Study: Spatial and racial disparities in COVID-19 mortality rates

Editor's Note

This study from the University of Chicago finds an association between social determinants of health measures and COVID-19 mortality rates that varied across racial and ethnic groups and community types.

Among 3,142 counties in the study, 531 were identified as concentrated longitudinal-impact counties. Of these, 347 (11%) had the largest share of Blacks or African Americans, 198 (6.3%) had the largest share of Hispanics or Latinos, and 33 (1.1%) had the largest share of non-Hispanic Whites. A total of 489,254 COVID-19-related deaths were reported.

All concentrated longitudinal-impact counties had significantly higher COVID-19 mortality rates than other counties.

The median deaths per 100,000 population were:

• 231.43 in counties with large Black or African American populations, which were spread across urban, suburban, and rural areas and experienced many disadvantages, including higher income inequality and more preventable hospital stays.
• 218.84 in counties with large Hispanic or Latino populations, which were located in urban areas and had a high percentage of people who lacked health insurance.
• 251.79 in counties with large non-Hispanic White populations, which were located in rural areas and included a large group of older adults and limited access to quality healthcare.

In addition, higher mortality rates in:

• Urban areas were associated with immigrant communities with traditional family structures, multiple accessibility stressors, and housing overcrowding.
• Rural areas were associated with preventable hospital stays.
• Suburban areas were associated with higher socioeconomic status vulnerability.

Across all community types, places with limited internet access had higher mortality rates, especially in urban areas.

Future research that addresses health inequity and guides policies and programs should explore the different dimensions and regional patterns of social determinants of health, the researchers say.