Assessment of COVID-19 Hospitalizations by Race and Ethnicity in 12 States

Given the reported health disparities in coronavirus disease 2019 (COVID-19) infection and mortality by race/ethnicity, there is an immediate need for increased assessment of the prevalence of COVID-19 across racial/ethnic subgroups of the population in the U.S. Karaca-Mandic, et al. (2020) examined the racial/ethnic prevalence of cumulative COVID-19 hospitalizations in the 12 states that report such data and compared how this prevalence differs from the racial/ethnic composition of each state’s population.

Using data extracted from the University of Minnesota COVID-19 Hospitalization Tracking Project, the researchers identified the 12 states that reported the race/ethnicity of individuals hospitalized with COVID-19 between April 30 and June 24, 2020. They calculated the percentage of cumulative hospitalizations by racial/ethnic categories averaged over the study period and then calculated the difference between the percentage of cumulative hospitalizations for each subgroup and the corresponding percentage of the state’s population for each racial/ethnic subgroup as reported in the US Census. The race/ethnicity categories included were White, Black, American Indian and/or Alaskan Native, Asian, and Hispanic.

This analysis of COVID-19 hospitalizations in 12 U.S. states during nearly a 2-month period represented a total of 48 788 cumulative hospitalizations among a total population of 66,796,666 individuals in 12 U.S. states by the end of the study period on June 24, 2020. The share of the hospitalizations of White patients was substantially smaller vs their share of state population in all 12 states. For example, in Minnesota, the share of hospitalizations of White patients was 52.9%, whereas their share of the state population was 84.1%. Conversely, the percentage of hospitalizations among Black patients exceeded the percentage of their representative proportion of the state population in all 12 states. Differences between the cumulative percentage of hospitalizations and the state population of Black individuals were greatest in Ohio (31.8% vs 13.0%), Minnesota (24.9% vs 6.8%), Indiana (28.1% vs 9.8%), and Kansas (22.0% vs 6.1%).

Eleven states reported the number of COVID-19 hospitalizations for Hispanic individuals, and in 10 states, the percentage of hospitalizations for Hispanic individuals was higher than their representative proportion of the state population. The disparity among Hispanic individuals was most pronounced in Virginia (36.2% of hospitalizations vs 9.6% of population), Utah (35.3% of hospitalizations vs 14.2% of population), and Rhode Island (33.0% of hospitalizations vs 15.9% of population).

The pattern was largely reversed for the Asian population. In 6 of 10 states that reported data for this subgroup, the proportion of hospitalizations was lower compared with their population representation. In Massachusetts, for example, the Asian population comprised 7.0% of the population but only 4.0% of the COVID-19 hospitalizations.

Hospitalization data for American Indian and Alaskan Native populations were only reported by 8 states. However, the disparity was substantial in select states. In Arizona, the American Indian and Alaskan Native population accounted for 15.7% of the hospitalizations but only 4.0% of the state’s population. Similarly, in Utah, this subgroup accounted for 5.0% of the hospitalizations in contrast with 0.9% representation of the state population.

Reference: Karaca-Mandic P, et al. Assessment of COVID-19 Hospitalizations by Race/Ethnicity in 12 States. JAMA Intern Med. Published online August 17, 2020. doi:10.1001/jamainternmed.2020.3857

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