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COVID-19 and All-Cause Mortality by Race, Ethnicity, and Age Across Five Periods of the Pandemic in the United States

Author

Listed:
  • Anneliese N. Luck

    (University of Pennsylvania)

  • Irma T. Elo

    (University of Pennsylvania)

  • Samuel H. Preston

    (University of Pennsylvania)

  • Eugenio Paglino

    (University of Pennsylvania)

  • Katherine Hempstead

    (Robert Wood Johnson Foundation)

  • Andrew C. Stokes

    (Boston University School of Public Health)

Abstract

Racial/ethnic and age disparities in COVID-19 and all-cause mortality during 2020 are well documented, but less is known about their evolution over time. We examine changes in age-specific mortality across five pandemic periods in the United States from March 2020 to December 2022 among four racial/ethnic groups (non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Asian) for ages 35+. We fit Gompertz models to all-cause and COVID-19 death rates by 5-year age groups and construct age-specific racial/ethnic mortality ratios across an Initial peak (Mar–Aug 2020), Winter peak (Nov 2020–Feb 2021), Delta peak (Aug–Oct 2021), Omicron peak (Nov 2021–Feb 2022), and Endemic period (Mar–Dec 2022). We then compare to all-cause patterns observed in 2019. The steep age gradients in COVID-19 mortality in the Initial and Winter peak shifted during the Delta peak, with substantial increases in mortality at working ages, before gradually returning to an older age pattern in the subsequent periods. We find a disproportionate COVID-19 mortality burden on racial and ethnic minority populations early in the pandemic, which led to an increase in all-cause mortality disparities and a temporary elimination of the Hispanic mortality advantage at certain age groups. Mortality disparities narrowed over time, with racial/ethnic all-cause inequalities during the Endemic period generally returning to pre-pandemic levels. Black and Hispanic populations, however, faced a younger age gradient in all-cause mortality in the Endemic period relative to 2019, with younger Hispanic and Black adults in a slightly disadvantageous position and older Black adults in a slightly advantageous position, relative to before the pandemic.

Suggested Citation

  • Anneliese N. Luck & Irma T. Elo & Samuel H. Preston & Eugenio Paglino & Katherine Hempstead & Andrew C. Stokes, 2023. "COVID-19 and All-Cause Mortality by Race, Ethnicity, and Age Across Five Periods of the Pandemic in the United States," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(4), pages 1-29, August.
    • Handle: RePEc:kap:poprpr:v:42:y:2023:i:4:d:10.1007_s11113-023-09817-8
    DOI: 10.1007/s11113-023-09817-8
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    1. Janet Currie & Hannes Schwandt, 2016. "Mortality Inequality: The Good News from a County-Level Approach," Journal of Economic Perspectives, American Economic Association, vol. 30(2), pages 29-52, Spring.
    2. Jonas Schöley & José Manuel Aburto & Ilya Kashnitsky & Maxi S. Kniffka & Luyin Zhang & Hannaliis Jaadla & Jennifer B. Dowd & Ridhi Kashyap, 2022. "Life expectancy changes since COVID-19," Nature Human Behaviour, Nature, vol. 6(12), pages 1649-1659, December.
    3. Neil K. Mehta & Irma T. Elo & Michal Engelman & Diane S. Lauderdale & Bert M. Kestenbaum, 2016. "Life Expectancy Among U.S.-born and Foreign-born Older Adults in the United States: Estimates From Linked Social Security and Medicare Data," Demography, Springer;Population Association of America (PAA), vol. 53(4), pages 1109-1134, August.
    4. Marc A Garcia & Patricia A Homan & Catherine García & Tyson H Brown & Deborah S Carr, 2021. "The Color of COVID-19: Structural Racism and the Disproportionate Impact of the Pandemic on Older Black and Latinx Adults [Racial disparities in mortality in the adult Hispanic population]," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 76(3), pages 75-80.
    5. Michelle S. Wong & Taona P. Haderlein & Anita H. Yuan & Ernest Moy & Kenneth T. Jones & Donna L. Washington, 2021. "Time Trends in Racial/Ethnic Differences in COVID-19 Infection and Mortality," IJERPH, MDPI, vol. 18(9), pages 1-14, May.
    6. Crimmins, E.M. & Kim, J.K. & Alley, D.E. & Karlamangla, A. & Seeman, T., 2007. "Hispanic paradox in biological risk profiles," American Journal of Public Health, American Public Health Association, vol. 97(7), pages 1305-1310.
    7. Cantor, Jonathan & Sood, Neeraj & Bravata, Dena M. & Pera, Megan & Whaley, Christopher, 2022. "The impact of the COVID-19 pandemic and policy response on health care utilization: Evidence from county-level medical claims and cellphone data," Journal of Health Economics, Elsevier, vol. 82(C).
    8. Isaac Sasson, 2021. "Age and COVID-19 mortality: A comparison of Gompertz doubling time across countries and causes of death," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 44(16), pages 379-396.
    9. Fenelon, Andrew, 2013. "Revisiting the Hispanic mortality advantage in the United States: The role of smoking," Social Science & Medicine, Elsevier, vol. 82(C), pages 1-9.
    10. Noreen Goldman & Anne R Pebley & Keunbok Lee & Theresa Andrasfay & Boriana Pratt, 2021. "Racial and ethnic differentials in COVID-19-related job exposures by occupational standing in the US," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-17, September.
    11. Hélène E. Aschmann & Alicia R. Riley & Ruijia Chen & Yea-Hung Chen & Kirsten Bibbins-Domingo & Andrew C. Stokes & M. Maria Glymour & Mathew V. Kiang, 2022. "Dynamics of racial disparities in all-cause mortality during the COVID-19 pandemic," Decision Analysis, INFORMS, vol. 119(40), pages 2210941119-, October.
    12. Ruiz, J.M. & Steffen, P. & Smith, T.B., 2013. "Hispanic mortality paradox: A systematic review and meta-analysis of the longitudinal literature," American Journal of Public Health, American Public Health Association, vol. 103(3), pages 52-60.
    13. Noreen Goldman & Theresa Andrasfay, 2022. "Life expectancy loss among Native Americans during the COVID-19 pandemic," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 47(9), pages 233-246.
    14. Marcella Alsan & Amitabh Chandra & Kosali Simon, 2021. "The Great Unequalizer: Initial Health Effects of COVID-19 in the United States," Journal of Economic Perspectives, American Economic Association, vol. 35(3), pages 25-46, Summer.
    15. Samuel Preston & Irma Elo & Ira Rosenwaike & Mark Hill, 1996. "African-american mortality at older ages: Results of a matching study," Demography, Springer;Population Association of America (PAA), vol. 33(2), pages 193-209, May.
    16. Diane Lauderdale & Bert Kestenbaum, 2002. "Mortality rates of elderly Asian American populations based on medicare and social security data," Demography, Springer;Population Association of America (PAA), vol. 39(3), pages 529-540, August.
    17. Christopher J L Murray & Sandeep C Kulkarni & Catherine Michaud & Niels Tomijima & Maria T Bulzacchelli & Terrell J Iandiorio & Majid Ezzati, 2006. "Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States," PLOS Medicine, Public Library of Science, vol. 3(9), pages 1-12, September.
    18. Mark R Cullen & Clint Cummins & Victor R Fuchs, 2012. "Geographic and Racial Variation in Premature Mortality in the U.S.: Analyzing the Disparities," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-13, April.
    19. Shiro Horiuchi & John Wilmoth, 1998. "Deceleration in the age pattern of mortality at olderages," Demography, Springer;Population Association of America (PAA), vol. 35(4), pages 391-412, November.
    20. Mara Sheftel & Frank W. Heiland, 2018. "Disability crossover: Is there a Hispanic immigrant health advantage that reverses from working to old age?," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 39(7), pages 209-250.
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