COVID-19 excess mortality by race

How did COVID-19 affect mortality rates and how did that vary by racial and ethnic groups? Using January 2011 – April 2020 data from the Census Bureau’s version of the Social Security Administration’s Numerical Identification (Numident) database, a paper by Polyakova et al. (2021) find significantly higher all-cause excess mortality rates for minority groups, particularly African-Americans.

Although the study does not measure COVID-19 mortality specifically, clearly COVID-19 is driving these results.

Three items catch my eye. The first thing to note is that COVID-19 lead to excess mortality across all racial and ethnic groups. COVID-19 leaves no group untouched. The second item to note is that the excess mortality disproportionately falls on minorities, particularly African-Americans. The third item of note is that while the disparities in unadjusted excess mortality are large, adjusting for age, sex and state exacerbate these inequalities. For instance, the CDC says that COVID-19 mortality rate ratio are 1.9 times as high for Blacks compared to Whites; using a different data and outcomes measures, this study found that the excess mortality ratio is 4.4 times as high.

Differences by race/ethnicity were more pronounced when adjusted for demographic differences, highlighting important differences in age and geographic distributions by race/ethnicity. Crude excess mortality overestimates the mortality effect for White people, who are on average older, and underestimates it for other races and Hispanic origin, who are on average younger.

The study also examines variation in excess mortality by race across states.

Michigan, for instance, had much higher adjusted Black excess mortality (18.3 excess deaths per 10,000) than Louisiana (9.8 per 10,000), even though the two states had comparable adjusted White excess mortality (2.8 and 2.7 per 10,000,respectively). Likewise, Pennsylvania had much higher adjusted Black excess mortality (10.6 excess deaths per 10,000) than Rhode Island (3.4 per 10,000), even though the two states had comparable adjusted White excess mortality (1.8 and 1.7 per 10,000, respectively)

While this study is a bit dated (data end in April 2020), it does provide robust evidence from large sample that COVID-19 is disproportionately affecting minorities. The solution: let’s ramp up vaccinations!

Source:

• Polyakova M, Udalova V, Kocks G, Genadek K, Finlay K, Finkelstein AN. Racial Disparities In Excess All-Cause Mortality During The Early COVID-19 Pandemic Varied Substantially Across States: Study examines the geographic variation in excess all-cause mortality by race to better understand the impact of the COVID-19 pandemic. Health Affairs. 2021 Feb 1;40(2):307-16.