17 Aug Large Racial and Ethnic Disparities in COVID-19 Hospitalizations
MedicalResearch.com Interview with:
Pinar Karaca-Mandic, PhD
Professor, Finance Department
Arthur Williams Jr. Professor of Healthcare Risk Management
Academic Director, Medical Industry Leadership Institute (MILI)
Carlson School of Management
University of Minnesota
MedicalResearch.com: What is the background for this study?
Response: Several studies have highlighted disparities in COVID-19 infection rates and deaths. Less is known about disparities in hospitalizations. Reports from the Centers for Disease Control showed that in the nation overall, non-Hispanic Blacks, Hispanics and American Indian Alaska Native persons have substantially higher rates of COVID-19 hospitalization. Our study extends this work by providing a state-by-state analysis of race/ethnic prevalence of cumulative COVID-19 hospitalizations and comparing this prevalence to ethnic/racial composition of each state’s population.
Through our University of Minnesota Covid-19 hospitalization tracking project (https://carlsonschool.umn.edu/mili-misrc-covid19-tracking-project) we collect data every day from state department of health websites, and we started collecting information on race/ethnicity breakdown of the hospitalizations as soon as states started reporting such data. During our study period, between April 30 and June 24, 12 states reported cumulative hospitalizations by race/ethnicity. By the end of our study, our data from these 12 states represented almost 50,000 hospitalizations.
MedicalResearch.com: What are the main findings?
Response: We find that in all of the 12 states, proportion of hospitalizations for Blacks is higher than the group’s representation in the state population. The exact opposite is true for Whites. Similarly, in 10 of the 11 states that report data on the COVID-19 hospitalizations of Hispanics, the proportion of hospitalizations by Hispanics exceed their representative proportion in the state population. In addition, disparity is substantial for the American Indian and Alaskan Native population in several states such as Arizona and Utah.
MedicalResearch.com: What should readers take away from your report?
Response: Based on our analysis of data from 12 states, we identified large racial and ethnic disparities in COVID-19 hospitalizations across the states, with Black and Hispanic communities representing a disproportionately large share of the hospitalizations relative to their proportion in the state population. It is a limitation that we could only analyze data from the 12 states that provided such data. More recently, a few additional states started providing data on racial/ethnic breakdown of the hospitalizations, but we need standardized data from all states.
In our opinion, the disparities we observe in COVID-19 hospitalizations stem from the long-standing structural inequities in our society and healthcare system. These include living and working conditions that put minority populations at higher risk of infections as well as prolonged barriers to health insurance and healthcare access that contribute higher prevalence of underlying conditions that increase hospitalization risk.
Our findings reinforce the importance of designing and executing solutions to minimize adverse consequences of COVID-19 on minority populations. While there is an important role for the healthcare sector and clinicians, there is a need to coordinate with non-healthcare sectors to enhance community support and resources in communities of minority populations.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: In addition to incorporating data from additional states as more states start reporting racial and ethnic composition of COVID-19 hospitalizations, future work could design and evaluate programs in clinical and non-clinical settings to minimize COVID-19 disparities in hospitalizations. These policies could center around facilitating and accelerating testing, contact tracing, encouraging vaccination when available, and developing methodologies to assess and manage quality of care for chronic, underlying conditions among the minority populations. In addition, policies could leverage community health workers and social workers, as well as coordinate support services through housing services, transportation services faith-based organizations, schools and other community organizations that work with minority populations.
MedicalResearch.com: Is there anything else you would like to add?
Response: All disclosures are noted in the manuscript. The study data collection is supported by grants from the University of Minnesota Office of Academic Clinical Affairs and United Health Foundation.
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