Table 1. Unadjusted Associations of Demographics, Chronic Disease, Social/Environmental Factors, and COVID-19 Diagnoses and Deaths by Proportion of Black Residents

University of Michigan - Ann Arbor

- 97% of disproportionately black counties reported at least one case, 49% reported at least one death (compared to 82% and 28% for other counties)
- Adjusted rate ratios suggest counties with a higher proportion of black residents are associated with greater rate ratios for COVID-19 cases (RR 1.23, 95% CI 1.17, 1.33) and deaths (RR 1.18, 95% CI 1.00-1.40)
- Counties with higher proportions of black residents were associated with greater prevalence of comorbidities, individuals 65+ years old, uninsured individuals, unemployed individuals, and air pollution.

Assessing Differential Impacts of COVID-19 on Black Communities: Results

The authors collected county-level data from the US Census on 3,142 counties and stratified them by the population of black Americans in the community (in relation to whether the community's black population was greater or less than the national average). The authors used Bayesian hierarchical models to control for sociodemographics, comorbidities, and socioeconomic determinants, including adjustments for county-specific characteristics (from Table 1) and temporality for the epidemic. Exponentiated regression coefficients were computed and rate ratios for COVID-19 morbidity and mortality were analyzed. 

Assessing Differential Impacts of COVID-19 on Black Communities: Methods

Millet, G.A et al (2020). Assessing Differential Impacts of COVID-19 on Black Communities. Annals of Epidemiology. https://doi.org/10.1016/j.annepidem.2020.05.003

Assessing Differential Impacts of COVID-19 on Black Communities

Figure 2 plots COVID-19 cases per 100,000 population (adjusted for days since detection) by proportion of black residents. (An interactive plot with ‘hover over’ data display functionality is available at https://ehe.amfar.org/bubble_plot_cases.html). For counties with >5% of black residents, higher proportions of black residents were associated with higher rates of COVID-19 diagnoses.

Assessing Differential Impacts of COVID-19 on Black Communities: Figure 2

Figure 1. Rates of COVID-19 Diagnoses and Deaths in Disproportionately Black (>13% of population) Versus All Other Counties (<13% of population) as of April 13, 2020

Assessing Differential Impacts of COVID-19 on Black Communities: Figure 1

Assessing Differential Impacts of COVID-19 on Black Communities: Table 1

Table 2. Adjusted Rate Ratios (Third Versus First Quartile) of Demographics, Chronic Disease, Social/Environmental Factors with COVID-19 Diagnoses and Deaths

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