COVID-19 Impact Highlights Racial and Health Disparities

According to a study by the National Cancer Institute (NCI) and the National Institute of Health (NIH), COVID-19 has disproportionately impacted Black, American Indian/Alaska Native, and Latinx populations in the United States, highlighting racial and health disparities.

“Focusing on COVID-19 deaths alone without examining total excess deaths — that is, deaths due to non-COVID-19 causes as well as to COVID-19 — may underestimate the true impact of the pandemic,” senior investigator in the Infections and Immunoepidemiology Branch in NCI’s Division of Cancer Epidemiology and Genetics Meredith S. Shiels, PhD, MHS, said in a press release. “These data highlight the profound impact of long-standing inequities.”

Scientists at NCI have plenty of experience tracking mortality trends in the US, mainly focusing on cancer death rates. However, recently the investigators have focused on analyzing national surveillance data to better understand the impact of COVID-19 on excess deaths in racial and ethnic groups.

In the study, scientists from NCI, NIH’s National Institute on Minority Health and Health Disparities (NIMHD), and the Pacific Institute for Research and Evaluation used provisional death certificate data from the Centers for Disease Control and Prevention (CDC), as well as population estimates from the US Census Bureau, to compare excess deaths by race/ethnicity, sex, age group, and cause of death.

The data was taken from records from March to December 2019 and March to December 2020. Excess deaths are the number of deaths in a specific period of time over the expected number of occurrences based on deaths in the same month from the previous years.

Shiels noted that investigators could not present the number of excess deaths as a rate because the study did not include a full year of death. Rather, they calculated the number of excess deaths in each racial/ethnic group according to its population size.

According to the data, about 2.9 million people died in the US between March 1, 2020, and December 31, 2020. Compared with the same period in 2019, there were 477,200 excess deaths, with COVID-19 responsible for 74 percent of them.

The scientists found that, after adjusting for age, the number of excess deaths by population size among Black, American Indian/Alaska Native, and Latinx groups were more than double those in White and Asian populations, highlighting health disparities.

“Looking more closely at the excess deaths where COVID-19 was not listed as the cause, the scientists found that excess deaths by population were three to four times higher among Black and American Indian/Alaska Native men and women compared with white men and women. And Latino men and women had nearly two times the number of excess non-COVID-19 deaths by population, compared with white men and women,” the press release stated.

Excess deaths during the pandemic have resulted in growing health disparities in overall US mortality. In 2019, total mortality by population among Black men was 26 percent higher than in white men, but in 2020 it was 45 percent higher. Additionally, total mortality by population among Black women in 2019 was 15 percent higher than in white women, but in 2020 it was 32 percent higher.

“Our efforts at NIH to help mitigate these COVID disparities have been heavily focused on promoting testing and vaccine uptake through community-engaged research. However, vaccine hesitancy poses a real threat, so we are addressing the misinformation and distrust through collaborative partnerships with trusted community stakeholders,” said study coauthor Eliseo J. Pérez-Stable, MD, director of NIMHD.