Data Reveals Disparities in COVID-19 Hospitalization Rates

Black, Hispanic, American Indian, and Alaskan Native patients are more likely to be hospitalized due to COVID-19 than white individuals, showing that there are significant disparities among racial and ethnic groups, a study published in JAMA Internal Medicine revealed.

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The findings reflect the disparities and inequities that have increasingly come to light since the pandemic began, University of Minnesota researchers noted.

“The unique clinical, financial and social impacts of COVID-19 on racial and ethnic populations that are often systematically marginalized in our society must be well understood in order to design and establish effective and equitable infrastructure solutions,” said Pinar Karaca-Mandic, professor and academic director of the Medical Industry Leadership Insitute in the Carlson School, and study’s lead author. 

For the study, the team reviewed nearly 49,000 COVID-19 hospitalizations over a two-month period in 12 US states that report this data for hospital patients. These states included Arizona, Indiana, Kansas, Massachusetts, Minnesota, New Hampshire, Ohio, Oregon, Rhode Island, Utah, Virginia, and Washington.

The results showed that, when compared to the populations of each state, black patients were hospitalized at higher rates than white individuals in all 12 states reporting data. Of all the states, Ohio, Minnesota, and Indiana had the largest disparities.

Hispanic patients were hospitalized at higher rates than those who were white in ten of the 11 states reporting this data, with Virginia, Utah, and Rhode Island having the largest disparities.

The results also showed that American Indian and/or Alaskan Native were hospitalized at higher rates than whites in the eight states reporting data, including Arizona where this population accounted for 15.7 percent of hospitalizations, but only four percent of the state’s population.

The results also showed that disparities found in other population groups are largely reversed among Asian communities. In six of the ten states that reported data for this group, the proportion of hospitalizations was lower relative to their population representation. For example, in Massachusetts, individuals who identify as Asian comprise seven percent of the population but just four percent of COVID-19 hospitalizations.

The study reveals the significant need for states to report race and ethnicity data during the pandemic, researchers stated.

“Our findings highlight the need for increased data reporting and consistency within and across all states,” said Archelle Georgiou, MD, chief health officer at Starkey Hearing Technologies and study co-author. “The fact that only 12 of 50 states report this type of information clearly shows there is more to learn about why non-whites are being hospitalized at such higher rates than whites.”

These words echo the findings from an April 2020 study, which found that COVID-19 disproportionately impacts black populations. Researchers from the Commonwealth Fund noted that improved data collection and reporting could help leaders identify and mitigate these trends.

“These trends — especially the diverging mortality between these groups of counties — should raise alarm bells. To address them, we need more consistent data collection and transparency on the impact of COVID-19 among communities of color,” the Commonwealth Fund team stated at the time.

“Going forward, the United States needs to mandate standardized collection and reporting of COVID data by race and ethnicity to provide a clear national picture of the disproportionate impact of the pandemic on communities of color. Only then will federal and local leaders be able to ensure resources for testing, treatment, and recovery are targeted to communities and people most affected by this pandemic.”

The University of Minnesota team noted that the current study was limited in that it did not adjust for age, sex, comorbidities, and other socioeconomic factors within each race and ethnic group that are likely related to COVID-19 hospitalizations. However, the results do emphasize the need to gather racial and ethnicity data to improve care during the pandemic.

“Given the reported health disparities in coronavirus disease 2019 (COVID-19) infection and mortality by race/ethnicity, there is an immediate need for increased assessment of the prevalence of COVID-19 across racial/ethnic subgroups of the population in the US,” researchers concluded.