MMWR Morb Mortal Wkly Rep. 2021 Apr 2;70(13):483-489. doi: 10.15585/mmwr.mm7013e1.
Long-standing systemic social, economic, and environmental inequities in the United States have put many communities of color (racial and ethnic minority groups) at increased risk for exposure to and infection with SARS-CoV-2, the virus that causes COVID-19, as well as more severe COVID-19-related outcomes (1-3). Because race and ethnicity are missing for a proportion of reported COVID-19 cases, counties with substantial missing information often are excluded from analyses of disparities (4). Thus, as a complement to these case-based analyses, population-based studies can help direct public health interventions. Using data from the 50 states and the District of Columbia (DC), CDC identified counties where five racial and ethnic minority groups (Hispanic or Latino [Hispanic], non-Hispanic Black or African American [Black], non-Hispanic Asian [Asian], non-Hispanic American Indian or Alaska Native [AI/AN], and non-Hispanic Native Hawaiian or other Pacific Islander [NH/PI]) might have experienced high COVID-19 impact during April 1-December 22, 2020. These counties had high 2-week COVID-19 incidences (>100 new cases per 100,000 persons in the total population) and percentages of persons in five racial and ethnic groups that were larger than the national percentages (denoted as "large"). During April 1-14, a total of 359 (11.4%) of 3,142 U.S. counties reported high COVID-19 incidence, including 28.7% of counties with large percentages of Asian persons and 27.9% of counties with large percentages of Black persons. During August 5-18, high COVID-19 incidence was reported by 2,034 (64.7%) counties, including 92.4% of counties with large percentages of Black persons and 74.5% of counties with large percentages of Hispanic persons. During December 9-22, high COVID-19 incidence was reported by 3,114 (99.1%) counties, including >95% of those with large percentages of persons in each of the five racial and ethnic minority groups. The findings of this population-based analysis complement those of case-based analyses. In jurisdictions with substantial missing race and ethnicity information, this method could be applied to smaller geographic areas, to identify communities of color that might be experiencing high potential COVID-19 impact. As areas with high rates of new infection change over time, public health efforts can be tailored to the needs of communities of color as the pandemic evolves and integrated with longer-term plans to improve health equity.
美国长期存在的社会、经济和环境不平等现象，使许多有色人种（种族和少数民族群体）面临更大的风险，更容易接触到导致 COVID-19 的 SARS-CoV-2 病毒，并感染该病毒，以及出现更严重的与 COVID-19 相关的后果（1-3）。由于报告的 COVID-19 病例中有一部分缺失了种族和族裔信息，因此大量缺失信息的县通常被排除在差异分析之外（4）。因此，作为基于病例的分析的补充，基于人群的研究可以帮助指导公共卫生干预措施。使用来自 50 个州和哥伦比亚特区（DC）的数据，CDC 确定了五个种族和族裔群体（西班牙裔或拉丁裔[西班牙裔]、非西班牙裔黑人和非洲裔美国人[黑人]、非西班牙裔亚裔[亚裔]、非西班牙裔美洲印第安人或阿拉斯加原住民[AI/AN]和非西班牙裔夏威夷原住民或其他太平洋岛民[NH/PI]）在 2020 年 4 月 1 日至 12 月 22 日期间可能经历过高 COVID-19 影响的县。这些县的两周 COVID-19 发病率（每 10 万总人口中有超过 100 例新病例）和五个种族和族裔群体中人数比例均高于全国比例（表示为“大”）。在 4 月 1 日至 14 日期间，共有 359 个（11.4%）美国县报告了高 COVID-19 发病率，其中 28.7%的县有大量亚洲人，27.9%的县有大量黑人。在 8 月 5 日至 18 日期间，有 2034 个（64.7%）县报告了高 COVID-19 发病率，其中 92.4%的县有大量黑人，74.5%的县有大量西班牙裔。在 12 月 9 日至 22 日期间，有 3114 个（99.1%）县报告了高 COVID-19 发病率，其中包括每个五个少数族裔群体中人数比例均超过 95%的县。这项基于人群的分析结果补充了基于病例的分析结果。在种族和族裔信息大量缺失的司法管辖区，可以将这种方法应用于较小的地理区域，以确定可能正在经历高潜在 COVID-19 影响的有色人种社区。随着新感染率较高的地区随时间而变化，公共卫生工作可以根据社区的需求进行调整，随着大流行的发展，这些工作可以与改善健康公平的长期计划相结合。
