the population.

Conclusions:

• Excess mortality during the COVID-19 PHE affected all racial and ethnic groups, with significant disparities impacting minoritized populations.
• The greatest relative increases in mortality were observed in the 25-64 age group.
• These pandemic-associated disparities differed from prepandemic trends.