County-Level Proportions of Black and Hispanic populations, and Socioeconomic Characteristics in Association with Confirmed COVID-19 Cases and Deaths in the United States

Khanijahani, A.

Objectives. The objective of this study was to investigate potential county-level disparities among racial/ethnic and economic groups in COVID-19 burden which was measured using confirmed cases and deaths in 100,000 population. Design. Secondary data analysis Using county-level data for 3,142 US counties was conducted in 2020. Hierarchical linear regression and concentration curve analyses were performed. The combined association of COVID-19 cases and deaths was examined separately by sociodemographic and economic characteristics of the county population. Data from the American Community Survey (ACS) 5-year estimates (2014-2018), Area Health Resources File (AHRF) 2018-2019, and 2020 COVID-19 data from Johns Hopkins University were used in this study. Results. After adjusting for covariates, US counties with a higher proportion of the black population, and a higher proportion of adults with less than high school diploma had disproportionately higher COVID-19 cases and deaths ({beta}>0, p<0.05). A higher proportion of the Hispanic population was associated with higher confirmed cases ({beta}= 1.03, 95% CI= 0.57-1.5), and higher housing cost to household income ratio was associated with higher deaths ({beta}= 3.74, 95% CI= 2.14-5.37). This can potentially aggravate the existing health disparities among these population groups. Conclusions. Identification of disproportionately impacted population groups can pave the way towards narrowing the disparity gaps and guide policymakers and stakeholders in designing and implementing population group-specific interventions to mitigate the negative consequences of COVID-19 pandemic.