Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA.
Division of Epidemiology, Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Jamaica Plain, Massachusetts, USA.
Influenza Other Respir Viruses. 2022 May;16(3):532-541. doi: 10.1111/irv.12945. Epub 2021 Dec 6.
COVID-19 hospitalizations of non-institutionalized persons during the first COVID-19 wave in Connecticut disproportionately affected the elderly, communities of color, and individuals of low socioeconomic status (SES). Whether the magnitude of these disparities changed after the initial lockdown and before vaccine rollout is not well documented.
All first-time hospitalizations with laboratory-confirmed COVID-19 during July to December 2020, including patients' geocoded residential addresses, were obtained from the Connecticut Department of Public Health. Those living in congregate settings, including nursing homes, were excluded. Community-dwelling patients were assigned census tract-level poverty and crowding measures from the 2014-2018 American Community Survey by linking their geocoded addresses to census tracts. Age-adjusted incidence and relative rates were calculated across demographic and SES measures and compared with those from a similar analysis of hospitalized cases during the initial wave.
During July to December 2020, there were 5652 COVID-19 hospitalizations in community residents in Connecticut. Incidence was highest among those >85 years, non-Hispanic Blacks and Hispanic/Latinx compared with non-Hispanic Whites {relative rate (RR) 3.1 (95% confidence interval [CI] 2.83-3.32) and 5.9 (95% CI 5.58-6.28)}, and persons living in high poverty and high crowding census tracts. Although racial/ethnic and SES disparities during the study period were substantial, they were significantly decreased compared with the first wave of COVID-19.
The finding of persistent, if reduced, large racial/ethnic disparities in COVID-19 hospitalizations 2-7 months after the initial lockdown was relaxed and before vaccination was widely available is of concern. These disparities cause a challenge to achieving health equity and are relevant for future pandemic planning.
在康涅狄格州的 COVID-19 第一波疫情中，非机构化人群的 COVID-19 住院治疗不成比例地影响了老年人、有色人种社区和社会经济地位（SES）较低的个人。在最初的封锁和疫苗推出之前，这些差异的程度是否发生变化，记录并不充分。
从康涅狄格州公共卫生部获得 2020 年 7 月至 12 月期间所有初次因 COVID-19 住院的患者，包括患者的地理编码居住地址。居住在集体环境中的患者，包括疗养院，被排除在外。通过将地理编码地址与普查区相链接，将居住在社区中的患者分配到 2014-2018 年美国社区调查的普查区层面的贫困和拥挤程度指标。根据人口统计学和 SES 指标计算年龄调整后的发病率和相对比率，并与 COVID-19 初始波住院患者的类似分析进行比较。
2020 年 7 月至 12 月期间，康涅狄格州社区居民中有 5652 例 COVID-19 住院患者。发病率最高的是>85 岁、非西班牙裔黑人以及西班牙裔/拉丁裔患者，而非非西班牙裔白人患者（相对比率[RR]为 3.1（95%置信区间[CI]为 2.83-3.32）和 5.9（95% CI 为 5.58-6.28））和生活在高贫困和高拥挤普查区的人群。尽管在研究期间，种族/族裔和 SES 差异很大，但与最初的 COVID-19 封锁放松和疫苗广泛使用之前的第一波相比，这些差异显著降低。
在最初的封锁放松和疫苗广泛使用之前的 2-7 个月，发现 COVID-19 住院治疗中仍然存在，如果减少的话，仍然存在很大的种族/族裔差异，这令人担忧。这些差异给实现健康公平带来了挑战，与未来的大流行规划有关。
