TY - JOUR
T1 - Estimating the effects of race and social vulnerability on hospital admission and mortality from COVID-19
AU - Landman, Joshua M.
AU - Steger-May, Karen
AU - Joynt Maddox, Karen E.
AU - Hammond, J. Gmerice
AU - Gupta, Aditi
AU - Rauseo, Adriana M.
AU - Zhao, Min
AU - Foraker, Randi E.
N1 - Publisher Copyright:
© 2021 The Author(s).
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Objective: To estimate the risk of hospital admission and mortality from COVID-19 to patients and measure the association of race and area-level social vulnerability with those outcomes. Materials and Methods: Using patient records collected at a multisite hospital system from April 2020 to October 2020, the risk of hospital admission and the risk of mortality were estimated for patients who tested positive for COVID-19 and were admitted to the hospital for COVID-19, respectively, using generalized estimating equations while controlling for patient race, patient area-level social vulnerability, and time course of the pandemic. Results: Black individuals were 3.57 as likely (95% CI, 3.18-4.00) to be hospitalized than White people, and patients living in the most disadvantaged areas were 2.61 times as likely (95% CI, 2.26-3.02) to be hospitalized than those living in the least disadvantaged areas. While Black patients had lower raw mortality than White patients, mortality was similar after controlling for comorbidities and social vulnerability. Discussion: Our findings point to potent correlates of race and socioeconomic status, including resource distribution, employment, and shared living spaces, that may be associated with inequitable burden of disease across patients of different races. Conclusions: Public health and policy interventions should address these social factors when responding to the next pandemic.
AB - Objective: To estimate the risk of hospital admission and mortality from COVID-19 to patients and measure the association of race and area-level social vulnerability with those outcomes. Materials and Methods: Using patient records collected at a multisite hospital system from April 2020 to October 2020, the risk of hospital admission and the risk of mortality were estimated for patients who tested positive for COVID-19 and were admitted to the hospital for COVID-19, respectively, using generalized estimating equations while controlling for patient race, patient area-level social vulnerability, and time course of the pandemic. Results: Black individuals were 3.57 as likely (95% CI, 3.18-4.00) to be hospitalized than White people, and patients living in the most disadvantaged areas were 2.61 times as likely (95% CI, 2.26-3.02) to be hospitalized than those living in the least disadvantaged areas. While Black patients had lower raw mortality than White patients, mortality was similar after controlling for comorbidities and social vulnerability. Discussion: Our findings point to potent correlates of race and socioeconomic status, including resource distribution, employment, and shared living spaces, that may be associated with inequitable burden of disease across patients of different races. Conclusions: Public health and policy interventions should address these social factors when responding to the next pandemic.
KW - COVID-19
KW - hospital admission
KW - mortality
KW - social determinants of health
KW - social vulnerability
UR - http://www.scopus.com/inward/record.url?scp=85124969670&partnerID=8YFLogxK
U2 - 10.1093/jamiaopen/ooab111
DO - 10.1093/jamiaopen/ooab111
M3 - Article
C2 - 35146378
AN - SCOPUS:85124969670
SN - 2574-2531
VL - 4
JO - JAMIA Open
JF - JAMIA Open
IS - 4
M1 - ooab111
ER -