Racial and ethnic disparities contribute to higher COVID-19 serious outcomes

Racial and ethnic disparities contribute to higher COVID-19 serious outcomes

The devastating impact of the highly infectious COVID-19 disease is affecting everyone, everywhere – regardless of race, education, or income level. But when examining COVID’s prevalence and mortality, there are clear racial and ethnic disparities.

Carelon Research, a research subsidiary of Elevance Health, conducted analyses of a commercially-insured population between January and August 2020 to begin to further our understanding of these trends. The analysis is based on individuals who provided race and ethnicity data, approximately 30 percent of the 35 million lives covered in the analysis.

Here’s some of what we learned:

• Black and Hispanic/Latino populations more likely to test positive:
  Among those who were tested for COVID, the Black and Hispanic/Latino populations showed the highest likelihood of testing positive. Between January and July 15, 2020, the Black population showed a 8.2 percent test positivity rate, while the Hispanic/Latino population showed a 7.4 percent test positivity rate, compared to the White and Asian populations who showed 4.2 percent and 5.4 percent test positivity rates, respectively.


• Racial and ethnic minority populations more likely to be hospitalized from COVID-19:
  The Asian, Hispanic/Latino, and Black populations who test positive for COVID are more likely to be hospitalized at younger ages compared to the White population—especially the Hispanic/Latino and Black populations. While more than one-third of all COVID cases occur in the 35-54 age group— contributing to the large proportion of hospitalizations that occur during these ages across all races, the share of hospitalizations occurring in the Black and Hispanic/Latino populations is disproportionately high. Roughly 75 percent of hospitalizations in the Black population occur among adults in their prime working-age years, including 40 percent among individuals ages 35 to 54 and 35 percent among individuals ages 55 to 64. Similarly, 70 percent of hospitalizations in the Hispanic/Latino population occur in their prime working-age years – 38 percent for ages 35 to 54 and 32 percent for ages 55 to 64.
  
  
• There are disparities in death:
  Across all age groups, the Hispanic/Latino population represents more than a third, or 38 percent, of COVID hospitalizations resulting in death among the commercially-insured, despite accounting for only 11 percent of the commercially insured population. As many as 12 percent of COVID hospitalizations (across all racial/ethnic groups) resulted in death among the Black commercially insured population, even though only 9 percent of commercially-insured enrollees identify as Black. Less than half, or 47 percent, of all COVID hospitalizations resulted in death among the White commercially-insured population, despite their accounting for 55 percent of the commercially-insured population. While deaths appear clustered at ages 65 years and older for the White population, the majority of deaths are spread across the relatively younger age groups in the Hispanic/Latino and Black populations. For example, 63 percent of deaths from COVID in the Black population occur between the ages of 45 and 64, while 54 percent of deaths from COVID in the Hispanic/Latino population occur between the ages of 45 and 64. Only 30 percent of deaths in the White population, in contrast, occur among this age group (see Figure 3).

Addressing racial and ethnic disparities in COVID-19

Racial and ethnic disparities in COVID-19 must be addressed if we wish to rein in the pandemic in the United States. Healthcare payors can be an integral part of the solution by working to reduce racial/ethnic disparities in the testing, treatment, and vaccinations (as they become available) for COVID-19.

To provide more equitable care and drive optimal health outcomes, it’s important to consider strategies like:

• Payors should work directly with trusted community leaders and organizations (e.g. churches, neighborhood groups/centers) to provide member outreach and information on COVID prevention, testing, and vaccinations.
• Testing sites need to be located at easily accessible and familiar locations throughout communities and with longer operating hours, extending past working hours.
  
• Communications and educational materials need to clearly state there is no charge for testing based on government guidelines or for the vaccine, as required by government regulations.
  

The pervasiveness of racial and ethnic disparities in COVID infections and outcomes emanates from a history of social inequities and racial disparities in healthcare¹, but with collaboration and commitment, we can begin to address them.