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Race, ethnicity, community-level socioeconomic factors, and risk of COVID-19 in the United States and the United Kingdom.
Lo, Chun-Han; Nguyen, Long H; Drew, David A; Warner, Erica T; Joshi, Amit D; Graham, Mark S; Anyane-Yeboa, Adjoa; Shebl, Fatma M; Astley, Christina M; Figueiredo, Jane C; Guo, Chuan-Guo; Ma, Wenjie; Mehta, Raaj S; Kwon, Sohee; Song, Mingyang; Davies, Richard; Capdevila, Joan; Sudre, Carole H; Wolf, Jonathan; Cozier, Yvette C; Rosenberg, Lynn; Wilkens, Lynne R; Haiman, Christopher A; Marchand, Loïc Le; Palmer, Julie R; Spector, Tim D; Ourselin, Sebastien; Steves, Claire J; Chan, Andrew T.
  • Lo CH; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
  • Nguyen LH; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Drew DA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Warner ET; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
  • Joshi AD; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Graham MS; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Anyane-Yeboa A; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
  • Shebl FM; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Astley CM; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
  • Figueiredo JC; Harvard/MGH Center on Genomics, Vulnerable Populations, And Health Disparities, Massachusetts General Hospital, Boston, MA, USA.
  • Guo CG; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
  • Ma W; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Mehta RS; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
  • Kwon S; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Song M; Medical Practice Evaluation Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Davies R; Computational Epidemiology Lab and Division of Endocrinology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
  • Capdevila J; Broad Institute of Harvard and MIT, Cambridge, MA, USA.
  • Sudre CH; Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles California, USA.
  • Wolf J; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
  • Cozier YC; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Rosenberg L; Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
  • Wilkens LR; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
  • Haiman CA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Marchand LL; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
  • Palmer JR; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Spector TD; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Ourselin S; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
  • Steves CJ; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Chan AT; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
EClinicalMedicine ; 38: 101029, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1313065
ABSTRACT

BACKGROUND:

There is limited prior investigation of the combined influence of personal and community-level socioeconomic factors on racial/ethnic disparities in individual risk of coronavirus disease 2019 (COVID-19).

METHODS:

We performed a cross-sectional analysis nested within a prospective cohort of 2,102,364 participants from March 29, 2020 in the United States (US) and March 24, 2020 in the United Kingdom (UK) through December 02, 2020 via the COVID Symptom Study smartphone application. We examined the contribution of community-level deprivation using the Neighborhood Deprivation Index (NDI) and the Index of Multiple Deprivation (IMD) to observe racial/ethnic disparities in COVID-19 incidence. ClinicalTrials.gov registration NCT04331509.

FINDINGS:

Compared with non-Hispanic White participants, the risk for a positive COVID-19 test was increased in the US for non-Hispanic Black (multivariable-adjusted odds ratio [OR], 1.32; 95% confidence interval [CI], 1.18-1.47) and Hispanic participants (OR, 1.42; 95% CI, 1.33-1.52) and in the UK for Black (OR, 1.17; 95% CI, 1.02-1.34), South Asian (OR, 1.39; 95% CI, 1.30-1.49), and Middle Eastern participants (OR, 1.38; 95% CI, 1.18-1.61). This elevated risk was associated with living in more deprived communities according to the NDI/IMD. After accounting for downstream mediators of COVID-19 risk, community-level deprivation still mediated 16.6% and 7.7% of the excess risk in Black compared to White participants in the US and the UK, respectively.

INTERPRETATION:

Our results illustrate the critical role of social determinants of health in the disproportionate COVID-19 risk experienced by racial and ethnic minorities.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: EClinicalMedicine Year: 2021 Document Type: Article Affiliation country: J.eclinm.2021.101029

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: EClinicalMedicine Year: 2021 Document Type: Article Affiliation country: J.eclinm.2021.101029