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COVID-19 and Overall Mortality Inequities in the Surge in Death Rates by Zip Code Characteristics: Massachusetts, January 1 to May 19, 2020.
Krieger, Nancy; Waterman, Pamela D; Chen, Jarvis T.
  • Krieger N; The authors are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA.
  • Waterman PD; The authors are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA.
  • Chen JT; The authors are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA.
Am J Public Health ; 110(12): 1850-1852, 2020 12.
Article in English | MEDLINE | ID: covidwho-1067488
ABSTRACT
Objectives. To address evidence gaps in COVID-19 mortality inequities resulting from inadequate race/ethnicity data and no socioeconomic data.Methods. We analyzed age-standardized death rates in Massachusetts by weekly time intervals, comparing rates for January 1 to May 19, 2020, with the corresponding historical average for 2015 to 2019 stratified by zip code social metrics.Results. At the surge peak (week 16, April 15-21), mortality rate ratios (comparing 2020 vs 2015-2019) were 2.2 (95% confidence interval [CI] = 1.4, 3.5) and 2.7 (95% CI = 1.4, 5.5) for the lowest and highest zip code tabulation area (ZCTA) poverty categories, respectively, with the 2020 peak mortality rate 1.1 (95% CI = 1.0, 1.3) times higher in the highest than the lowest poverty ZCTA. Similarly, rate ratios were significantly elevated for the highest versus lowest quintiles with respect to household crowding (1.7; 95% CI = 1.0, 2.9), racialized economic segregation (3.1; 95% CI = 1.8, 5.3), and percentage population of color (1.8; 95% CI = 1.6, 2.0).Conclusions. The COVID-19 mortality surge exhibited large inequities.Public Health Implications. Using zip code social metrics can guide equity-oriented COVID-19 prevention and mitigation efforts.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Poverty / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male Country/Region as subject: North America Language: English Journal: Am J Public Health Year: 2020 Document Type: Article Affiliation country: Ajph.2020.305913

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Poverty / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male Country/Region as subject: North America Language: English Journal: Am J Public Health Year: 2020 Document Type: Article Affiliation country: Ajph.2020.305913