ABSTRACT

Objectives

The objective of this study was to investigate potential county-level disparities among racial/ethnic and socioeconomic groups in confirmed COVID-19 cases and deaths in the United States in 100,000 population.

Design

Secondary data analysis using county-level data for 3,142 US counties was conducted in 2020. Hierarchical linear regression and concentration curve analyses were performed. The combined association of COVID-19 cases and deaths was examined separately by the county population's socioeconomic characteristics. Data from the American Community Survey (ACS) 5-year estimates (2014–2018), Area Health Resources File (AHRF) 2018–2019, Kaiser Health News 2020, and 2020 COVID-19 data from Johns Hopkins University were used in this study.

Results

After adjusting for covariates, U.S. counties with a higher proportion of the Black population and a higher proportion of adults with less than a high school diploma had disproportionately higher COVID-19 cases and deaths (β > 0, p<0.05 for all relations). A higher proportion of the Hispanic population was associated with higher confirmed cases (β = 0.68, 95% CI = 0.48–0.87). The majority observed disparities in COVID-19 deaths persisted even after controlling for all-cause deaths in 2019 and COVID-19 cases per 100,000 county population. This can potentially aggravate the existing health disparities among these population groups.

Conclusions

Identification of disproportionately impacted population groups can pave the way towards narrowing the disparity gaps and guide policymakers and stakeholders in designing and implementing population group-specific interventions to mitigate the negative consequences of the COVID-19 pandemic.

中文翻译：

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美国确诊的COVID-19病例和死亡中的种族，族裔和社会经济差异：截至2020年11月的县级分析

摘要

目标

这项研究的目的是调查在美国确诊的COVID-19病例和100,000例死亡中，种族/民族和社会经济群体之间潜在的县级差距。

设计

2020年，使用县级数据对3,142个美国县进行了二次数据分析。进行了线性回归和浓度曲线分析。通过县人口的社会经济特征分别检查了COVID-19病例与死亡的组合关联。本研究使用了美国社区调查（ACS）的5年估算值（2014-2018），2018-2019的地区卫生资源档案（AHRF），2020年的Kaiser Health News 2020和2020年约翰霍普金斯大学的COVID-19数据。

结果

在对协变量进行校正后，黑人人口比例较高的美国县和中学文凭以下的成年人比例较高的美国县的COVID-19病例和死亡比例异常高（β> 0，所有关系的p <0.05）。西班牙裔人口比例较高与确诊病例相关（β= 0.68，95％CI = 0.48–0.87）。即使在控制了2019年的全因死亡和每100,000个县人口的COVID-19病例之后，大多数观察到的COVID-19死亡差异仍然存在。这可能会加剧这些人群之间现有的健康差距。

结论

查明受影响严重的人口群体可为缩小差距差距铺平道路，并指导政策制定者和利益相关者设计和实施针对特定人群的干预措施，以减轻COVID-19大流行的负面影响。