UAB study: Blacks bear heavy burden of COVID-19 mortality, but key geographic disparities in health determinants exist

UAB researchers showed that Black individuals have a disproportionately higher COVID-19 mortality burden across all of the United States, which is driven by a high incidence of COVID-19 infection. (UAB)
A study by UAB investigators has outlined that Black people are disproportionately affected by COVID-19, and there are key geographic differences in health determinants in the United States.

UAB’s Dr. Vibhu Parcha
The new study in the Mayo Clinic Proceedings: Innovations, Quality & Outcomes showed that there are key geographic differences in the distribution of health determinants and COVID-19 mortality patterns. Dr. Vibhu Parcha and his team analyzed data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System survey and COVID-19 mortality data from state public health department databases.
The investigation by UAB researchers is the first attempt to look into race-stratified geographic differences in health determinants and their relationship with COVID-19 mortality using nationwide data.
“Crude mortality is defined as the number of deaths due to COVID-19 in the respective population subgroup, such as within all Black persons or white persons,” Parcha said. “The infection-fatality ratio is calculated by looking at the number of deaths among people infected with COVID-19. Crude mortality is a measure of the disease burden and explains how badly a population is affected by the deaths due to a disease, whereas infection fatality ratio is a measure of how severely the disease affects those who are infected with the virus.”
Researchers found that Blacks in the U.S. have a higher prevalence of co-morbidities and poor socioeconomic conditions. Both Black and white people living in the South and Midwest regions have a higher prevalence of these health determinants. The researchers found that Blacks have a three-times-higher likelihood of COVID-19 infection and twofold-higher crude mortality. They noted that the infection fatality, the ratio of COVID-19 deaths among those infected with COVID-19, is similar between Black and white people.
“COVID-19 is a serious condition that has disproportionately impacted minority populations with key geographic differences within them,” said senior author Dr. Pankaj Arora, a physician-scientist in UAB’s Division of Cardiovascular Disease. “The persistent racial disparities in health care, as underlined by our study, may predispose Black individuals to bear a hefty share of the COVID-19 pandemic. These important findings may help inform public health policy not just during the pandemic but also in its aftermath so that we can help address some important and persisting health disparities.”
Arora said there may be limitations with the study, citing that findings based on the observed data at the population level may be prone to ecological fallacy of being inferred as consistent at an individual level. Importantly, the pandemic is still evolving, and data is still accumulating.
“We will have a better understanding of the devastating impact of the pandemic, especially among minority populations, as more data accumulates,” Arora said. “We need urgent efforts to mitigate the systemic racial health disparities that have been heightened during the pandemic. Under the leadership of Dr. Selwyn Vickers, and UAB’s Minority Health and Health Disparities Research Center under Dr. Mona Fouad’s leadership, UAB has been leading efforts in this direction. We are all trying to fight this pandemic together and, I hope, with our resilience and adherence with CDC’s health recommendations, we will overcome these difficult times.”
For up-to-date information about UAB and how to practice health safety during the pandemic, visit uab.edu/coronavirus.
This story originally appeared on the University of Alabama at Birmingham’s UAB News website.