Affiliation:
1. The authors are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA.
Abstract
Objectives. To address evidence gaps in COVID-19 mortality inequities resulting from inadequate race/ethnicity data and no socioeconomic data. Methods. We analyzed age-standardized death rates in Massachusetts by weekly time intervals, comparing rates for January 1 to May 19, 2020, with the corresponding historical average for 2015 to 2019 stratified by zip code social metrics. Results. At the surge peak (week 16, April 15–21), mortality rate ratios (comparing 2020 vs 2015–2019) were 2.2 (95% confidence interval [CI] = 1.4, 3.5) and 2.7 (95% CI = 1.4, 5.5) for the lowest and highest zip code tabulation area (ZCTA) poverty categories, respectively, with the 2020 peak mortality rate 1.1 (95% CI = 1.0, 1.3) times higher in the highest than the lowest poverty ZCTA. Similarly, rate ratios were significantly elevated for the highest versus lowest quintiles with respect to household crowding (1.7; 95% CI = 1.0, 2.9), racialized economic segregation (3.1; 95% CI = 1.8, 5.3), and percentage population of color (1.8; 95% CI = 1.6, 2.0). Conclusions. The COVID-19 mortality surge exhibited large inequities. Public Health Implications. Using zip code social metrics can guide equity-oriented COVID-19 prevention and mitigation efforts.
Publisher
American Public Health Association
Subject
Public Health, Environmental and Occupational Health
Cited by
69 articles.
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