Unraveling US National COVID-19 Racial/Ethnic Disparities using County Level Data Among 328 Million Americans

ABSTRACTRacial and ethnic disparities in COVID-19 outcomes reflect the unequal burden experienced by vulnerable communities in the United States (US). Proposed explanations include socioeconomic factors that influence how people live, work, and play, and pre-existing comorbidities. It is important to assess the extent to which observed US COVID-19 racial and ethnic disparities can be explained by these factors. We study 9.8 million confirmed cases and 234,000 confirmed deaths from 2,990 US counties (3,142 total) that make up 99.8% of the total US population (327.6 out of 328.2 million people) through 11/8/20. We found national COVID-19 racial health disparities in US are partially explained by various social determinants of health and pre-existing comorbidities that have been previously proposed. However, significant unexplained racial and ethnic health disparities still persist at the US county level after adjusting for these variables. There is a pressing need to develop strategies to address not only the social determinants but also other factors, such as testing access, personal protection equipment access and exposures, as well as tailored intervention and resource allocation for vulnerable groups, in order to combat COVID-19 and reduce racial health disparities.

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Unraveling US National COVID-19 Racial/Ethnic Disparities using County Level Data Among 328 Million Americans

10.21203/rs.3.rs-111104/v1 ◽

2020 ◽

Author(s):

Daniel Li ◽

Sheila Gaynor ◽

Corbin Quick ◽

Jarvis Chen ◽

Briana Stephenson ◽

...

Keyword(s):

Health Disparities ◽

Social Determinants ◽

Ethnic Disparities ◽

The United States ◽

Vulnerable Groups ◽

County Level ◽

Racial And Ethnic Disparities ◽

Racial Health Disparities ◽

Personal Protection Equipment ◽

Level Data

Abstract Racial and ethnic disparities in COVID-19 outcomes reflect the unequal burden experienced by vulnerable communities in the United States (US). Proposed explanations include socioeconomic factors that influence how people live, work, and play, and pre-existing comorbidities. It is important to assess the extent to which observed US COVID-19 racial and ethnic disparities can be explained by these factors. We study 9.8 million confirmed cases and 234,000 confirmed deaths from 2,990 US counties (3,142 total) that make up 99.8% of the total US population (327.6 out of 328.2 million people) through 11/8/20. We found national COVID-19 racial health disparities in US are partially explained by various social determinants of health and pre-existing comorbidities that have been previously proposed. However, significant unexplained racial and ethnic health disparities still persist at the US county level after adjusting for these variables. There is a pressing need to develop strategies to address not only the social determinants but also other factors, such as testing access, personal protection equipment access and exposures, as well as tailored intervention and resource allocation for vulnerable groups, in order to combat COVID-19 and reduce racial health disparities.

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Abstract P636: Social Determinants of Stroke Hospitalization and Mortality in the United States

Stroke ◽

10.1161/str.52.suppl_1.p636 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Randhir Sagar Yadav ◽

Durgesh Chaudhary ◽

Shima Shahjouei ◽

Jiang Li ◽

Vida Abedi ◽

...

Keyword(s):

United States ◽

Income Inequality ◽

Social Determinants ◽

Hemorrhagic Stroke ◽

The United States ◽

Care Physician ◽

County Level ◽

Medicare Beneficiaries ◽

Level Data ◽

Control And Prevention

Introduction: Stroke hospitalization and mortality are influenced by various social determinants. This ecological study aimed to determine the associations between social determinants and stroke hospitalization and outcome at county-level in the United States. Methods: County-level data were recorded from the Centers for Disease Control and Prevention as of January 7, 2020. We considered four outcomes: all-age (1) Ischemic and (2) Hemorrhagic stroke Death rates per 100,000 individuals (ID and HD respectively), and (3) Ischemic and (4) Hemorrhagic stroke Hospitalization rate per 1,000 Medicare beneficiaries (IH and HH respectively). Results: Data of 3,225 counties showed IH (12.5 ± 3.4) and ID (22.2 ± 5.1) were more frequent than HH (2.0 ± 0.4) and HD (9.8 ± 2.1). Income inequality as expressed by Gini Index was found to be 44.6% ± 3.6% and unemployment rate was 4.3% ± 1.5%. Only 29.8% of the counties had at least one hospital with neurological services. The uninsured rate was 11.0% ± 4.7% and people living within half a mile of a park was only 18.7% ± 17.6%. Age-adjusted obesity rate was 32.0% ± 4.5%. In regression models, age-adjusted obesity (OR for IH: 1.11; HH: 1.04) and number of hospitals with neurological services (IH: 1.40; HH: 1.50) showed an association with IH and HH. Age-adjusted obesity (ID: 1.16; HD: 1.11), unemployment (ID: 1.21; HD: 1.18) and income inequality (ID: 1.09; HD: 1.11) showed an association with ID and HD. Park access showed inverse associations with all four outcomes. Additionally, population per primary-care physician was associated with HH while number of pharmacy and uninsured rate were associated with ID. All associations and OR had p ≤0.04. Conclusion: Unemployment and income inequality are significantly associated with increased stroke mortality rates.

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Racial and Ethnic Disparities as a Public Health Ethics Issue

The Oxford Handbook of Public Health Ethics ◽

10.1093/oxfordhb/9780190245191.013.26 ◽

2019 ◽

pp. 276-289

Author(s):

Stephen B. Thomas

Keyword(s):

Public Health ◽

Health Disparities ◽

Ethnic Disparities ◽

The United States ◽

Health Conditions ◽

Moral Foundations ◽

Racial And Ethnic Disparities ◽

Health Issues ◽

Policy Initiatives ◽

Made In

It is well established that racial and ethnic minorities in the United States have lower life expectancies and suffer more from numerous health conditions than their white counterparts. This chapter draws on a US perspective to provide an overview of racial and ethnic health disparities and their causes. It describes public health policy initiatives that address racial and ethnic health disparities, situates racial disparities in the current social and political context, examines what progress has been made in reducing racial and ethnic disparities, offers an account of the moral foundations for further efforts to reduce disparities, and suggests a way forward for eliminating racial and ethnic health disparities. Public health issues of social justice, racism, and violence are discussed.

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Developing County-level Data of Nitrogen Fertilizer and Manure Inputs for Corn Production in the United States

Journal of Cleaner Production ◽

10.1016/j.jclepro.2021.126957 ◽

2021 ◽

pp. 126957

Author(s):

Yushu Xia ◽

Hoyoung Kwon ◽

Michelle Wander

Keyword(s):

United States ◽

Nitrogen Fertilizer ◽

The United States ◽

County Level ◽

Corn Production ◽

Level Data

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Timing of social distancing policies and COVID-19 mortality: county-level evidence from the U.S.

Journal of Population Economics ◽

10.1007/s00148-021-00845-2 ◽

2021 ◽

Author(s):

Catalina Amuedo-Dorantes ◽

Neeraj Kaushal ◽

Ashley N. Muchow

Keyword(s):

New York ◽

Political Ideology ◽

Death Rate ◽

The United States ◽

County Level ◽

Level Data ◽

Level Information ◽

Alternative Measures ◽

The U.S ◽

Pharmaceutical Interventions

AbstractUsing county-level data on COVID-19 mortality and infections, along with county-level information on the adoption of non-pharmaceutical interventions (NPIs), we examine how the speed of NPI adoption affected COVID-19 mortality in the United States. Our estimates suggest that adopting safer-at-home orders or non-essential business closures 1 day before infections double can curtail the COVID-19 death rate by 1.9%. This finding proves robust to alternative measures of NPI adoption speed, model specifications that control for testing, other NPIs, and mobility and across various samples (national, the Northeast, excluding New York, and excluding the Northeast). We also find that the adoption speed of NPIs is associated with lower infections and is unrelated to non-COVID deaths, suggesting these measures slowed contagion. Finally, NPI adoption speed appears to have been less effective in Republican counties, suggesting that political ideology might have compromised their efficacy.

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