We found several findings that build upon prior work. First, we found a strong relation between Black race, Latinx ethnicity, and population-level Covid-19 mortality. Our findings also underscore the importance of adjusting for age differences across population groups, given that unadjusted mortality rates will underestimate disparities in populations that skew younger (such as Black, and particularly Latinx). Although we found substantial variation in the completeness of race data across states, it is important to note that completeness is only one aspect of quality. Accuracy is also critical, and future work should ensure that accuracy of race/ethnicity data is assessed and optimized. Notably, we also found that the magnitude of these Covid-19 disparities varied substantially across states.
It is unclear whether the accuracy of attribution of Covid-19 as a cause of death varies across racial/ethnic groups, which could present a source of bias. Future work should explore Covid-19 outcomes in other racial groups, using data from different time points as the epidemic progresses, and assess variability in the reporting of other relevant Covid-19 data. It is also important to note that we applied age-related mortality risks based on national data to individual states, given the lack of state-level age-specific data. However, when we compared our approach to a state that does report its own age-adjusted rates by race group, we found that the Black vs White age-adjusted mortality as estimated by New York State was 4.17 (compared with our estimate of 4.30).
Given our nation’s long-standing history of structural racism, Ppublic health officials, healthcare systems, and policymakers should work together to improve the availability of high-quality Covid-19 data, and to thoroughly investigate and mitigate factors that contribute to inequity in Covid-19 mortality disparities. Poor-quality data intrinsically limits our ability to conduct rigorous research that can provide critical insights into how best to target and evaluate public health and clinical interventions.