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The Great Unequalizer: Initial Health Effects of COVID-19 in the United States

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  • Marcella Alsan
  • Amitabh Chandra
  • Kosali I. Simon

Abstract

We measure inequities from the COVID-19 pandemic on mortality and hospitalizations in the United States during the early months of the outbreak. We discuss challenges in measuring health outcomes and health inequality, some of which are specific to COVID-19 and others that complicate attribution during most large health shocks. As in past epidemics, pre-existing biological and social vulnerabilities profoundly influenced the distribution of disease. In addition to the elderly, Hispanic, Black and Native American communities were disproportionately affected by the virus, particularly when assessed using the years of potential life lost metric. For example, Hispanic and Black Americans in 2020 saw 39.5 and 25 percent increases in excess mortality relative to trend, compared to a less than 15 percent increase for Whites; we find losses in potential years of life three to four times larger among Hispanic and Black compared to White Americans. Individual-level data from a commercially insured population show that otherwise similar Black and Hispanic enrollees were hospitalized due to COVID-19 at a higher rate than White enrollees. We provide a conceptual framework and initial empirical analysis which seek to shed light on contributors to pandemic-related health inequality, and suggest areas for future research.

Suggested Citation

  • Marcella Alsan & Amitabh Chandra & Kosali I. Simon, 2021. "The Great Unequalizer: Initial Health Effects of COVID-19 in the United States," NBER Working Papers 28958, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:28958
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    Cited by:

    1. Anne Case & Angus Deaton, 2021. "Mortality Rates by College Degree Before and During COVID-19," NBER Working Papers 29328, National Bureau of Economic Research, Inc.

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    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J1 - Labor and Demographic Economics - - Demographic Economics
    • J78 - Labor and Demographic Economics - - Labor Discrimination - - - Public Policy (including comparable worth)
    • N0 - Economic History - - General

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