Assessing inequities underlying racial disparities of COVID-19 mortality in Louisiana parishes

Abstract

High COVID-19 mortality among Black communities heightened the pandemic’s devastation. In the state of Louisiana, the racial disparity associated with COVID-19 mortality was significant; Black Americans accounted for 50% of known COVID-19–related deaths while representing only 32% of the state’s population. In this paper, we argue that structural racism resulted in a synergistic framework of cumulatively negative determinants of health that ultimately affected COVID-19 deaths in Louisiana Black communities. We identify the spatial distribution of social, environmental, and economic stressors across Louisiana parishes using hot spot analysis to develop aggregate stressors. Further, we examine the correlation between stressors, cumulative health risks, COVID-19 mortality, and the size of Black populations throughout Louisiana. We hypothesized that parishes with larger Black populations (percentages) would have larger stressor values and higher cumulative health risks as well as increased COVID-19 mortality rates. Our results suggest two categories of parishes. The first group has moderate levels of aggregate stress, high population densities, predominately Black populations, and high COVID-19 mortality. The second group of parishes has high aggregate stress, lower population densities, predominantly Black populations, and initially low COVID-19 mortality that increased over time. Our results suggest that structural racism and inequities led to severe disparities in initial COVID-19 effects among highly populated Black Louisiana communities and that as the virus moved into less densely populated Black communities, similar trends emerged.

Admission systolic blood pressure and obesity correlate with fatal and severe acute COVID-19 in the population of New Orleans, LA

“…From March to August 2020, of the 89 patients recruited, ∼70% are Black, 54% female, and, on average, 66 years old ( Table 1 ). ZIP code and eHR indicate that the cohort’s Black patients live in areas of higher social vulnerability [2, 3] with 30% enrolled in Medicaid vs 21% national average [17]. Enrolled Black male and female patients are younger than White males (∼50% vs ≤30% in 45-64 years age bracket), while most White females are 85 and older ( Table 1 , Fig.1 ).…”

“…The cohort illustrates the CDC statement that “The pandemic has highlighted racial, ethnic, and socio-economic disparities in COVID-19 illnesses, hospitalizations, and deaths” [16] as marked inequity underlined by racial disparities paralleled COVID mortality in LA [17] and in the U.S. by the decrease in life expectancy by ∼2 years from 2018 to 2020 (Black Americans lost 3.25 years while White Americans lost 1.36 years) [18].…”

Risk factors among Black and White COVID-19 patients from a Louisiana Hospital System, March, 2020 – August, 2021

“…For the period of March 1, 2020 -August 31, 2021, 37.7% of Louisiana's COVID-19 deaths occurred in people identifying as non-Hispanic Black (hereafter referred to as "Black patients") [19]; in 2020, that proportion was 41.7%, compared to 31.2% of Louisiana residents identifying as Black [20]. A recent analysis connected disparities, systemic racism, economic stress, and COVID-19 mortality [21].…”

“Data makes the story come to life:” understanding the ethical and legal implications of Big Data research involving ethnic minority healthcare workers in the United Kingdom—a qualitative study

“…The COVID-19 pandemic has affected individuals and communities across the world, but some more than others. The disproportionate impact of the disease (caused by the SARS-CoV-2 virus) on minority ethnic communities and lower-income populations in dense, urban areas has been well documented in the literature [1][2][3][4]. What has been covered less extensively is the impact of the disease on healthcare workers (HCWs) within the same communities [5][6][7][8][9].…”