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National Institute of Environmental Health Sciences

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Your Environment. Your Health.

Publication Detail

Title: COVID-19 mortality in California based on death certificates: disproportionate impacts across racial/ethnic groups and nativity.

Authors: Garcia, Erika; Eckel, Sandrah P; Chen, Zhanghua; Li, Kenan; Gilliland, Frank D

Published In Ann Epidemiol, (2021 Jun)

Abstract: PURPOSE: To examine characteristics of coronavirus disease 2019 (COVID-19) decedents in California (CA) and evaluate for disproportionate mortality across race/ethnicity and ethnicity/nativity. METHODS: COVID-19 deaths were identified from death certificates. Age-adjusted mortality rate ratios (MRR) were compared across race/ethnicity. Proportionate mortality rates (PMR) were compared across race/ethnicity and by ethnicity/nativity. RESULTS: We identified 10,200 COVID-19 deaths in CA occurring February 1 through July 31, 2020. The most frequently observed characteristics among decedents were age 65 years or above, male, Hispanic, foreign-born, and educational attainment of High School or below. MRR indicated elevated COVID-19 morality rates among Asian/Pacific Islander, Black, and Hispanic groups compared with the White group, with Black and Hispanic groups having the highest MRR at 2.75 (95%CI: 2.54-2.97) and 4.18 (95%CI: 3.99-4.37), respectively. Disparities were larger at younger ages. Similar results were observed with PMR, and patterns of age-racial/ethnic disparities remained in analyses stratified by education. Elevated PMR were observed in all ethnicity/nativity groups, especially foreign-born Hispanic individuals, relative to U.S.-born non-Hispanic individuals. These were generally larger at younger ages and persisted after stratifying by education. CONCLUSIONS: Differential COVID-19 mortality was observed in California across racial/ethnic groups and by ethnicity/nativity groups with evidence of greater disparities among younger age groups. Identifying COVID-19 disparities is an initial step toward mitigating disease impacts in vulnerable communities.

PubMed ID: 33746033 Exiting the NIEHS site

MeSH Terms: Aged; COVID-19*; California/epidemiology; Death Certificates; Ethnicity*; Hispanic or Latino; Humans; Male; Racial Groups; SARS-CoV-2; United States

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