Increases in SARS-CoV-2 Test Positivity Rates Among Hispanic People in a Northern California Health System

Abstract

Racial/ethnic minority groups are disproportionately affected by the COVID-19 pandemic. We examined ethnic differences in SARS-CoV-2 testing patterns and positivity rates in a large health care system in Northern California. The study population included patients tested for SARS-CoV-2 from March 4, 2020, through January 12, 2021, at Stanford Health Care. We used adjusted hierarchical logistic regression models to identify factors associated with receiving a positive test result. During the study period, 282 916 SARS-CoV-2 tests were administered to 179 032 unique patients, 32 766 (18.3%) of whom were Hispanic. Hispanic patients were 3 times more likely to receive a positive test result than patients in other racial/ethnic groups (odds ratio = 3.16; 95% CI, 3.00-3.32). The rate of receiving a positive test result for SARS-CoV-2 among Hispanic patients increased from 5.4% in mid-March to 15.7% in mid-July, decreased to 3.9% in mid-October, and increased to 21.2% toward the end of December. Hispanic patients were more likely than non-Hispanic patients to receive a positive test result for SARS-CoV-2, with increasing trends during regional surges. The disproportionate and growing overrepresentation of Hispanic people receiving a positive test result for SARS-CoV-2 demonstrates the need to focus public health prevention efforts on these communities.

Vitamin D Levels and SARS-CoV-2 Infection among Medically Underserved Populations in the Minority and Rural Coronavirus Insights Study

“…Additionally, African American people experience lower serum vitamin D levels [ 19 ]. Our findings are consistent with those of Rodriguez and colleagues who concluded that Hispanics experience increased odds of SARS-CoV-2 infection [ 20 ].…”

Trends in national and county-level Hispanic mortality in the United States, 2011–2020

“…A systematic review showed disproportionately higher COVID-19 related mortality in Hispanic populations 12 . In a large health system in Northern California, Hispanic populations were more likely than non-Hispanic populations to test positive for SARS-CoV-2 13 . A recent study of US-wide age- and sex-adjusted deaths further found that Hispanic populations experienced a rise in heart disease and cerebrovascular disease deaths in March-August 2020 as compared with March–August 2019 14 .…”

“…Potential explanations for these findings include Hispanic overrepresentation in frontline or essential roles; a higher likelihood of living in denser communities and multigenerational households, making it more challenging to isolate and contain exposure risk; differential burden of underlying comorbidities such as diabetes; and language differences that may limit access to public health messaging 13 . The links between COVID-19 and downstream effects on the traditional leading causes of death in the US may lead to long-term disparities beyond the pandemic if their structural underpinnings remain unaddressed.…”