Assessing racial and ethnic disparities using a COVID-19 outcomes continuum for New York State
Assessing racial and ethnic disparities using a COVID-19 outcomes continuum for New York State
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DOI：
10.1016/j.annepidem.2020.06.010
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发表时间：
2020-08-01
影响因子：
5.6
通讯作者：
Rosenberg, Eli S.
中科院分区：
文献类型：
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作者：
Holtgrave, David R.;Barranco, Meredith A.;Rosenberg, Eli S.
目的：黑人、非西班牙裔和西班牙裔社区(相对于非西班牙裔白人)新冠肺炎死亡率升高已成定局。这项研究旨在根据SARS-CoV-2感染、诊断和疾病严重程度的差异来估计死亡差异的相对贡献。方法：我们构建了纽约州非西班牙裔白人、黑人非西班牙裔和西班牙裔成年人的新冠肺炎结局连续体(类似于艾滋病毒护理连续体)。对于新冠肺炎结果连续序列中的每个阶段(人口、感染经历、诊断、住院、病死率)，我们综合了最新的公开数据。我们使用总体百分比、死亡率和不同阶段之间的相对变化来描述每个连续体，并使用风险比来比较种族和民族。结果：非西班牙裔白人、非西班牙裔黑人和西班牙裔成年人的人均新冠肺炎死亡率估计分别为0.03%、0.18%和0.12%。西班牙裔社区与白人社区的差距是3.48倍，这是由感染经验的差异解释的，而非西班牙裔黑人社区相对于白人社区的差距5.38倍主要是由感染经验和因感染而住院需求的差异造成的。结论：这些发现建议了干预项目和政策以建立新冠肺炎健康公平的最有影响力的阶段。(C)2020 Elsevier Inc.保留所有权利。
Purpose: Heightened COVID-19 mortality among Black non-Hispanic and Hispanic communities (relative to white non-Hispanic) is well established. This study aims to estimate the relative contributions to fatality disparities in terms of differences in SARS-CoV-2 infections, diagnoses, and disease severity.Methods: We constructed COVID-19 outcome continua (similar to the HIV care continuum) for white non-Hispanic, Black non-Hispanic, and Hispanic adults in New York State. For each stage in the COVID-19 outcome continua (population, infection experience, diagnosis, hospitalization, fatality), we synthesized the most recent publicly available data. We described each continuum using overall percentages, fatality rates, and relative changes between stages, with comparisons between race and ethnicity using risk ratios.Results: Estimated per-population COVID-19 fatality rates were 0.03%, 0.18%, and 0.12% for white non-Hispanic, Black non-Hispanic, and Hispanic adults, respectively. The 3.48-fold disparity for Hispanic, relative to white, communities was explained by differences in infection experience, whereas the 5.38-fold disparity for non-Hispanic Black, relative to white, communities was primarily driven by differences in both infection experience and in the need for hospitalization, given infection.Conclusions: These findings suggest the most impactful stages on which to intervene with programs and policies to build COVID-19 health equity. (C) 2020 Elsevier Inc. All rights reserved.