COVID-19 and the Unequal Surge in Mortality Rates in Massachusetts, by City/Town and ZIP Code Measures of Poverty, Household Crowding, Race/Ethnicity,and Racialized Economic Segregation

ABSTRACT

From the Abstract Despite the paucity of adequate data on race/ethnicity - and no data on socioeconomic position - in US national data on COVID-19 [coronavirus disease 2019] mortality, both investigative journalism and some state and local health departments are beginning to document evidence of the greater mortality burden of COVID-19 on communities of color and low-income communities. To date, such documentation has been in relation to deaths categorized as due to COVID-19. However, in a context when assignment of cause of death to COVID-19 is dynamic and incomplete, given developing scientific evidence, one important strategy for assessing differential impacts of COVID-19 is that of evaluating the overall excess of deaths, as compared to the same time period in prior years. We employ this approach in this working paper and provide a transparent, easy-to-replicate methodology that relies on the reported data (i.e., no model-based estimates or complex modeling assumptions) and that can be readily used by any local or state health agency to monitor the social patterning of excess mortality rates during the COVID-19 pandemic. Key findings are that the surge in excess death rates, both relative and absolute, was evident starting in early April, and was greater in city/towns and ZCTAs [ZIP Code Tabulation Area] with higher poverty, higher household crowding, higher percentage of populations of color, and higher racialized economic segregation.COVID-19 (Disease);Public health case studies;Mortality