COVID-19 Death Rates Are Higher in Rural Counties With Larger Shares of Blacks and Hispanics.
J Rural Health
; 36(4): 602-608, 2020 09.
Article
in English
| MEDLINE | ID: covidwho-823641
ABSTRACT
PURPOSE:
This study compared the average daily increase in COVID-19 mortality rates by county racial/ethnic composition (percent non-Hispanic Black and percent Hispanic) among US rural counties.METHODS:
COVID-19 daily death counts for 1,976 US nonmetropolitan counties for the period March 2-July 26, 2020, were extracted from USAFacts and merged with county-level American Community Survey and Area Health Resource File data. Covariates included county percent poverty, age composition, adjacency to a metropolitan county, health care supply, and state fixed effects. Mixed-effects negative binomial regression with random intercepts to account for repeated observations within counties were used to predict differences in the average daily increase in the COVID-19 mortality rate across quartiles of percent Black and percent Hispanic.FINDINGS:
Since early March, the average daily increase in the COVID-19 mortality rate has been significantly higher in rural counties with the highest percent Black and percent Hispanic populations. Compared to counties in the bottom quartile, counties in the top quartile of percent Black have an average daily increase that is 70% higher (IRR = 1.70, CI 1.48-1.95, P < .001), and counties in the top quartile of percent Hispanic have an average daily increase that is 50% higher (IRR = 1.50, CI 1.33-1.69, P < .001), net of covariates.CONCLUSION:
COVID-19 mortality risk is not distributed equally across the rural United States, and the COVID-19 race penalty is not restricted to cities. Among rural counties, the average daily increase in COVID-19 mortality rates has been significantly higher in counties with the largest shares of Black and Hispanic residents.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Black or African American
/
Hispanic or Latino
/
Coronavirus Infections
/
Betacoronavirus
/
Health Services Accessibility
Type of study:
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Female
/
Humans
Country/Region as subject:
North America
Language:
English
Journal:
J Rural Health
Journal subject:
Nursing
/
Public Health
Year:
2020
Document Type:
Article
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