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The synchronicity of COVID-19 disparities: Statewide epidemiologic trends in SARS-CoV-2 morbidity, hospitalization, and mortality among racial minorities and in rural America.
Dixon, Brian E; Grannis, Shaun J; Lembcke, Lauren R; Valvi, Nimish; Roberts, Anna R; Embi, Peter J.
  • Dixon BE; Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Bloomington, Indiana, United States of America.
  • Grannis SJ; Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, United States of America.
  • Lembcke LR; Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, United States of America.
  • Valvi N; Department of Family Medicine, School of Medicine, Indiana University, Indianapolis, Indiana, United States of America.
  • Roberts AR; Research Data Services, Regenstrief Institute, Indianapolis, Indiana, United States of America.
  • Embi PJ; Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, United States of America.
PLoS One ; 16(7): e0255063, 2021.
Article in English | MEDLINE | ID: covidwho-1323016
ABSTRACT

BACKGROUND:

Early studies on COVID-19 identified unequal patterns in hospitalization and mortality in urban environments for racial and ethnic minorities. These studies were primarily single center observational studies conducted within the first few weeks or months of the pandemic. We sought to examine trends in COVID-19 morbidity, hospitalization, and mortality over time for minority and rural populations, especially during the U.S. fall surge.

METHODS:

Data were extracted from a statewide cohort of all adult residents in Indiana tested for SARS-CoV-2 infection between March 1 and December 31, 2020, linked to electronic health records. Primary measures were per capita rates of infection, hospitalization, and death. Age adjusted rates were calculated for multiple time periods corresponding to public health mitigation efforts. Comparisons across time within groups were compared using ANOVA.

RESULTS:

Morbidity and mortality increased over time with notable differences among sub-populations. Initially, hospitalization rates among racial minorities were 3-4 times higher than whites, and mortality rates among urban residents were twice those of rural residents. By fall 2020, hospitalization and mortality rates in rural areas surpassed those of urban areas, and gaps between black/brown and white populations narrowed. Changes across time among demographic groups was significant for morbidity and hospitalization. Cumulative morbidity and mortality were highest among minority groups and in rural communities.

CONCLUSIONS:

The synchronicity of disparities in COVID-19 by race and geography suggests that health officials should explicitly measure disparities and adjust mitigation as well as vaccination strategies to protect those sub-populations with greater disease burden.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Rural Population / Ethnicity / Health Status Disparities / SARS-CoV-2 / COVID-19 / Hospitalization / Minority Groups Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0255063

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rural Population / Ethnicity / Health Status Disparities / SARS-CoV-2 / COVID-19 / Hospitalization / Minority Groups Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0255063