Racial Disparities in Coronavirus Disease 2019 (COVID-19) Mortality Are Driven by Unequal Infection Risks.
Racial Disparities in Coronavirus Disease 2019 (COVID-19) Mortality Are Driven by Unequal Infection Risks.
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DOI：
10.1093/cid/ciaa1723
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发表时间：
2021-03-01
期刊：
影响因子：
--
通讯作者：
Delamater P
中科院分区：
文献类型：
--
作者：
Zelner J;Trangucci R;Naraharisetti R;Cao A;Malosh R;Broen K;Masters N;Delamater P
截至2020年11月1日，美国已有超过23万人死亡，900万例确诊和可能病例归因于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。 然而，这一压倒性的死亡人数并不是平均分布的，美国2019冠状病毒病（COVID-19）疫情的暴露和死亡率存在地理、种族/民族、年龄和社会经济差异。我们使用密歇根州的个人水平COVID-19发病率和死亡率数据，按种族/族裔群体估计年龄特异性发病率和死亡率。使用分层贝叶斯回归模型分析数据，并使用后验预测检查验证模型结果。在粗略的和年龄标准化的分析中，我们发现除了美洲原住民之外，所有群体的发病率和死亡率都比白人高出一倍以上。黑人经历了确诊和可能的COVID-19（年龄标准化发病率，1626/100 000人口）和死亡率（年龄标准化死亡率，244/100 000）的最大负担。这些比率反映了巨大的差异，因为黑人的年龄标准化发病率和死亡率分别比白人高5.5（95%后验可信区间[CrI]，5.4-5.6）和6.7（95% CrI，6.4-7.1）倍。我们发现，黑人和白人之间死亡率的大部分差异是由所有年龄组（特别是老年人）的COVID-19感染率显著升高所驱动的，而不是病例死亡率的年龄特异性差异。这项工作表明，在密歇根州等重灾区，COVID-19死亡率的种族差异主要是由家庭、社区和工作场所暴露的差异而不是病死率造成的。来自美国密歇根州的数据显示，观察到的COVID-19死亡率的种族/族裔差异，大部分可以通过种族/族裔群体之间年龄特定暴露率的差异与群体之间病死率的差异来解释。
As of 1 November 2020, there have been >230 000 deaths and 9 million confirmed and probable cases attributable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United States. However, this overwhelming toll has not been distributed equally, with geographic, race/ethnic, age, and socioeconomic disparities in exposure and mortality defining features of the US coronavirus disease 2019 (COVID-19) epidemic. We used individual-level COVID-19 incidence and mortality data from the state of Michigan to estimate age-specific incidence and mortality rates by race/ethnic group. Data were analyzed using hierarchical Bayesian regression models, and model results were validated using posterior predictive checks. In crude and age-standardized analyses we found rates of incidence and mortality more than twice as high than for Whites for all groups except Native Americans. Blacks experienced the greatest burden of confirmed and probable COVID-19 (age-standardized incidence, 1626/100 000 population) and mortality (age-standardized mortality rate, 244/100 000). These rates reflect large disparities, as Blacks experienced age-standardized incidence and mortality rates 5.5 (95% posterior credible interval [CrI], 5.4–5.6) and 6.7 (95% CrI, 6.4–7.1) times higher than Whites, respectively. We found that the bulk of the disparity in mortality between Blacks and Whites is driven by dramatically higher rates of COVID-19 infection across all age groups, particularly among older adults, rather than age-specific variation in case-fatality rates. This work suggests that well-documented racial disparities in COVID-19 mortality in hard-hit settings, such as Michigan, are driven primarily by variation in household, community, and workplace exposure rather than case-fatality rates. Data from the US state of Michigan show that much of the observed race/ethnic disparities in COVID-19 mortality be explained by differential rates of age-specific exposure across race/ethnic groups as compared with variation in case-fatality rates across groups.
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影响因子：
5.6
作者：
Keyes, Katherine;Galea, Sandro
通讯作者：
Galea, Sandro
影响因子：
4.4
作者：
Mahajan, Uma, V;Larkins-Pettigrew, Margaret
通讯作者：
Larkins-Pettigrew, Margaret
DOI：
10.1016/j.ijid.2020.09.1464
发表时间：
2020-12
期刊：
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
影响因子：
--
作者：
Meyerowitz-Katz G;Merone L
通讯作者：
Merone L
影响因子：
39
作者：
Weinberger, Daniel M.;Chen, Jenny;Viboud, Cecile
通讯作者：
Viboud, Cecile
影响因子：
12.7
作者：
Kajeepeta, Sandhya;Rutherford, Caroline G.;Prins, Seth J.
通讯作者：
Prins, Seth J.