scholarly journals Racial and ethnic inequalities in COVID-19 mortality within Texas carceral settings

2021 ◽  
Author(s):  
Neal Marquez ◽  
Destiny Moreno ◽  
Amanda Klonsky ◽  
Sharon Dolovich
Keyword(s):  
Health Outcomes ◽  
Ethnic Disparities ◽  
Black Population ◽  
The United States ◽  
Mortality Rates ◽  
Bayesian Regression ◽  
White Population ◽  
Racial Inequalities ◽  
Racial And Ethnic Differences ◽  
Adjusted Risk

ABSTRACTSeveral analyses have highlighted racial and ethnic disparities related to COVID-19 health outcomes across the United States. Less focus has been placed on more localized contexts, such as carceral settings, where racial and ethnic inequities in COVID-19 health outcomes also exist, but the proximal drivers of inequality are different. In this study, we analyzed mortality rates among incarcerated people in the Texas Department of Criminal Justice (TDCJ) to assess racial and ethnic differences in COVID-19 mortality. We obtained monthly demographic and mortality information of the TDCJ population from April 1, 2019 to March 31, 2021 from TDCJ monthly reports and open record requests filed by the Texas Justice Initiative. We estimated the risk of COVID-19 mortality for the Hispanic and Black population relative to the White population using a Bayesian regression framework, adjusting for sex and age. In the first 12 months of the pandemic, Hispanic and Black all-cause mortality rates were higher than that of the White population, reversing the pattern observed the 12 months prior. Adjusted risk of COVID-19 mortality relative to the White population was 1.96 (CI 1.32–2.93) for the Hispanic population and 1.66 (CI 1.10–2.52) for the Black population. We find that COVID-19 mortality has disproportionately impacted Hispanic and Black individuals within the TDCJ population. As the proximal mechanisms which drive these inequalities are likely different than those which lead to racial inequalities in the non-incarcerated populations, future studies should look to assess and address the specific drivers of COVID-19 related disparities in carceral settings.

scholarly journals Racial/Ethnic Disparities in Mortality: Contributions and Variations by Rurality in the United States, 2012–2015

2019 ◽  
Vol 16 (3) ◽  
pp. 436 ◽  
Author(s):  
Jeffrey Hall ◽  
Ramal Moonesinghe ◽  
Karen Bouye ◽  
Ana Penman-Aguilar
Keyword(s):  
Rural Areas ◽  
Ethnic Disparities ◽  
The United States ◽  
Mortality Rates ◽  
Malignant Neoplasms ◽  
Ethnic Populations ◽  
Asian Pacific Islanders ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
Racial Ethnic

The value of disaggregating non-metropolitan and metropolitan area deaths in illustrating place-based health effects is evident. However, how place interacts with characteristics such as race/ethnicity has been less firmly established. This study compared socioeconomic characteristics and age-adjusted mortality rates by race/ethnicity in six rurality designations and assessed the contributions of mortality rate disparities between non-Hispanic blacks (NHBs) and non-Hispanic whites (NHWs) in each designation to national disparities. Compared to NHWs, age-adjusted mortality rates for: (1) NHBs were higher for all causes (combined), heart disease, malignant neoplasms, and cerebrovascular disease; (2) American Indian and Alaska Natives were significantly higher for all causes in rural areas; (3) Asian Pacific islanders and Hispanics were either lower or not significantly different in all areas for all causes combined and all leading causes of death examined. The largest contribution to the U.S. disparity in mortality rates between NHBs and NHWs originated from large central metropolitan areas. Place-based variations in mortality rates and disparities may reflect resource, and access inequities that are often greater and have greater health consequences for some racial/ethnic populations than others. Tailored, systems level actions may help eliminate mortality disparities existing at intersections between race/ethnicity and place.

scholarly journals Differences in RAAS/vitamin D linked to genetics and socioeconomic factors could explain the higher mortality rate in African Americans with COVID-19

2020 ◽  
Vol 14 ◽  
pp. 175394472097771
Author(s):  
Virna Margarita Martín Giménez ◽  
León Ferder ◽  
Felipe Inserra ◽  
Joxel García ◽  
Walter Manucha
Keyword(s):  
Vitamin D ◽  
Skin Color ◽  
Black People ◽  
Ethnic Disparities ◽  
Black Population ◽  
The United States ◽  
Ethnic Origin ◽  
Plasma Vitamin ◽  
Susceptibility To Infection ◽  
Vitamin D Levels

COVID-19 is said to be a pandemic that does not distinguish between skin color or ethnic origin. However, data in many parts of the world, especially in the United States, begin to show that there is a sector of society suffering a more significant impact from this pandemic. The Black population is more vulnerable than the White population to infection and death by COVID-19, with hypertension and diabetes mellitus as probable predisposing factors. Over time, multiple disparities have been observed between the health of Black and White populations, associated mainly with socioeconomic inequalities. However, some mechanisms and pathophysiological susceptibilities begin to be elucidated that are related directly to the higher prevalence of multiple diseases in the Black population, including infection and death by COVID-19. Plasma vitamin D levels and evolutionary adaptations of the renin-angiotensin-aldosterone system (RAAS) in Black people differ considerably from those of other races. The role of these factors in the development and progression of hypertension and multiple lung diseases, among them SARS-CoV-2 infection, is well established. In this sense, the present review attempts to elucidate the link between vitamin D and RAAS ethnic disparities and susceptibility to infection and death by COVID-19 in Black people, and suggests possible mechanisms for this susceptibility.

scholarly journals Racial disparities in COVID-19 mortality are driven by unequal infection risks.

2020 ◽  
Author(s):  
Jon Zelner ◽  
Rob Trangucci ◽  
Ramya Naraharisetti ◽  
Alex Cao ◽  
Ryan Malosh ◽  
...  
Keyword(s):  
Racial Disparities ◽  
Data Science ◽  
Age Groups ◽  
Case Fatality ◽  
The United States ◽  
Mortality Rates ◽  
Bayesian Regression ◽  
Mortality Data ◽  
Incidence And Mortality ◽  
The U.S

Background. As of August 5, 2020, there were more than 4.8M confirmed and probable cases and 159K deaths attributable to SARS-CoV-2 in the United States, with these numbers undoubtedly reflecting a significant underestimate of the true toll. Geographic, racial-ethnic, age and socioeconomic disparities in exposure and mortality are key features of the first and second wave of the U.S. COVID-19 epidemic. Methods. We used individual-level COVID-19 incidence and mortality data from the U.S. state of Michigan to estimate age-specific incidence and mortality rates by race/ethnic group. Data were analyzed using hierarchical Bayesian regression models, and model results were validated using posterior predictive checks. Findings. In crude and age-standardized analyses we found rates of incidence and mortality more than twice as high than Whites for all groups other than Native Americans. Of these, Blacks experienced the greatest burden of confirmed and probable COVID-19 infection (Age- standardized incidence = 1,644/100,000 population) and mortality (age-standardized mortality rate 251/100,000). These rates reflect large disparities, as Blacks experienced age-standardized incidence and mortality rates 5.6 (95% CI = 5.5, 5.7) and 6.9 (6.5, 7.3) times higher than Whites, respectively. We also found that the bulk of the disparity in mortality between Blacks and Whites is driven by dramatically higher rates of COVID-19 infection across all age groups, particularly among older adults, rather than age-specific variation in case-fatality rates. Interpretation. This work suggests that well-documented racial disparities in COVID-19 mortality in hard-hit settings, such as the U.S. state of Michigan, are driven primarily by variation in household, community and workplace exposure rather than case-fatality rates. Funding. This work was supported by a COVID-PODS grant from the Michigan Institute for Data Science (MIDAS) at the University of Michigan. The funding source had no role in the preparation of this manuscript.

scholarly journals Social determinants of adult sex ratios and racial/ethnic disparities in transmission of HIV and other sexually transmitted infections in the USA

2017 ◽  
Vol 372 (1729) ◽  
pp. 20160323 ◽  
Author(s):  
Enrique Rodriguez Pouget
Keyword(s):  
Sexually Transmitted Infections ◽  
Social Determinants ◽  
Sex Ratios ◽  
Ethnic Disparities ◽  
Black Population ◽  
Mortality Rates ◽  
Sexually Transmitted ◽  
Historical Factors ◽  
The Usa ◽  
Male Incarceration

In Black population centres in the USA, adult sex ratios (ASRs) are strongly female-biased primarily due to high male incarceration and early mortality rates. I explore the system of social determinants that shape these ASRs, and describe their apparent consequences. Evidence suggests that female-biased ASRs play a role, along with racial residential segregation, to increase mixing between core and peripheral members of sexual networks, facilitating transmission of human immunodeficiency virus and other sexually transmitted infections. Unique historical factors underlie Black male incarceration and mortality rates in the USA, making comparisons with other groups or other countries challenging. This article is part of the themed issue ‘Adult sex ratios and reproductive decisions: a critical re-examination of sex differences in human and animal societies’.

State-Level Infant, Neonatal, and Postneonatal Mortality: The Contribution of Selected Structural Socioeconomic Variables

1998 ◽  
Vol 28 (1) ◽  
pp. 13-27 ◽  
Author(s):  
Sheryl Thorburn Bird ◽  
Karl E. Bauman
Keyword(s):  
Infant Mortality ◽  
Health Outcomes ◽  
Neonatal Mortality ◽  
State Level ◽  
The United States ◽  
Mortality Rates ◽  
Structural Factors ◽  
Postneonatal Mortality ◽  
Structural Variables ◽  
Black Populations

Reducing infant mortality in the United States is a national priority. States' infant mortality rates vary substantially. Public health researchers, practitioners, and leaders have long argued that social and other structural factors must be addressed if health outcomes are to be improved. A knowledge of which structural variables are most strongly related to state-level infant mortality is needed to guide the development of policies and programs to reduce this mortality. The authors examine the importance of several structural (social, economic, and political) variables for state-level infant, neonatal, and postneonatal mortality. With the state as the unit of analysis, data for all 50 states were analyzed using multiple regression. Together, the structural variables accounted for two-thirds of the variance in infant and neonatal mortality rates and over half of the variance in postneonatal mortality rates. States with proportionately larger black populations had higher infant, neonatal, and postneonatal mortality rates. States with greater percentages of high school graduates had lower neonatal mortality rates but higher postneonatal mortality rates. The findings suggest that a better understanding of the relationship between states' social structure and infant health outcomes is needed if state-level infant mortality is to be reduced.

scholarly journals Exacerbating Inequalities: Social Networks, Racial/Ethnic Disparities, and the COVID-19 Pandemic in the United States

2020 ◽  
Author(s):  
Gertrude R Gauthier ◽  
Jeffrey A Smith ◽  
Catherine García ◽  
Marc A Garcia ◽  
Patricia A Thomas
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Social Networks ◽  
Social Network ◽  
Health Outcomes ◽  
Ethnic Disparities ◽  
The United States ◽  
Mental Health Outcomes ◽  
Physical And Mental Health ◽  
Racial Ethnic

Abstract Objectives The disruption and contraction of older adults’ social networks are among the less discussed consequences of the COVID-19 pandemic. Our objective was to provide an evidence-based commentary on racial/ethnic disparities in social network resources and draw attention to the ways in which disasters differentially affect social networks, with meaningful insight for the ongoing pandemic. Methods We draw upon prior research on social networks and past natural disasters to identify major areas of network inequality. Attention is given to how pre-pandemic racial/ethnic network disparities are exacerbated during the current crisis, with implications for physical and mental health outcomes. Results Evidence from the literature shows a robust association between strong social networks and physical and mental health outcomes. During times of crisis, access to social networks for older adults is disrupted, particularly for marginalized groups. We document pre-pandemic disparities in social networks resources and offer insight for examining the impact of COVID-19 on disrupting social networks among older adults. Discussion Importantly, racial/ethnic disparities in social networks both prior to and as a result of the pandemic intensify existing inequalities and demonstrate the necessity of better understanding social network inequalities for marginalized older adults, particularly in the context of the COVID-19 health crisis.

Predictive Strength of Self-Rated Health for Mortality Risk Among Older Adults in the United States: Does It Differ by Race and Ethnicity?

2016 ◽  
Vol 39 (7) ◽  
pp. 879-905 ◽  
Author(s):  
Hyeyoung Woo ◽  
Anna Zajacova
Keyword(s):  
Older Adults ◽  
Predictive Validity ◽  
Mortality Risk ◽  
Race And Ethnicity ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial And Ethnic Differences ◽  
Self Rated Health ◽  
Cox Proportional Hazard Models ◽  
Using Data

Self-rated health (SRH) is widely used to capture racial and ethnic disparities in health. It is therefore critical to understand whether individuals with different racial and ethnic backgrounds assess their SRH differently. Despite the high overall predictive validity of SRH for subsequent mortality, few studies paid attention to potential variations by race and ethnicity. This study examines racial and ethnic differences in the predictive validity of SRH for subsequent mortality risk among older adults (55–84) by estimating Cox Proportional Hazard models using data from the National Health Interview Surveys Linked Mortality Files (1989–2006; N = 289,432). Results indicate that SRH predicts mortality risk less well for non-Hispanic Blacks and Hispanics than non-Hispanic Whites. Three proposed mechanisms—socioeconomic status, immigration status, and cause of death—explain only a modest proportion of the variation. These results suggest that individuals from different racial and ethnic groups may evaluate their heath differently, and thus caution is necessary when using SRH to estimate racial and ethnic health disparities.

scholarly journals Racial Disparities in Coronavirus Disease 2019 (COVID-19) Mortality Are Driven by Unequal Infection Risks

2020 ◽  
Author(s):  
Jon Zelner ◽  
Rob Trangucci ◽  
Ramya Naraharisetti ◽  
Alex Cao ◽  
Ryan Malosh ◽  
...  
Keyword(s):  
Native Americans ◽  
Racial Disparities ◽  
Age Groups ◽  
Case Fatality ◽  
Credible Interval ◽  
The United States ◽  
Mortality Rates ◽  
Bayesian Regression ◽  
Mortality Data ◽  
Incidence And Mortality

Abstract Background As of 1 November 2020, there have been >230 000 deaths and 9 million confirmed and probable cases attributable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United States. However, this overwhelming toll has not been distributed equally, with geographic, race/ethnic, age, and socioeconomic disparities in exposure and mortality defining features of the US coronavirus disease 2019 (COVID-19) epidemic. Methods We used individual-level COVID-19 incidence and mortality data from the state of Michigan to estimate age-specific incidence and mortality rates by race/ethnic group. Data were analyzed using hierarchical Bayesian regression models, and model results were validated using posterior predictive checks. Results In crude and age-standardized analyses we found rates of incidence and mortality more than twice as high than for Whites for all groups except Native Americans. Blacks experienced the greatest burden of confirmed and probable COVID-19 (age-standardized incidence, 1626/100 000 population) and mortality (age-standardized mortality rate, 244/100 000). These rates reflect large disparities, as Blacks experienced age-standardized incidence and mortality rates 5.5 (95% posterior credible interval [CrI], 5.4–5.6) and 6.7 (95% CrI, 6.4–7.1) times higher than Whites, respectively. We found that the bulk of the disparity in mortality between Blacks and Whites is driven by dramatically higher rates of COVID-19 infection across all age groups, particularly among older adults, rather than age-specific variation in case-fatality rates. Conclusions This work suggests that well-documented racial disparities in COVID-19 mortality in hard-hit settings, such as Michigan, are driven primarily by variation in household, community, and workplace exposure rather than case-fatality rates.

scholarly journals Opioid Deaths by Race in the United States, 2000–2015

2017 ◽  
Author(s):  
Monica Alexander ◽  
Magali Barbieri ◽  
Mathew Vinhhoa Kiang
Keyword(s):  
United States ◽  
Black Population ◽  
The United States ◽  
White Population ◽  
Death Rates ◽  
Rate Of Increase ◽  
Black Populations ◽  
Opioid Deaths ◽  
Changes Over Time ◽  
Over Time

The opioid-related mortality rate in the United States more than tripled between 2000 and 2015. However, there were stark differences in the trend for the non-Hispanic black and non-Hispanic white populations. In this paper we assess differences in opioid deaths by race. We analyze patterns and trends in multiple cause-of-death data to gain a better understanding of how deaths differ by race and what has contributed to changes over time. The trend in race-specific opioid death rates over 2000–2015 can be divided into two periods: 2000–2010 and 2010–2015. The increase in 2000–2010 was more substantial for the white population and was driven by prescription painkillers. Since 2010, the rates of opioid-mortality increase for both the white and black populations have been similar and largely due to heroin and fentanyl-type opioids. For the white population, death rates due to heroin and fentanyl-type drugs decrease with age, but for the black population, the opposite is true. In addition, the number of deaths that involve more than one opioid drug has increased over time, with the rate of increase coinciding with the overall rate of increase in opioid deaths.

scholarly journals National Population-Level Disparities in COVID-19 Mortality Across the Intersection of Race/Ethnicity and Sex in the United States

2021 ◽  
Author(s):  
Jay J Xu ◽  
Jarvis T Chen ◽  
Thomas R Belin ◽  
Ronald S Brookmeyer ◽  
Marc A Suchard ◽  
...  
Keyword(s):  
United States ◽  
American Indian ◽  
Ethnic Disparities ◽  
Population Level ◽  
The United States ◽  
Mortality Rates ◽  
Hispanic American ◽  
National Population ◽  
Race Ethnicity ◽  
Racial Ethnic

Males and certain racial/ethnic minority groups have borne a disproportionate burden of COVID-19 mortality in the United States, and substantial scientific research has sought to quantify and characterize population-level disparities in COVID-19 mortality outcomes by sex and across categories of race/ethnicity. However, there has not yet been a national population-level study to quantify disparities in COVID-19 mortality outcomes across the intersection of these demographic dimensions. Here, we analyze a publicly available dataset from the National Center for Health Statistics comprising COVID-19 death counts stratified by race/ethnicity, sex, and age for the year 2020, calculating mortality rates for each race/ethnicity-sex-age stratum and age-adjusted mortality rates for each race/ethnicity-sex stratum, quantifying disparities in terms of mortality rate ratios and rate differences. Our results reveal persistently higher COVID-19 age-adjusted mortality rates for males compared to females within every racial/ethnic group, with notable variation in the magnitudes of the sex disparity by race/ethnicity. However, non-Hispanic Black, Hispanic, and non-Hispanic American Indian or Alaska Native females have higher age-adjusted mortality rates than non-Hispanic White and non-Hispanic Asian/Pacific Islander males. Moreover, persistent racial/ethnic disparities are observed among both males and females, with higher COVID-19 age-adjusted mortality rates observed for non-Hispanic Blacks, Hispanics, and non-Hispanic American Indian or Alaska Natives relative to non-Hispanic Whites.

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