The recent poll suffered from "COVID fatigue." We all remain aware of the risk of COVID-19 and its many ramifications but are being more selective about the COVID-19 content we're willing to engage with. As a result, the poll's response rate was too low to consider the results meaningful. So instead of sharing the results themselves, I am providing a summary of recent publications emphasizing the racial challenges that have been highlighted by the COVID-19 pandemic.

The Quick Takes above that reflect CDC data emphasize the great disparity in the incidence of COVID-19 infection in the United States, disproportionately affecting Native Americans and Alaskans and non-Hispanic Black people—all over 5 times more often infected with COVID-19—and Hispanic people, who are 4 times more likely to be infected.¹

Other more localized studies further emphasize the disparity, particularly for Black Americans. Data from March 1 to April 11, 2020, from the Louisiana-based Ochsner integrated health system, in which Black people compose 31% of the population, 76.9% of hospitalizations and 70.6% of deaths caused by COVID-19 were Black people. However, after adjustment for social, demographic, and clinical admission characteristics, there was no difference in deaths for Black versus White race.²

In a report from the Detroit area of Michigan, within the Henry Ford Health System, African Americans represented 32% of cases and 41% of deaths attributed to COVID-19. For Michigan as a whole, African Americans compose 14% of the population, though specific data for the actual treatment area were not presented. Importantly, co-morbid conditions for those with COVID-19 included body mass index >30 and hypertension, which are both more prevalent in Black versus White people. Social determinants of health like employment, income, housing, and transportation, certainly also come into play. In the state of Michigan in 2019, 27% of African Americans versus 11% of White people lived in poverty.³

One other important risk factor is access to information about the virus. Alsan et al.⁴ conducted a national survey with emphasis on COVID-19 "hot spot" cities and reported that Black persons, male persons, and persons <55 years of age demonstrated less knowledge of the virus and appropriate behaviors. For example, African Americans and Hispanics had significantly less knowledge regarding methods of viral spread and symptoms of COVID-19 infection.

Thus, the poll has provided a vehicle to highlight the disparities in COVID-19 infection rates and outcomes, particularly for Native American, African American, and Hispanic populations in the United States, which are the product of higher rates of baseline health risk factors, such as obesity and hypertension, and other complex socioeconomic, educational, and financial factors.

References

1. COVID-19 in Racial and Ethnic Minority Groups (Centers for Disease Control and Prevention website). June 4, 2020. Available at https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html. Accessed June 17, 2020.
2. Price-Haywood EG, Burton J, Fort D, Seoane L. Hospitalization and Mortality among Black Patients and White Patients with Covid-19. N Engl J Med 2020;382:2534-43.
3. Suleyman G, Fadel RA, Malette KM, et al. Clinical Characteristics and Morbidity Associated With Coronavirus Disease 2019 in a Series of Patients in Metropolitan Detroit. JAMA Netw Open 2020;3:e2012270.
4. Alsan M, Stantcheva S, Yang D, Cutler D. Disparities in Coronavirus 2019 Reported Incidence, Knowledge, and Behavior Among US Adults. JAMA Netw Open 2020;3:e2012403.

Clinical Topics: COVID-19 Hub, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Interventions and Imaging, Angiography, Nuclear Imaging

Keywords: Coronary Angiography, COVID-19, severe acute respiratory syndrome coronavirus 2, Coronavirus, Pandemics, Social Determinants of Health, Access to Information, Body Mass Index, Indians, North American, African Americans, Incidence, Risk Factors, Poverty

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