scholarly journals The Magnitude of Black/Hispanic Disparity in COVID-19 Mortality Across United States Counties During the First Waves of the COVID-19 Pandemic

2021 ◽  
Vol 66 ◽  
Author(s):  
Cindy Im ◽  
Lalani L. Munasinghe ◽  
José M. Martínez ◽  
William Letsou ◽  
Farideh Bagherzadeh-Khiabani ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Diversity ◽  
The United States ◽  
County Level ◽  
Urbanization Level ◽  
The Us ◽  
Disparity Gradient ◽  
Rate Ratios ◽  
Racial Ethnic ◽  
Death Count

Objectives: To quantify the Black/Hispanic disparity in COVID-19 mortality in the United States (US).Methods: COVID-19 deaths in all US counties nationwide were analyzed to estimate COVID-19 mortality rate ratios by county-level proportions of Black/Hispanic residents, using mixed-effects Poisson regression. Excess COVID-19 mortality counts, relative to predicted under a counterfactual scenario of no racial/ethnic disparity gradient, were estimated.Results: County-level COVID-19 mortality rates increased monotonically with county-level proportions of Black and Hispanic residents, up to 5.4-fold (≥43% Black) and 11.6-fold (≥55% Hispanic) higher compared to counties with <5% Black and <15% Hispanic residents, respectively, controlling for county-level poverty, age, and urbanization level. Had this disparity gradient not existed, the US COVID-19 death count would have been 92.1% lower (177,672 fewer deaths), making the rate comparable to other high-income countries with substantially lower COVID-19 death counts.Conclusion: During the first 8 months of the SARS-CoV-2 pandemic, the US experienced the highest number of COVID-19 deaths. This COVID-19 mortality burden is strongly associated with county-level racial/ethnic diversity, explaining most US COVID-19 deaths.

scholarly journals Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

2021 ◽  
Vol 18 (6) ◽  
pp. 2921
Author(s):  
Jay J. Xu ◽  
Jarvis T. Chen ◽  
Thomas R. Belin ◽  
Ronald S. Brookmeyer ◽  
Marc A. Suchard ◽  
...  
Keyword(s):  
United States ◽  
District Of Columbia ◽  
Ethnic Disparities ◽  
The United States ◽  
Attributable Mortality ◽  
Race Ethnicity ◽  
Using Data ◽  
Rate Ratios ◽  
Degree Of Association ◽  
Racial Ethnic

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

Political Climate, Voter Suppression Policies and Federal Sentencing Outcomes

2020 ◽  
Vol 60 (5) ◽  
pp. 1155-1180
Author(s):  
Jeffrey S Nowacki ◽  
Danielle Creech ◽  
Megan Parks
Keyword(s):  
United States ◽  
Ethnic Diversity ◽  
The United States ◽  
Sentence Length ◽  
District Courts ◽  
Racial Threat ◽  
Political Climate ◽  
The Us ◽  
Voter Suppression ◽  
And Gender

Abstract Many states in the United States have recently implemented voter suppression policies, which make voting more difficult, particularly for members of marginalized populations (e.g. non-white and female voters). In this article, we examine how these policies and other measures of political climate influence criminal sentencing in US district courts. Using 2015 data from the US Sentencing Commission, alongside other district-level measures, we find both direct and conditioning relationships between political climate and extra-legal variables. Specifically, we find that, while voter suppression policies do not directly affect sentence length, racial threat effects are enhanced in districts governed by such policies. Conversely, districts without such policies see larger mitigating effects at high levels of ethnic diversity and gender equality.

scholarly journals Changing Spatiotemporal Trends in County‐Level Heart Failure Death Rates in the United States, 1999 to 2018

2021 ◽  
Vol 10 (4) ◽  
Author(s):  
Adam S. Vaughan ◽  
Mary G. George ◽  
Sandra L. Jackson ◽  
Linda Schieb ◽  
Michele Casper
Keyword(s):  
United States ◽  
Heart Failure ◽  
Ethnic Group ◽  
The United States ◽  
Local Context ◽  
County Level ◽  
Age Group ◽  
Death Rates ◽  
Spatiotemporal Trends ◽  
Racial Ethnic

Background Amid recently rising heart failure (HF) death rates in the United States, we describe county‐level trends in HF mortality from 1999 to 2018 by racial/ethnic group and sex for ages 35 to 64 years and 65 years and older. Methods and Results Applying a hierarchical Bayesian model to National Vital Statistics data representing all US deaths, ages 35 years and older, we estimated annual age‐standardized county‐level HF death rates and percent change by age group, racial/ethnic group, and sex from 1999 through 2018. During 1999 to 2011, ~30% of counties experienced increasing HF death rates among adults ages 35 to 64 years. However, during 2011 to 2018, 86.9% (95% CI, 85.2–88.2) of counties experienced increasing mortality. Likewise, for ages 65 years and older, during 1999 to 2005 and 2005 to 2011, 27.8% (95% CI, 25.8–29.8) and 12.6% (95% CI, 11.2–13.9) of counties, respectively, experienced increasing mortality. However, during 2011 to 2018, most counties (67.4% [95% CI, 65.4–69.5]) experienced increasing mortality. These temporal patterns by age group held across racial/ethnic group and sex. Conclusions These results provide local context to previously documented recent national increases in HF death rates. Although county‐level declines were most common before 2011, some counties and demographic groups experienced increasing HF death rates during this period of national declines. However, recent county‐level increases were pervasive, occurring across counties, racial/ethnic group, and sex, particularly among ages 35 to 64 years. These spatiotemporal patterns highlight the need to identify and address underlying clinical risk factors and social determinants of health contributing to these increasing trends.

scholarly journals Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

2021 ◽  
Author(s):  
Jay J. Xu ◽  
Jarvis T. Chen ◽  
Thomas R. Belin ◽  
Ronald S. Brookmeyer ◽  
Marc A. Suchard ◽  
...  
Keyword(s):  
United States ◽  
District Of Columbia ◽  
Ethnic Disparities ◽  
The United States ◽  
Attributable Mortality ◽  
Estimation Uncertainty ◽  
Race Ethnicity ◽  
Using Data ◽  
Rate Ratios ◽  
Racial Ethnic

AbstractThe coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios – anchoring comparisons to non-Hispanic Whites – in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of December 30, 2020. Using a novel Monte Carlo simulation procedure to quantify estimation uncertainty, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, observed disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

Perceiving demographic diversity as a threat: Divergent effects of multiculturalism and polyculturalism

2019 ◽  
Vol 23 (7) ◽  
pp. 1014-1031
Author(s):  
Hannah J. Osborn ◽  
Nicholas Sosa ◽  
Kimberly Rios
Keyword(s):  
Ethnic Diversity ◽  
The United States ◽  
White Americans ◽  
Demographic Diversity ◽  
Donald Trump ◽  
Political Views ◽  
The Us ◽  
Political Conservatism ◽  
Racial Ethnic ◽  
Political Figure

The growing racial/ethnic diversity in the United States can be perceived as threatening to White Americans. The present work examines how interethnic ideologies—different ways of framing ethnic diversity—moderate perceptions of threat and political conservatism among White Americans exposed to a passage about the US becoming a “majority-minority” nation. Across 3 studies, we found divergent effects of multiculturalism and polyculturalism within the context of growing diversity. Priming multiculturalism increased perceived threats to the ingroup’s power and status, which in turn led to greater endorsement of conservative political views (Studies 1 and 3) and warmer feelings toward a conservative political figure (i.e., Donald Trump; Studies 2 and 3); however, these relationships were attenuated and sometimes reversed among participants primed with polyculturalism. We discuss implications for how interethnic ideologies influence White Americans’ threatened responses to increasing diversity.

scholarly journals Trends in Mortality Due to Cancer in the United States by Age and County-Level Income, 1999–2015

2019 ◽  
Vol 111 (8) ◽  
pp. 863-866 ◽  
Author(s):  
Diana R Withrow ◽  
Amy Berrington de González ◽  
Susan Spillane ◽  
Neal D Freedman ◽  
Ana F Best ◽  
...  
Keyword(s):  
United States ◽  
Cancer Mortality ◽  
Death Certificate ◽  
The United States ◽  
Mortality Rates ◽  
Income Quintile ◽  
County Level ◽  
Younger Adults ◽  
Rate Ratios ◽  
Over Time

Abstract Disparities in cancer mortality by county-level income have increased. It is unclear whether these widening disparities have affected older and younger adults equally. National death certificate data were utilized to ascertain cancer deaths during 1999–2015. Average annual percent changes in mortality rates and mortality rate ratios (RRs) were estimated by county-level income quintile and age (25–64 vs ≥65 years). Among 25- to 64-year-olds, cancer mortality rates were 30% higher (RR = 1.30, 95% confidence interval [CI] = 1.29 to 1.31) in the lowest-vs the highest-income counties in 1999–2001 and 56% higher (RR = 1.56, 95% CI = 1.55 to 1.57) in 2013–2015; the disparities among those 65 years and older were smaller but also widened over time (RR1999–2001 = 1.04, 95% CI = 1.03 to 1.05; RR2013–2015 = 1.14, 95% CI = 1.13 to 1.14). Widening disparities occurred across cancer sites. If all counties had the mortality rates of the highest-income counties, 21.5% of cancer deaths among 25- to 64-year-olds and 7.3% of cancer deaths in those 65 years and older would have been avoided in 2015. These results highlight an ongoing need for equity-focused interventions, particularly among younger adults.

scholarly journals Understanding Implementation Challenges to Genetic Testing for Familial Hypercholesterolemia in the United States

2019 ◽  
Vol 9 (1) ◽  
pp. 9 ◽  
Author(s):  
Rachele Hendricks-Sturrup ◽  
Christine Lu
Keyword(s):  
United States ◽  
Genetic Testing ◽  
Familial Hypercholesterolemia ◽  
Ethnic Diversity ◽  
Heart Association ◽  
The United States ◽  
Cvd Risk ◽  
Implementation Challenges ◽  
The Us ◽  
Control And Prevention

Cardiovascular disease (CVD) is the leading cause of death in the United States (US), with familial hypercholesterolemia (FH) being a major inherited and genetic risk factor for premature CVD and atherosclerosis. Genetic testing has helped patients and providers confirm the presence of known pathogenic and likely pathogenic variations in FH-associated genes. Key organizations, such as the Centers for Disease Control and Prevention (CDC), American Heart Association (AHA), FH Foundation, and National Lipid Association (NLA), have recognized the clinical utility of FH genetic testing. However, FH genetic testing is underutilized in clinical practice in the US for reasons that are underexplored through the lens of implementation science. In this commentary, we discuss seven key implementation challenges that must be overcome to strengthen the clinical adoption of FH genetic testing in the US. These implementation challenges center on evidence of cost-effectiveness, navigating patient and provider preferences and concerns, gender and ethnic diversity and representation in genetic testing, and establishing clinical consensus around FH genetic testing based on the latest and most relevant research findings. Overcoming these implementation challenges is imperative to the mission of reducing CVD risk in the US.

scholarly journals Characterizing the spatiotemporal heterogeneity of the COVID-19 vaccination landscape

2021 ◽  
Author(s):  
Andrew Tiu ◽  
Zachary Susswein ◽  
Alexes Merritt ◽  
Shweta Bansal
Keyword(s):  
United States ◽  
Vaccination Coverage ◽  
Vaccination Campaign ◽  
The United States ◽  
County Level ◽  
Spatial Clusters ◽  
Southern Us ◽  
The Us ◽  
Target Locations ◽  
County Scale

AbstractIt is critical that we maximize vaccination coverage across the United States so that SARS-CoV-2 transmission can be suppressed, and we can sustain the recent reopening of the nation. Maximizing vaccination requires that we track vaccination patterns to measure the progress of the vaccination campaign and target locations that may be undervaccinated. To improve efforts to track and characterize COVID-19 vaccination progress in the United States, we integrate CDC and state-provided vaccination data, identifying and rectifying discrepancies between these data sources. We find that COVID-19 vaccination coverage in the US exhibits significant spatial heterogeneity at the county level and statistically identify spatial clusters of undervaccination, all with foci in the southern US. Vaccination progress at the county level is also variable; many counties stalled in vaccination into June 2021 and few recovered by July, with transmission of the Delta variant rapidly rising. Using a comparison with a mechanistic growth model fitted to our integrated data, we classify vaccination dynamics across time at the county scale. Our findings underline the importance of curating accurate, fine-scale vaccination data and the continued need for widespread vaccination in the US, especially in the wake of the highly transmissible Delta variant.

scholarly journals Investigating associations between COVID-19 mortality and population-level health and socioeconomic indicators in the United States: A modeling study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (7) ◽  
pp. e1003693
Author(s):  
Sasikiran Kandula ◽  
Jeffrey Shaman
Keyword(s):  
United States ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Nursing Homes ◽  
Spatial Autocorrelation ◽  
Population Level ◽  
The United States ◽  
County Level ◽  
Socioeconomic Indicators ◽  
The Us

Background With the availability of multiple Coronavirus Disease 2019 (COVID-19) vaccines and the predicted shortages in supply for the near future, it is necessary to allocate vaccines in a manner that minimizes severe outcomes, particularly deaths. To date, vaccination strategies in the United States have focused on individual characteristics such as age and occupation. Here, we assess the utility of population-level health and socioeconomic indicators as additional criteria for geographical allocation of vaccines. Methods and findings County-level estimates of 14 indicators associated with COVID-19 mortality were extracted from public data sources. Effect estimates of the individual indicators were calculated with univariate models. Presence of spatial autocorrelation was established using Moran’s I statistic. Spatial simultaneous autoregressive (SAR) models that account for spatial autocorrelation in response and predictors were used to assess (i) the proportion of variance in county-level COVID-19 mortality that can explained by identified health/socioeconomic indicators (R2); and (ii) effect estimates of each predictor. Adjusting for case rates, the selected indicators individually explain 24%–29% of the variability in mortality. Prevalence of chronic kidney disease and proportion of population residing in nursing homes have the highest R2. Mortality is estimated to increase by 43 per thousand residents (95% CI: 37–49; p < 0.001) with a 1% increase in the prevalence of chronic kidney disease and by 39 deaths per thousand (95% CI: 34–44; p < 0.001) with 1% increase in population living in nursing homes. SAR models using multiple health/socioeconomic indicators explain 43% of the variability in COVID-19 mortality in US counties, adjusting for case rates. R2 was found to be not sensitive to the choice of SAR model form. Study limitations include the use of mortality rates that are not age standardized, a spatial adjacency matrix that does not capture human flows among counties, and insufficient accounting for interaction among predictors. Conclusions Significant spatial autocorrelation exists in COVID-19 mortality in the US, and population health/socioeconomic indicators account for a considerable variability in county-level mortality. In the context of vaccine rollout in the US and globally, national and subnational estimates of burden of disease could inform optimal geographical allocation of vaccines.

Sign in / Sign up

Export Citation Format

Share Document