4.3 Article

Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

Publisher

MDPI
DOI: 10.3390/ijerph18062921

Keywords

communities of color; coronavirus; COVID-19; medical mistrust; Monte Carlo simulation; public health; racial and ethnic disparities; SARS-CoV-2; social determinants of health; years of potential life lost

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The study found significant racial/ethnic disparities in COVID-19 attributable YPLL across states in the United States, with non-Hispanic Blacks and Hispanics experiencing disproportionately high YPLL and non-Hispanic Whites experiencing disproportionately low YPLL. The disparities were more pronounced when measuring YPLL compared to death counts, especially in younger age groups. Additionally, there was substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting a connection to social determinants of health that vary by state.
The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios-anchoring comparisons to non-Hispanic Whites-in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

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