Racial and Ethnic Disparities in Excess Deaths During the COVID-19 Pandemic, March to December 2020
Racial and Ethnic Disparities in Excess Deaths During the COVID-19 Pandemic, March to December 2020
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DOI：
10.7326/m21-2134
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发表时间：
2021-10-05
影响因子：
39.2
通讯作者：
de Gonzalez, Amy Berrington
中科院分区：
文献类型：
--
作者：
Shiels, Meredith S.;Haque, Anika T.;de Gonzalez, Amy Berrington
背景资料：尽管美国COVID-19死亡率的种族/族裔差异令人震惊，但仅关注COVID-19死亡人数可能低估了大流行对差异的真正影响。超额死亡估计包括COVID-19直接和间接造成的死亡。目的：按种族/民族估计美国的超额死亡。设计：监测研究。地点：美国。参与者：所有死者。测量：2020年3月至12月的超额死亡和每10万人超额死亡是按种族/民族、性别、年龄组和死因估计的，使用美国疾病控制与预防中心（CDC）和美国人口普查局人口估计的临时死亡证明数据。结果：2020年3月至12月期间估计有288万人死亡。与基于2019年数据的预期死亡人数相比，在此期间发生了47.72万例超额死亡，其中74%归因于COVID-19。在美国印第安人/阿拉斯加原住民（AI/AN）和拉丁美洲人男性和女性中，每10万人的标准化超额死亡率是白色和亚洲男性和女性的两倍多。非COVID-19的超额死亡也不成比例地影响了黑人，AI/AN和拉丁美洲人。与白色男性和女性相比，非COVID-19每10万人的超额死亡率在黑人AI/AN和拉丁裔男性和女性中高出2至4倍，包括糖尿病、心脏病、脑血管疾病和阿尔茨海默病导致的死亡。2020年的超额死亡导致2019年至2020年全因死亡率的种族差异大幅扩大。局限性：CDC临时数据的完整性和可用性;没有对结果的精确度进行估计。2020年美国在COVID-19大流行期间的超额死亡人数存在严重的种族/民族差异，导致2019年至2020年期间全因死亡率的种族/民族差异迅速增加。
Background: Although racial/ethnic disparities in U.S. COVID-19 death rates are striking, focusing on COVID-19 deaths alone may underestimate the true effect of the pandemic on disparities. Excess death estimates capture deaths both directly and indirectly caused by COVID-19.Objective: To estimate U.S. excess deaths by racial/ethnic group.Design: Surveillance study.Setting: United States.Participants: All decedents.Measurements: Excess deaths and excess deaths per 100 000 persons from March to December 2020 were estimated by race/ethnicity, sex, age group, and cause of death, using provisional death certificate data from the Centers for Disease Control and Prevention (CDC) and U.S. Census Bureau population estimates.Results: An estimated 2.88 million deaths occurred between March and December 2020. Compared with the number of expected deaths based on 2019 data, 477200 excess deaths occurred during this period, with 74% attributed to COVID-19. Age-standardized excess deaths per 100 000 persons among Black American Indian/Alaska Native (AI/AN), and Latino males and females were more than double those in White and Asian males and females. Non-COVID-19 excess deaths also disproportionately affected Black, AI/AN, and Latino persons. Compared with White males and females, non-COVID-19 excess deaths per 100 000 persons were 2 to 4 times higher in Black AI/AN, and Latino males and females, including deaths due to diabetes, heart disease, cerebrovascular disease, and Alzheimer disease. Excess deaths in 2020 resulted in substantial widening of raciaV ethnic disparities in all-cause mortality from 2019 to 2020.Limitations: Completeness and availability of provisional CDC data; no estimates of precision around results.Conclusion: There were profound racial/ethnic disparities in excess deaths in the United States in 2020 during the COVID-19 pandemic, resulting in rapid increases in racial/ethnic disparities in all-cause mortality between 2019 and 2020.