新冠疫情期间,黑人和拉丁裔的死亡人数超过白人。

Excess Deaths Among Blacks and Latinx Compared to Whites During Covid-19.

机构信息

Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA.

Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, Farmington, CT, 06030, USA.

出版信息

J Racial Ethn Health Disparities. 2021 Jun;8(3):783-789. doi: 10.1007/s40615-021-01010-x. Epub 2021 Mar 22.

Abstract

IMPORTANCE

Blacks and Latinx are disproportionately affected by Coronavirus disease 2019 (Covid-19) and experience higher mortality rates than Whites and Asians in the USA. Such racial disparities, in Covid-19 testing, cases, and mortality are visible in Connecticut too. Recently, excess deaths have become an important consideration in news reports and academic research. However, data on racial differences in excess death is limited.

OBJECTIVE

This study examines racial/ethnic differences in excess deaths in the state of Connecticut during the Covid-19 pandemic.

DESIGN

This is a cross-sectional epidemiological study to estimate excess deaths by racial/ethnic status utilizing mortality data during the peak months of Covid-19 infections from March 1 to June 30, 2020, in Connecticut. The following assumption is applied: expected non-Covid-19 deaths from March 1 to June 30, 2020, are equal to the number of deaths occurring during the period of March 1 to June 30, 2019. Race/ethnicity are defined as Non-Hispanic White, Non-Hispanic Black, and Latinx. Descriptive statistics and rates with 95% confidence intervals are presented. Chi-square analyses are performed where applicable.

SETTING

Connecticut PARTICIPANTS: All deaths in Connecticut from March 1 to June 30, 2020.

EXPOSURE

Covid-19 and race/ethnicity RESULTS: From March 1 to June 30, 2020, a total of 14,226 all-cause deaths occurred including 1514 Blacks (10.6%), 1095 Latinx (7.7%), and 11,617 Whites (81.7%). This represented a 74% increase in mortality for Blacks; 63% for Latinx, and 30% for Whites. In addition, 42.70% of the deaths in Blacks were attributed to Covid-19; 38.5% for Latinx, and 23.0% for Whites (p<0.001). Covid-19 deaths accounted for over 90% of the excess deaths in Blacks and Hispanics. In contrast, in Whites, Covid-19 deaths exceeded the number of excess deaths by 353 cases (113.2%), indicating that some Whites may have died from other underlined health conditions with a positive Covid-19 diagnosis. Furthermore, there was an increase in undetermined deaths in 2020, which accounted for 10.8% of deaths in Blacks, 13% in Latinx, and 6.2% of deaths in Whites.

CONCLUSIONS AND RELEVANCE

Excess deaths in Blacks and Latinx were found above the numbers of deaths determined to have occurred due to Covid-19. The fact that a large number of undetermined deaths were found for Blacks and Latinx individuals, and testing rates for Blacks and Latinx individuals (as determined by positivity rates) were lacking during this period strongly suggests, these excess deaths were Covid-19-related deaths. The study findings indicate that Black and Latinx COVID-19-related deaths may be underreported in this pandemic. We advocate for targeted strategies that increase testing capacity, treatment, and vaccine availability in Black and Latinx communities.

摘要

重要性

在美国,黑人和拉丁裔人群 disproportionately 受到 2019 年冠状病毒病(Covid-19)的影响,死亡率比白人(White)和亚洲人(Asian)高。康涅狄格州(Connecticut)也存在类似的种族差异,表现在 Covid-19 检测、病例和死亡率方面。最近,超额死亡(excess deaths)已成为新闻报道和学术研究的一个重要考虑因素。然而,关于种族差异导致超额死亡的数据有限。

目的

本研究旨在探讨美国康涅狄格州在 Covid-19 大流行期间种族/族裔差异导致的超额死亡情况。

设计

这是一项横断面流行病学研究,利用 2020 年 3 月 1 日至 6 月 30 日期间 Covid-19 感染高峰期的死亡率数据,按种族/族裔状况估算超额死亡。我们假设 2020 年 3 月 1 日至 6 月 30 日期间非 Covid-19 死亡人数与 2019 年同期相同。种族/族裔定义为非西班牙裔白人(Non-Hispanic White)、非西班牙裔黑人(Non-Hispanic Black)和拉丁裔(Latinx)。呈现描述性统计数据和 95%置信区间的比率。适用时进行卡方分析。

地点

康涅狄格州

参与者

2020 年 3 月 1 日至 6 月 30 日期间康涅狄格州的所有死亡病例。

暴露因素

Covid-19 和种族/族裔

结果

2020 年 3 月 1 日至 6 月 30 日期间,共发生 14226 例全因死亡,其中包括 1514 名黑人(10.6%)、1095 名拉丁裔(7.7%)和 11617 名白人(81.7%)。黑人的死亡率增加了 74%;拉丁裔增加了 63%;白人增加了 30%。此外,黑人死亡人数中有 42.70%归因于 Covid-19;拉丁裔为 38.5%;白人为 23.0%(p<0.001)。Covid-19 死亡人数占黑人和西班牙裔超额死亡人数的 90%以上。相比之下,在白人中,Covid-19 死亡人数超过超额死亡人数 353 例(113.2%),这表明一些白人可能因其他健康状况而死亡,尽管新冠病毒检测呈阳性。此外,2020 年的不明死因死亡人数有所增加,占黑人死亡人数的 10.8%,拉丁裔死亡人数的 13%,白人死亡人数的 6.2%。

结论和相关性

在黑人(Black)和拉丁裔(Latinx)中发现的超额死亡人数超过了因 Covid-19 而确定的死亡人数。黑人(Black)和拉丁裔(Latinx)个体中发现大量未确定死因的事实,以及在此期间黑人(Black)和拉丁裔(Latinx)个体的检测率(由阳性率确定)较低,强烈表明这些超额死亡与 Covid-19 有关。研究结果表明,在这场大流行中,黑人和拉丁裔的与 COVID-19 相关的死亡人数可能被低估了。我们提倡采取有针对性的策略,增加黑人和拉丁裔社区的检测能力、治疗和疫苗供应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c75/7983962/44bacce351c5/40615_2021_1010_Fig1_HTML.jpg

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