Understanding Drivers of Coronavirus Disease 2019 (COVID-19) Racial Disparities: A Population-Level Analysis of COVID-19 Testing Among Black and White Populations.
Understanding Drivers of Coronavirus Disease 2019 (COVID-19) Racial Disparities: A Population-Level Analysis of COVID-19 Testing Among Black and White Populations.
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DOI：
10.1093/cid/ciaa1848
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发表时间：
2021-11-02
期刊：
影响因子：
--
通讯作者：
Geng EH
中科院分区：
文献类型：
--
作者：
Mody A;Pfeifauf K;Bradley C;Fox B;Hlatshwayo MG;Ross W;Sanders-Thompson V;Joynt Maddox K;Reidhead M;Schootman M;Powderly WG;Geng EH
2019 年冠状病毒病 (COVID-19) 检测（此次大流行最关键但最有限的资源）的差异可能是造成 COVID-19 不平等的一个重要但可改变的驱动因素。我们分析了密苏里州卫生和高级服务部在圣路易斯和堪萨斯城地区进行的所有 COVID-19 测试的数据。我们采用了一种行之有效的衡量不平等的工具——洛伦兹曲线——来比较黑人和白人群体中每个诊断病例的 COVID-19 检测率。 2020 年 3 月 14 日至 9 月 15 日期间，圣路易斯和堪萨斯城地区分别进行了 606 725 次和 328 204 次 COVID-19 检测。随着时间的推移，黑人的每例检测率始终是白人的一半左右。在早期（2020年3月14日至2020年6月15日），检测率最低四分位的邮政编码仅占圣路易斯和堪萨斯城地区所有检测的12.1%和8.8%，尽管它们占每个地区所有病例的25%。这些邮政编码地区的黑人居民比例较高，没有保险，收入中位数较低。这些差异有所缩小，但在大流行的后期阶段（2020年6月16日至2020年9月15日）仍然存在。最后，即使在相同的邮政编码内，黑人居民的每例检测率也低于白人居民。在密苏里州的 2 个地区，黑人群体中每例确诊病例的 COVID-19 检测率始终低于白人群体。公共卫生战略应积极关注解决 COVID-19 检测中的公平性差距，以提高整体应对措施的公平性。每个确诊病例的 COVID-19 检测中的种族差异是一致的：(1) 随着时间的推移，(2) 邮政编码之间的差异（即，黑人居民比例较高的邮政编码中的比率较低），以及 (3) 同一邮政编码的黑人和白人居民之间的差异。
Disparities in coronavirus disease 2019 (COVID-19) testing—the pandemic’s most critical but limited resource—may be an important but modifiable driver of COVID-19 inequities. We analyzed data from the Missouri State Department of Health and Senior Services on all COVID-19 tests conducted in the St Louis and Kansas City regions. We adapted a well-established tool for measuring inequity—the Lorenz curve—to compare COVID-19 testing rates per diagnosed case among Black and White populations. Between 14/3/2020 and 15/9/2020, 606 725 and 328 204 COVID-19 tests were conducted in the St Louis and Kansas City regions, respectively. Over time, Black individuals consistently had approximately half the rate of testing per case than White individuals. In the early period (14/3/2020 to 15/6/2020), zip codes in the lowest quartile of testing rates accounted for only 12.1% and 8.8% of all tests in the St Louis and Kansas City regions, respectively, even though they accounted for 25% of all cases in each region. These zip codes had higher proportions of residents who were Black, without insurance, and with lower median incomes. These disparities were reduced but still persisted during later phases of the pandemic (16/6/2020 to 15/9/2020). Last, even within the same zip code, Black residents had lower rates of tests per case than White residents. Black populations had consistently lower COVID-19 testing rates per diagnosed case than White populations in 2 Missouri regions. Public health strategies should proactively focus on addressing equity gaps in COVID-19 testing to improve equity of the overall response. Racial disparities in COVID-19 testing per diagnosed case were consistent (1) over time, (2) between zip codes (ie, lower rates in zip codes with higher proportions of Black residents), and (3) between Black and White residents of the same zip code.
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