Anaele Beverly I, Doran Cierrah, McIntire Russell
College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA.
J Racial Ethn Health Disparities. 2021 Dec;8(6):1356-1363. doi: 10.1007/s40615-020-00897-2. Epub 2021 Feb 9.
The Centers for Disease Control and Prevention has identified African-Americans as having increased risk of COVID-19-associated mortality. Access to healthcare and related social determinants of health are at the core of this disparity. To explore the geographical links between race and COVID-19 mortality, we created descriptive maps of COVID-19 mortality rates in relation to the percentage of populations self-identifying as African-American across the USA, by state, and Pennsylvania (PA), by county. In addition, we used bivariate and logistic regression analyses to quantify the statistical relationship between these variables, and control for area-level demographic, healthcare access, and comorbidity risk factors. We found that COVID-19 mortality rates were generally higher in areas that had higher African-American populations, particularly in the northeast USA and eastern PA. These relationships were quantified through Pearson correlations showing significant positive associations at the state and county level. At the US state-level, percent African-American population was the only significant correlate of COVID-19 mortality rate. In PA at the county-level, higher percent African-American population was associated with higher COVID-19 mortality rate even after controlling for area-level confounders. More resources should be allocated to address high COVID-19 mortality rates among African-American populations.
美国疾病控制与预防中心已确定非裔美国人感染新冠病毒相关死亡率较高。获得医疗保健及相关健康社会决定因素是造成这种差异的核心所在。为探究种族与新冠病毒死亡率之间的地理联系,我们绘制了描述性地图,展示了美国各州以及宾夕法尼亚州(PA)各县新冠病毒死亡率与自我认定为非裔美国人的人口百分比之间的关系。此外,我们使用双变量和逻辑回归分析来量化这些变量之间的统计关系,并控制地区层面的人口统计学、医疗保健可及性和合并症风险因素。我们发现,非裔美国人人口较多的地区新冠病毒死亡率普遍较高,尤其是在美国东北部和宾夕法尼亚州东部。这些关系通过皮尔逊相关性进行了量化,显示在州和县级层面存在显著的正相关。在美国州一级,非裔美国人人口百分比是新冠病毒死亡率的唯一显著相关因素。在宾夕法尼亚州县级层面,即使在控制了地区层面的混杂因素后,非裔美国人人口百分比越高,新冠病毒死亡率也越高。应分配更多资源来解决非裔美国人中新冠病毒高死亡率的问题。