Racial/Ethnic Differences in Non-Discretionary Risk Factors for COVID-19 Among Patients in an Early COVID-19 Hotspot.

BACKGROUND: Baseline disparities in non-discretionary risk factors, i.e., those not readily altered, like family size and work environment, appear to underlie the disproportionate COVID-19 infection rates seen among Hispanic persons and, at surge onsets, Black persons. No study has systematically compared such risk factors by race/ethnicity among infected individuals. METHODS: Using a cross-sectional survey, we compared household, job, and socioeconomic characteristics among 260 Hispanic, non-Hispanic Black, and non-Hispanic White adults with confirmed or probable COVID-19 in New York from March to May 2020. We used logistic regression to identify independent relationships. RESULTS: In bivariate analysis, we found significant differences by race/ethnicity in the following: (1) rates of household crowding (p < 0.001), which were highest for Hispanic patients (45.1%) and lowest for White patients (0.9%); (2) rates of non-healthcare frontline work (p < 0.001), which were highest for Hispanic patients (71.0% of those employed) and lowest for White patients (31.4%); (3) rates of working close to people (p < 0.001), which were highest for Black patients (69.4%) and lowest for Hispanic patients (32.3%); and (4) rates of frontline healthcare work (p = 0.004), which were higher for Black (44.9%) and White (44.3%) patients than Hispanic patients (19.4%). Adjusting for covariates eliminated most differences but not that for household crowding. CONCLUSIONS: Non-discretionary COVID-19 risk factors among patients in the initial surge differed substantially by race/ethnicity. Socioeconomic factors explained most differences, but household crowding was independently associated with Hispanic ethnicity. Our findings highlight the ongoing need for universal safeguards for US frontline workers, including mandated paid sick leave and expanded affordable housing options.

Persistent Disparities in Immunization Rates for the Seven-Vaccine Series Among Infants 19-35 Months in the United States.

Objective: The seven-vaccine series protects infants from several preventable diseases, yet disparities in its use remain in the United States. Methods: We assessed the seven-vaccine immunization rate and its predictors in infants 19-35 months using the National Immunization Survey from 2009 to 2018. Results: The seven-vaccine series rate was 72.8%, well short of the healthy people 2020 target of 90%. African American infants, infants born to mothers with less than high school education, and infants in families with an income below poverty were less likely to get the complete series. Conclusion: Disparities still exist in protecting infants from preventable diseases in the United States.