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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:

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    2. Amy Finkelstein & Geoffrey Kocks & Maria Polyakova & Victoria Udalova, 2022. "Heterogeneity in Damages from A Pandemic," NBER Working Papers 30658, National Bureau of Economic Research, Inc.
    3. Johannes S. Kunz & Carol Propper, 2022. "Is Hospital Quality Predictive of Pandemic Deaths? Evidence from US Counties," Papers 2022-01, Centre for Health Economics, Monash University.
    4. Susan Athey & Kristen Grabarz & Michael Luca & Nils Wernerfelt, 2022. "The Effectiveness of Digital Interventions on COVID-19 Attitudes and Beliefs," Papers 2206.10214, arXiv.org.
    5. Angus Deaton & Anne Case, 2022. "The Great Divide: Education, Despair, and Death," Annual Review of Economics, Annual Reviews, vol. 14(1), pages 1-21, August.
    6. John Brownstein & Jonathan H. Cantor & Benjamin Rader & Kosali I. Simon & Christopher M. Whaley, 2022. "If You Build it, Will They Vaccinate? The Impact of COVID-19 Vaccine Sites on Vaccination Rates and Outcomes," NBER Working Papers 30429, National Bureau of Economic Research, Inc.
    7. Kairon Shayne D. Garcia & Benjamin W. Cowan, 2022. "The Impact of U.S. School Closures on Labor Market Outcomes during the COVID-19 Pandemic," NBER Working Papers 29641, National Bureau of Economic Research, Inc.
    8. 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.
    9. Engy Ziedan & Kosali I. Simon & Coady Wing, 2022. "Mortality Effects of Healthcare Supply Shocks: Evidence Using Linked Deaths and Electronic Health Records," NBER Working Papers 30553, 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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