Racial, Economic and Health Inequality and COVID-19 Infection in the United States

Racial, Economic and Health Inequality and COVID-19 Infection in the United States

Publication date: Apr 30, 2020

Abstract Background: There is preliminary evidence of racial and social-economic disparities in the population infected by and dying from COVID-19. The goal of this study is to report the associations of COVID-19 with respect to race, health and economic inequality in the United States. Methods: We performed a cross-sectional study of the associations between infection and mortality rate of COVID-19 and demographic, socioeconomic and mobility variables from 369 counties (total population: 102,178,117 [median: 73,447, IQR: 30,761-256,098]) from the seven most affected states (Michigan, New York, New Jersey, Pennsylvania, California, Louisiana, Massachusetts). Findings: The risk factors for infection and mortality are different. Our analysis shows that counties with more diverse demographics, higher population, education, income levels, and lower disability rates were at a higher risk of COVID-19 infection. However, counties with higher disability and poverty rates had a higher death rate. African Americans were more vulnerable to COVID-19 than other ethnic groups (1,981 African American infected cases versus 658 Whites per million). Data on mobility changes corroborate the impact of social distancing. Interpretation: The observed inequality might be due to the workforce of essential services, poverty, and access to care. Counties in more urban areas are probably better equipped at providing care. The lower rate of infection, but a higher death rate in counties with higher poverty and disability could be due to lower levels of mobility, but a higher rate of comorbidities and health care access. Keywords: Healthcare Disparities, Health Status Disparities, Socioeconomic Factors, COVID-19, Economic Inequality, Racial Disparity, United States, Population-Based Analysis.

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Concepts Keywords
African American Immunosuppression
African Americans Cross sectional infection
Blacksburg COVID related infection
Body Mass Rate infection
California COVID infection
Cardiovascular Diseases Ethnic racial
CDC Part pre processing
Comorbidities Articles
Coronavirus Health
Correlation Public health
Correlation Coefficients Health economics
Correlation Matrix Aid
County Poverty
Cross Social inequality
Danville Health equity
Death Rate Neuroscience
Demographic
Disability
East Coast
Economic Inequality
Google
H1N1
Higher Education
Hochberg Procedure
Hypertension
IBM SPSS Statistics
Immunosuppression
Imperative
Independent Variable
Independent Variables
Infection
Influenza
Insurance
IQR
Linear Regression
Louisiana
Manuscript
Massachusetts
Michigan
Mortality
Mortality Rate
Multiple Testing
Neurology
Northeast Region
Nursing
Outliers
Pandemic
Pearson Correlation
Pennsylvania
Poverty
Quartile
Quartiles
Regression Test
Scranton
Shima
Smoking
Socioeconomic
South Louisiana
Standard Deviation
Summary Statistics
United States
Venkatesh
Virginia Tech
West Coast
Zand

Semantics

Type Source Name
disease MESH Infection
disease MESH risk factors
disease MESH death
drug DRUGBANK Tropicamide
drug DRUGBANK Methylphenidate
disease MESH Stroke
drug DRUGBANK Coenzyme M
disease MESH hypertension
disease MESH cardiovascular diseases
disease MESH influenza

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