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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

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  • Jay J. Xu

    (Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
    Current address: 650 Charles E. Young Drive South, 51-254 CHS, Los Angeles, CA 90095, USA.)

  • Jarvis T. Chen

    (Department of Social and Behavioral Sciences, Harvard T.H. Chan School Of Public Health, Harvard University, Cambridge, MA 02115, USA)

  • Thomas R. Belin

    (Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
    Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA)

  • Ronald S. Brookmeyer

    (Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA)

  • Marc A. Suchard

    (Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
    Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
    Department of Computational Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA)

  • Christina M. Ramirez

    (Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA)

Abstract

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.

Suggested Citation

  • Jay J. Xu & Jarvis T. Chen & Thomas R. Belin & Ronald S. Brookmeyer & Marc A. Suchard & Christina M. Ramirez, 2021. "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," IJERPH, MDPI, vol. 18(6), pages 1-29, March.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:6:p:2921-:d:515946
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    References listed on IDEAS

    as
    1. Amal K. Mitra & Marinelle Payton & Nusrat Kabir & April Whitehead & Kimberly N. Ragland & Alexis Brown, 2020. "Potential Years of Life Lost Due to COVID-19 in the United States, Italy, and Germany: An Old Formula with Newer Ideas," IJERPH, MDPI, vol. 17(12), pages 1-9, June.
    2. Marilyn D. Thomas & Eli K. Michaels & Sean Darling-Hammond & Thu T. Nguyen & M. Maria Glymour & Eric Vittinghoff, 2020. "Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States," IJERPH, MDPI, vol. 17(22), pages 1-19, November.
    3. Arca, M. & Di Orio, F. & Forastiere, F. & Tasco, C. & Perucci, C.A., 1988. "Years of potential life lost (YPLL) before age 65 in Italy," American Journal of Public Health, American Public Health Association, vol. 78(9), pages 1202-1205.
    4. Max, W. & Sung, H.-Y. & Shi, Y., 2012. "Deaths from secondhand smoke exposure in the United States: Economic implications," American Journal of Public Health, American Public Health Association, vol. 102(11), pages 2173-2180.
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