Not a New Story: Place- and Race-Based Disparities in COVID-19 and Influenza Hospitalizations among Medicaid-Insured Adults in New York City

Abstract

While SARS-CoV-2 is a novel virus, contagious respiratory illnesses are not a new problem. Limited research has examined the extent to which place- and race-based disparities in severe illness are similar across waves of the COVID-19 pandemic and historic influenza seasons. In this study, we focused on these disparities within a low-income population, those enrolled in Medicaid in New York City. We used 2015–2020 New York State Medicaid claims to compare the characteristics of patients hospitalized with COVID-19 during three separate waves of 2020 (first wave: January 1–April 30, 2020; second wave: May 1–August 31, 2020; third wave: September 1–December 31, 2020) and with influenza during the 2016 (July 1, 2016–June 30, 2017) and 2017 influenza seasons (July 1, 2017–June 30, 2018). We found that patterns of hospitalization by race/ethnicity and ZIP code across the two influenza seasons and the first wave of COVID-19 were similar (increased risk among non-Hispanic Black (aOR = 1.17, 95% CI: 1.10–1.25) compared with non-Hispanic white Medicaid recipients). Black/white disparities in hospitalization dissipated in the second COVID wave and reversed in the third wave. The commonality of disparities across influenza seasons and the first wave of COVID-19 suggests there are community factors that increase hospitalization risk across novel respiratory illness incidents that emerge in the period before aggressive public health intervention. By contrast, convergence in hospitalization patterns in later pandemic waves may reflect, in part, the distinctive public health response to COVID-19.

Association Between Race/Ethnicity and COVID‐19 Outcomes in Systemic Lupus Erythematosus Patients From the United States: Data From the COVID‐19 Global Rheumatology Alliance

“…Individuals of lower socioeconomic status are also more likely to live in crowded settings, limiting their ability to prevent household exposure to infected individuals ( 15 ). When each wave was evaluated independently, the differences between Black, Hispanic, and White individuals was more evident during the first wave of the pandemic than afterward, reflecting, perhaps, the impact of health policy changes and of immunity acquired through earlier infection ( 16 ). Similarly, in the UK, racial and ethnic minorities were more likely to be hospitalized, to be admitted to an ICU, and to die of COVID‐19 ( 17 ).…”