Marissa B. Reitsma is a PhD student in the Centers for Health Policy and Primary Care and Outcomes Research, Stanford Health Policy, Freeman Spogli Institute for International Studies and the Stanford School of Medicine, Stanford University, in Stanford, California. She and Anneke Claypool contributed equally to this article.
Anneke L. Claypool is a PhD candidate in the Department of Management Science and Engineering, Stanford University. She and Marissa Reitsma contributed equally to this article.
Health Aff (Millwood). 2021 Jun;40(6):870-878. doi: 10.1377/hlthaff.2021.00098. Epub 2021 May 12.
With a population of forty million and substantial geographic variation in sociodemographics and health services, California is an important setting in which to study disparities. Its population (37.5 percent White, 39.1 percent Latino, 5.3 percent Black, and 14.4 percent Asian) experienced 59,258 COVID-19 deaths through April 14, 2021-the most of any state. We analyzed California's racial/ethnic disparities in COVID-19 exposure risks, testing rates, test positivity, and case rates through October 2020, combining data from 15.4 million SARS-CoV-2 tests with subcounty exposure risk estimates from the American Community Survey. We defined "high-exposure-risk" households as those with one or more essential workers and fewer rooms than inhabitants. Latino people in California are 8.1 times more likely to live in high-exposure-risk households than White people (23.6 percent versus 2.9 percent), are overrepresented in cumulative cases (3,784 versus 1,112 per 100,000 people), and are underrepresented in cumulative testing (35,635 versus 48,930 per 100,000 people). These risks and outcomes were worse for Latino people than for members of other racial/ethnic minority groups. Subcounty disparity analyses can inform targeting of interventions and resources, including community-based testing and vaccine access measures. Tracking COVID-19 disparities and developing equity-focused public health programming that mitigates the effects of systemic racism can help improve health outcomes among California's populations of color.
加利福尼亚州拥有 4000 万人口，社会人口统计学和医疗服务在地域上存在很大差异，因此是研究差异的重要场所。截至 2021 年 4 月 14 日，加利福尼亚州的人口（37.5%为白人，39.1%为拉丁裔，5.3%为黑人，14.4%为亚洲人）经历了 59258 例 COVID-19 死亡病例，是所有州中死亡人数最多的。我们通过合并来自 1540 万次 SARS-CoV-2 检测的数据以及美国社区调查的亚县暴露风险估计值，分析了加利福尼亚州在 COVID-19 暴露风险、检测率、检测阳性率和病例率方面的种族/族裔差异。我们将“高暴露风险”家庭定义为有一个或多个必要工人且居住房间少于居民人数的家庭。加利福尼亚州的拉丁裔人生活在高暴露风险家庭中的可能性比白人高 8.1 倍（23.6%比 2.9%），在累计病例中占比过高（每 10 万人中有 3784 例比 1112 例），在累计检测中占比过低（每 10 万人中有 35635 例比 48930 例）。与其他少数族裔群体的成员相比，拉丁裔人面临着更大的这些风险和结果。对亚县差异的分析可以为干预措施和资源的目标定位提供信息，包括社区为基础的检测和疫苗获取措施。跟踪 COVID-19 差异，并制定以公平为重点的公共卫生规划，以减轻系统性种族主义的影响，有助于改善加利福尼亚州有色人种的健康结果。
