Disparities in Incidence of COVID-19 Among Underrepresented Racial/Ethnic Groups in Counties Identified as Hotspots During June 5–18, 2020 — 22 States, February–June 2020

Moore, Jazmyn T.; Ricaldi, Jessica N.; Rose, Charles E.; Fuld, Jennifer; Parise, Monica; Kang, Gloria J.; Driscoll, Anne K.; Norris, Tina; Wilson, Nana; Rainisch, Gabriel; Valverde, Eduardo; Beresovsky, Vladislav; Agnew Brune, Christine; Oussayef, Nadia L.; Rose, Dale A.; Adams, Laura E.; Awel, Sindoos; Villanueva, Julie; Meaney-Delman, Dana; Honein, Margaret A.; Bautista, Gregory; Cowins, Janet; Edge, Charles; Grant, Gail; Gray, Robbie; Griffing, Sean; Hayes, Nikki; Hughes, Laura; Lavinghouze, Rene; Leonard, Sarah; Montierth, Robert; Palipudi, Krishna; Rayle, Victoria; Ruiz, Andrew; Washington, Malaika; Davidson, Sherri; Dillaha, Jennifer; Herlihy, Rachel; Blackmore, Carina; Troelstrup, Thomas; Edison, Laura; Thomas, Ebony; Pedati, Caitlin; Ahmed, Farah; Brown, Catherine; Lyon Callo, Sarah; Como-Sabetti, Kathryn; Byers, Paul; Sutton, Victor; Moore, Zackary; de Fijter, Sietske; Zhang, Alexia; Bell, Linda; Dunn, John; Pont, Stephen; McCaffrey, Keegan; Stephens, Emily; Westergaard, Ryan

During January 1, 2020-August 10, 2020, an estimated 5 million cases of coronavirus disease 2019 (COVID-19) were reported in the United States.* Published state and national data indicate that persons of color might be more likely to become infected with SARS-CoV-2, the virus that causes COVID-19, experience more severe COVID-19-associated illness, including that requiring hospitalization, and have higher risk for death from COVID-19 (1-5). CDC examined county-level disparities in COVID-19 cases among underrepresented racial/ethnic groups in counties identified as hotspots, which are defined using algorithmic thresholds related to the number of new cases and the changes in incidence.†Disparities were defined as difference of ≥5% between the proportion of cases and the proportion of the population or a ratio ≥1.5 for the proportion of cases to the proportion of the population for underrepresented racial/ethnic groups in each county. During June 5-18, 205 counties in 33 states were identified as hotspots; among these counties, race was reported for ≥50% of cumulative cases in 79 (38.5%) counties in 22 states; 96.2% of these counties had disparities in COVID-19 cases in one or more underrepresented racial/ethnic groups. Hispanic/Latino (Hispanic) persons were the largest group by population size (3.5 million persons) living in hotspot counties where a disproportionate number of cases among that group was identified, followed by black/African American (black) persons (2 million), American Indian/Alaska Native (AI/AN) persons (61,000), Asian persons (36,000), and Native Hawaiian/other Pacific Islander (NHPI) persons (31,000). Examining county-level data disaggregated by race/ethnicity can help identify health disparities in COVID-19 cases and inform strategies for preventing and slowing SARS-CoV-2 transmission. More complete race/ethnicity data are needed to fully inform public health decision-making. Addressing the pandemic's disproportionate incidence of COVID-19 in communities of color can reduce the community-wide impact of COVID-19 and improve health outcomes.