种族/民族和严重住房问题与美国 COVID-19 死亡的关联:对前三波疫情的分析。

Association of race/ethnicity and severe housing problems with COVID-19 deaths in the United States: Analysis of the first three waves.

机构信息

School of International Affairs, The Pennsylvania State University, Pennsylvania, PA, United States of America.

School of Economics and Finance, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

PLoS One. 2024 May 29;19(5):e0303667. doi: 10.1371/journal.pone.0303667. eCollection 2024.

Abstract

The objective of this study is to assess the associations of race/ethnicity and severe housing problems with COVID-19 death rates in the US throughout the first three waves of the COVID-19 pandemic in the US. We conducted a cross-sectional study using a negative binomial regression model to estimate factors associated with COVID-19 deaths in 3063 US counties between March 2020 and July 2021 by wave and pooled across all three waves. In Wave 1, counties with larger percentages of Black, Hispanic, American Indian and Alaska Native (AIAN), and Asian American and Pacific Islander (AAPI) residents experienced a greater risk of deaths per 100,000 residents of +22.82 (95% CI 15.09, 30.56), +7.50 (95% CI 1.74, 13.26), +13.52 (95% CI 8.07, 18.98), and +5.02 (95% CI 0.92, 9.12), respectively, relative to counties with larger White populations. By Wave 3, however, the mortality gap declined considerably in counties with large Black, AIAN and AAPI populations: +10.38 (95% CI 4.44, 16.32), +7.14 (95% CI 1.14, 13.15), and +3.72 (95% CI 0.81, 6.63), respectively. In contrast, the gap increased for counties with a large Hispanic population: +13 (95% CI 8.81, 17.20). Housing problems were an important predictor of COVID-19 deaths. However, while housing problems were associated with increased COVID-19 mortality in Wave 1, by Wave 3, they contributed to magnified mortality in counties with large racial/ethnic minority groups. Our study revealed that focusing on a wave-by-wave analysis is critical to better understand how the associations of race/ethnicity and housing conditions with deaths evolved throughout the first three COVID-19 waves in the US. COVID-19 mortality initially took hold in areas characterized by large racial/ethnic minority populations and poor housing conditions. Over time, as the virus spread to predominantly White counties, these disparities decreased substantially but remained sizable.

摘要

本研究旨在评估在美国 COVID-19 大流行的前三个波次中,种族/族裔和严重住房问题与 COVID-19 死亡率之间的关联。我们通过负二项回归模型进行了一项横断面研究,以估计 2020 年 3 月至 2021 年 7 月期间美国 3063 个县在三个波次中与 COVID-19 死亡相关的因素。在第 1 波中,黑种人、西班牙裔、美洲印第安人和阿拉斯加原住民(AIAN)以及亚裔美国人和太平洋岛民(AAPI)居民比例较大的县,每 10 万人的死亡人数风险更高,分别为+22.82(95%CI 15.09,30.56)、+7.50(95%CI 1.74,13.26)、+13.52(95%CI 8.07,18.98)和+5.02(95%CI 0.92,9.12),而白种人居民比例较大的县则风险较低。然而,到第 3 波时,黑种人、AIAN 和 AAPI 居民比例较大的县的死亡率差距大大缩小:+10.38(95%CI 4.44,16.32)、+7.14(95%CI 1.14,13.15)和+3.72(95%CI 0.81,6.63)。相比之下,西班牙裔居民比例较大的县的差距则增加:+13(95%CI 8.81,17.20)。住房问题是 COVID-19 死亡的一个重要预测因素。然而,虽然住房问题与第 1 波的 COVID-19 死亡率增加有关,但到第 3 波时,它们导致了种族/族裔少数群体比例较大的县的死亡率增加。我们的研究表明,关注逐波分析对于更好地理解美国 COVID-19 前三个波次中种族/族裔和住房条件与死亡之间的关联如何演变至关重要。COVID-19 死亡率最初在以大量少数族裔和住房条件较差的地区出现。随着时间的推移,当病毒传播到以白种人为主的县时,这些差距大幅缩小,但仍然很大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b086/11135708/1d09ede9dfc9/pone.0303667.g001.jpg

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