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Not quite a month ago, in NYC: Age Adjusted Fatal Lab Confirmed COVID-19 Cases By Race/Ethnicity Group, we looked at the stark disparity in fatal outcomes among severe COVID-19 patients from minority populations (see chart above) in New York City.
Two weeks ago, the CDC published:
COVID-19 in Racial and Ethnic Minority Groups
The effects of COVID-19 on the health of racial and ethnic minority groups is still emerging; however, current data suggest a disproportionate burden of illness and death among racial and ethnic minority groups.
A recent CDC MMWR report included race and ethnicity data from 580 patients hospitalized with lab-confirmed COVID-19 found that 45% of individuals for whom race or ethnicity data was available were white, compared to 55% of individuals in the surrounding community.
However, 33% of hospitalized patients were black compared to 18% in the community and 8% were Hispanic, compared to 14% in the community.
These data suggest an overrepresentation of blacks among hospitalized patients. Among COVID-19 deaths for which race and ethnicity data were available, New York Citypdf iidentified death rates among Black/African American persons (92.3 deaths per 100,000 population) and Hispanic/Latino persons (74.3) that were substantially higher than that of white (45.2) or Asian (34.5) persons.
Studies are underway to confirm these data and understand and potentially reduce the impact of COVID-19 on the health of racial and ethnic minorities.
(Continue . . . )
This week, the New York City Health Department has published an update in their Dear Colleague: COVID-19 Updates (PDF, May 5).
Race, Ethnicity, and COVID-19-related Deaths in New York City
Preliminary NYC data show that the rate of deaths among people with laboratory-confirmed COVID-19 has been higher among Black/African American and Hispanic/Latino New Yorkers compared with White and Asian New Yorkers.
As of April 27, 2020, a total of 17,682 COVID-19- related deaths had been reported in NYC, including 12,287 deaths among persons with a positive laboratory test for COVID-19 and 5,395 probable deaths. Race/ethnicity information was available for 82% of decedents. The age-adjusted COVID-19 death rate per 100,000 population was 209.4 for Blacks/African Americans, 195.3 for Hispanics/Latinos, 107.7 for Whites, and 90.8 for Asians (Figure 1).
Deaths are reported to the NYC Health Department through the NYC Office of the Chief Medical Examiner and the NYC Health Department’s Bureau of Vital Statistics, which is responsible for the registration, analysis, and reporting of all deaths in the city. The mortality rates presented here include deaths that occurred among people who tested positive for SARS-CoV-2 and those whose death certificate listed as a cause of death “COVID-19” or an equivalent (i.e., “probable death”).
Limitations notwithstanding, the preliminary data highlight disparities in the impact that COVID-19 is having on these communities that must be addressed.
Disparities in COVID-19-related deaths may reflect, in part, an increased risk for exposure among New Yorkers who do not have the option to work from home or shelter at home during a period of furlough or unemployment. Black/African American and Hispanic/Latino people dominate employment in many sectors of the NYC service economy, which may increase their risk of being exposed to SARS-CoV-2 while earning a living as an essential worker. Black/African Americans and Hispanics/Latinos are disproportionately affected by chronic health conditions, such as hypertension, diabetes, or obesity, which may also contribute to a higher risk for COVID-19- related death.
Figure 1. Age-adjusted rates of confirmed and probable COVID-19 deaths in New York City, by race and ethnicity, as of April 27, 2020.
Note: A death is classified as confirmed if the decedent was a NYC resident who had a positive SARS-CoV-2 laboratory test. A death is classified as probable if the decedent was a NYC resident who had no known positive laboratory test for SARS- CoV-2 but the death certificate lists as a cause of death “COVID-19” or an equivalent. Hispanic/Latino includes people of any race. People of other races are not shown Data from the New York City Health Department
Additionally, decreased access to timely and appropriate health care could play a role.
Black/African American and Hispanic/Latino people in the United States (U.S.) are less likely to have health insurance, which can help facilitate access to care, than other groups. Barriers to care are likely to be exacerbated by the current economic downturn leading to increased unemployment rates in the service economy, since many people are likely to lose employer-based health insurance.
The NYC Health Department is committed to providing COVID-19-related data according to race/ethnicity and neighborhood whenever possible, so that inequities in the impact of COVID-19 can be identified and their root causes investigated and addressed. Racism is a fundamental cause of these inequities. To advance efforts that address health inequities in NYC, including structural racism, the NYC Health Department is critically reviewing policies and practices, both current and past, that perpetuate conditions that may lead to higher rates of COVID-19. We are supporting tailored messaging for communities that have been disproportionately impacted by COVID-19 and are developing strategies to direct other resources toward those communities.
NYC health care providers can partner in these efforts by ensuring continued outreach to people in communities that have been disproportionately affected by the COVID-19 pandemic. Consider contacting patients with underlying medical conditions or other risk factors for severe COVID-19 and encouraging them to continue taking prescribed medicines, maintain a 90-day supply of5 essential medications, and promptly seek care if they have warning signs or if their condition worsens.
Communication can be via telemedicine or in person if necessary. Providers can also reinforce that there are some symptoms for which medical care should always be sought immediately. These include trouble breathing, chest pain, acute change in mental status, cyanosis, and signs suggestive of a stroke.
Patients with possible COVID-19 who do not have a regular health care provider or who lack access to medical services can call 844-NYC-4NYC (844-692-4692) or 311 to receive medical advice and assistance, regardless of their immigration status or ability to pay.
For more information on the NYC Health Department’s work to address health inequities, visit the Center for Health Equity and Community Wellness webpage:
www1.nyc.gov/site/doh/health/neighborhood-health/center-for-health-equity.page.
The NYC Health Department has launched Race to Justice, an internal reform effort to help staff learn what they can do to address racial health gaps and improve health outcomes for all New Yorkers. For more information, visit: https://www1.nyc.gov/site/doh/health/health-topics/race-to-justice.page.
