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Black–White Risk Differentials in COVID-19 (SARS-COV2) Transmission, Mortality and Case Fatality in the United States: Translational Epidemiologic Perspective and Challenges

Author

Listed:
  • Laurens Holmes

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Biological Sciences Department, University of Delaware, Newark, DE 19716, USA
    Emergency Department, Thomas Jefferson University, College of population Health, Philadelphia, PA 19107, USA)

  • Michael Enwere

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA
    Public Health Department, Walden University, Minneapolis, MN 55401, USA)

  • Janille Williams

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Benjamin Ogundele

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Prachi Chavan

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Tatiana Piccoli

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Chinacherem Chinaka

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Camillia Comeaux

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Lavisha Pelaez

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Osatohamwen Okundaye

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Leslie Stalnaker

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Fanta Kalle

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Edward Via College of Osteopathic Medicine, Auburn, AL 36832, USA)

  • Keeti Deepika

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Glen Philipcien

    (Emergency Department, Victoria Hospital, Castries, St. Lucia)

  • Maura Poleon

    (School of Nursing, Florida International University, Miami, FL 33139, USA)

  • Gbadebo Ogungbade

    (Global Health Services Initiatives Incorporated, Arlington, TX 76014 USA)

  • Hikma Elmi

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Valescia John

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Fellow of Translational Health Disparities Science (FTHDS), Wilmington, DE 19803, USA)

  • Kirk W. Dabney

    (Nemours Children’s Healthcare System, Wilmington, DE 19803, USA
    Emergency Department, Thomas Jefferson University, College of population Health, Philadelphia, PA 19107, USA)

Abstract

Background: Social and health inequities predispose vulnerable populations to adverse morbidity and mortality outcomes of epidemics and pandemics. While racial disparities in cumulative incidence (CmI) and mortality from the influenza pandemics of 1918 and 2009 implicated Blacks with survival disadvantage relative to Whites in the United States, COVID-19 currently indicates comparable disparities. We aimed to: (a) assess COVID-19 CmI by race, (b) determine the Black–White case fatality (CF) and risk differentials, and (c) apply explanatory model for mortality risk differentials. Methods: COVID-19 data on confirmed cases and deaths by selective states health departments were assessed using a cross-sectional ecologic design. Chi-square was used for CF independence, while binomial regression model for the Black–White risk differentials. Results: The COVID-19 mortality CmI indicated Blacks/AA with 34% of the total mortality in the United States, albeit their 13% population size. The COVID-19 CF was higher among Blacks/AA relative to Whites; Maryland, (2.7% vs. 2.5%), Wisconsin (7.4% vs. 4.8%), Illinois (4.8% vs. 4.2%), Chicago (5.9% vs. 3.2%), Detroit (Michigan), 7.2% and St. John the Baptist Parish (Louisiana), 7.9%. Blacks/AA compared to Whites in Michigan were 15% more likely to die, CmI risk ratio (CmIRR) = 1.15, 95% CI, 1.01–1.32. Blacks/AA relative to Whites in Illinois were 13% more likely to die, CmIRR = 1.13, 95% CI, 0.93–1.39, while Blacks/AA compared to Whites in Wisconsin were 51% more likely to die, CmIRR = 1.51, 95% CI, 1.10–2.10. In Chicago, Blacks/AA were more than twice as likely to die, CmIRR = 2.24, 95% CI, 1.36–3.88. Conclusion: Substantial racial/ethnic disparities are observed in COVID-19 CF and mortality with Blacks/AA disproportionately affected across the United States.

Suggested Citation

  • Laurens Holmes & Michael Enwere & Janille Williams & Benjamin Ogundele & Prachi Chavan & Tatiana Piccoli & Chinacherem Chinaka & Camillia Comeaux & Lavisha Pelaez & Osatohamwen Okundaye & Leslie Staln, 2020. "Black–White Risk Differentials in COVID-19 (SARS-COV2) Transmission, Mortality and Case Fatality in the United States: Translational Epidemiologic Perspective and Challenges," IJERPH, MDPI, vol. 17(12), pages 1-18, June.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:12:p:4322-:d:372586
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    References listed on IDEAS

    as
    1. Laurens Holmes & Emily Shutman & Chinacherem Chinaka & Kerti Deepika & Lavisha Pelaez & Kirk W. Dabney, 2019. "Aberrant Epigenomic Modulation of Glucocorticoid Receptor Gene (NR3C1) in Early Life Stress and Major Depressive Disorder Correlation: Systematic Review and Quantitative Evidence Synthesis," IJERPH, MDPI, vol. 16(21), pages 1-17, November.
    2. Yousey-Hindes, K.M. & Hadler, J.L., 2011. "Neighborhood socioeconomic status and influenza hospitalizations among children: New Haven County, Connecticut, 2003-2010," American Journal of Public Health, American Public Health Association, vol. 101(9), pages 1785-1789.
    3. Helene Økland & Svenn-Erik Mamelund, 2019. "Race and 1918 Influenza Pandemic in the United States: A Review of the Literature," IJERPH, MDPI, vol. 16(14), pages 1-18, July.
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    Cited by:

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    2. Jean C. Bikomeye & Sima Namin & Chima Anyanwu & Caitlin S. Rublee & Jamie Ferschinger & Ken Leinbach & Patricia Lindquist & August Hoppe & Lawrence Hoffman & Justin Hegarty & Dwayne Sperber & Kirsten , 2021. "Resilience and Equity in a Time of Crises: Investing in Public Urban Greenspace Is Now More Essential Than Ever in the US and Beyond," IJERPH, MDPI, vol. 18(16), pages 1-39, August.

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