Half-Million Excess U.S. Deaths in 2020 Hit Minorities Worse

Half-Million Excess U.S. Deaths in 2020 Hit Minorities Worse

Racial and ethnic minorities accounted for a disproportionate number of the half million excess deaths last year, according to a new U.S. study that examines mortality both directly and indirectly related to Covid-19.

Researchers compared the number of people who died from March to December 2020 with the number of deaths that had been projected to occur before the pandemic. They found 477,200 excess deaths, with more than twice as many occurring among Blacks, Latinos, American Indians and Alaskan Natives compared with Whites and Asians of similar age. About 74% of the excess deaths were attributed to Covid-19.

The study, which was published Monday in the Annals of Internal Medicine, is the first of its kind to look at excess deaths by taking into account the annual growth of the U.S. population by age, race and ethnicity. It adds to a growing body of research about the unequal burden of the pandemic through a race and ethnicity lens.

“Black, Latino and Indigenous populations historically have lived in lower-income communities with poorer access to care and education than wealthier white communities,” said Harrison Lobdell, an emergency room physician in Austin, Texas, and co-founder of the Wellness and Equity Alliance, who was not involved in the study.  “When a second hit, such as Covid-19, comes along, the effects of these health inequities are magnified, and result is the excess deaths amongst these populations.”

Lack of access to testing and a higher chance of being exposed to Covid at work contributed to higher infection rates among minorities, according to Thomas LaVeist, dean of the Tulane University School of Public Health and Tropical Medicine. Multigenerational households are also more common in minority families, meaning less room for physical distance, said LaVeist, who wasn’t involved in the study.

The study was conducted by the National Cancer Institute, the National Institute on Minority Health and Health Disparities, and the Pacific Institute for Research and Evaluation. The researchers relied on death certificate data from the Centers for Disease Control and Prevention and population projections from the U.S. Census Bureau.

They found the discrepancy in excess deaths was even wider for conditions not related to Covid-19. Excess mortality for Black, American Indian and Alaskan Native men and women was three to four times higher from conditions not related to Covid-19 compared with Whites.

These disparities were particularly pronounced among people ages 75 and older, in whom non-Covid deaths were 9 times higher for Black men compared to White men. 

While disparities in health-care access and outcomes are well-known to researchers, most public attention has been focused on Covid-19 specifically, said Steven Cohen, a social epidemiologist at the University of Rhode Island who wasn’t involved in the study. There’s been less discussion about how to reduce the gaps in other diseases that affect racial and ethnic minorities more often.

Black Americans, for example, have a higher mortality rate for all cancers combined than any racial or ethnic group, and Latinos have a higher death rate from diabetes than White Americans. Indigenous people remain understudied, according to Cohen, but research has shown that American Indians and Alaskan Natives have a life expectancy that’s 5.5 years shorter than all other races in the U.S., with more deaths from liver disease, diabetes and accidental injuries.

“When the pandemic is over, we’ll still have health disparities,” Cohen said in a phone interview. “We’ll still have to address these issues based on all those other causes of death unrelated to Covid. These are symptoms of a much larger systematic problem.”

©2021 Bloomberg L.P.

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