: Black and Hispanic people aren’t ‘inherently more susceptible’ to worse COVID-19 outcomes, a new study says

Black and Hispanic people have borne a disproportionate brunt of illness and mortality from the pandemic compared to their white counterparts, data have shown. But a recent study suggests that existing social determinants, and not an inherent susceptibility, are driving those disparities.

While Black and Hispanic patients in a study of 9,722 patients tested at NYU Langone Health system were more likely than their white counterparts to test positive for the virus, Black patients hospitalized with COVID-19 were less likely than white hospitalized patients to experience severe illness or die after adjusting for variables like comorbidity and neighborhood characteristics, according to a recent article published in the journal JAMA Network Open.

Moreover, Black and Hispanic patients who tested positive for the coronavirus weren’t any likelier than white patients to end up in the hospital, they found.

“Our findings support the notion that Black and Hispanic populations are not inherently more susceptible to having poor COVID-19 outcomes than other groups and, more importantly, that if they make it to the hospital they fare as well as or better than their White counterparts,” the authors wrote.

“ ‘Black and Hispanic individuals are experiencing an excess burden of SARS-CoV-2 infection not entirely explained by underlying medical conditions or where they live or receive care.’ ”

— PLOS Medicine study

“This supports the assertion that existing structural determinants — including inequality in housing, access to [health] care, differential employment opportunities and poverty — that remain pervasive in Black and Hispanic communities should be addressed in order to improve outcomes in COVID-19-related mortality.”

Multiple other recent studies highlighted by the New York Times have drawn similar conclusions, including one published in September in the journal PLOS Medicine that found “Black and Hispanic individuals are experiencing an excess burden of SARS-CoV-2 infection not entirely explained by underlying medical conditions or where they live or receive care.” (SARS-CoV-2 is the virus that causes the disease COVID-19.)

In the study of 5.8 million people who received care in the Veterans Affairs department, most of whom were men, Black and Hispanic people were twice as likely as white people to test positive for the virus even after adjusting for factors such as underlying conditions and rural or urban residence.

Meanwhile, the researchers observed no difference in 30-day mortality along racial or ethnic lines among people who tested positive for COVID-19. They noted that their findings might underestimate U.S. population risk, because VA health disparities “tend to be smaller than in the private sector.”

“Among other factors, future research should consider the role of other social determinants of health, including employment type, number of individuals in household, nursing home residence, and incarceration,” the authors wrote. 

Centers for Disease Control and Prevention data show that Black Americans are 3.7 times as likely as white Americans to be hospitalized with COVID-19 and 2.8 times as likely to die. Hispanic people are 4.1 times as likely to be hospitalized and 2.8 times as likely to die; Native American people are 4 times as likely to be hospitalized and 2.6 times as likely to die; and Asian Americans are 1.2 times as likely to be hospitalized and 1.1 times as likely to die, the agency says.

The CDC has also acknowledged that social inequalities could be putting many people of color at greater risk for poor COVID-19 outcomes.

The agency names systemic discrimination; disparities in health-care coverage and access; disproportionate representation in “essential work settings” that often carry greater likelihood of COVID-19 exposure; crowded housing conditions; and disparities in education, income and wealth as factors that could drive some racial and ethnic minority groups’ heightened risk.

“ ‘We find that the Black-white wealth gap persisted heading into the COVID-19 pandemic, leaving Black households with far fewer resources to weather the storm.’ ”

— Brookings Institution analysis

In fact, the existing Black-white wealth gap has left Black Americans more vulnerable in the pandemic-induced economic downturn, argued a new analysis published Tuesday by the center-left Brookings Institution’s Hamilton Project.

Wealth “provides a critical safety net to households during economic downturns,” the authors wrote. They noted that Black and white households saw their median wealth decline at almost equal rates during the Great Recession — but while white households started to recover their lost wealth in the ensuing years, Black household median wealth kept declining.

“The Great Recession exacerbated the Black-white wealth gap and left Black households more vulnerable to the current COVID-19 recession,” the authors wrote. “We find that the Black-white wealth gap persisted heading into the COVID-19 pandemic, leaving Black households with far fewer resources to weather the storm.”

The Brookings analysis provided “clear evidence of the relatively meager resources that women — Black women, in particular — have to withstand the economic shocks of the COVID-19 recession,” they added. Black women have experienced substantial job losses during the pandemic.

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December 10, 2020 at 11:56PM

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