COVID-19 accounted for about 11% of all American deaths last year – right behind heart disease and cancer – and thevast majority of patients who died of the virus already had health problems before they were infected,according to two government reports released Wednesday.
The reports from the Centers for Disease Control and Prevention, based on death certificate data, also illustrated the staggering impact COVID-19 had in 2020 on different racial groups.
Overall, American Indian and Alaska Native people were more likely to die than people of the same age from other racial and ethnic groups. Hispanics were second most likely to die of COVID-19, followed by Black people.
“Sadly, based on the current state of the pandemic, these impacts have remained in 2021, where we continue to see that communities of color account for an outsized portion of these deaths,” CDC Director Dr. Rochelle Walensky said during a Wednesday news briefing.
Dr. Abdul El-Sayed, a Michigan-based epidemiologist and former director of the Detroit Health Department, said the findings confirm the disparities public health officials have been reporting.
“If we look at what these death certificates show us, they confirm a lot of the other evidence about the disparities in the experience of COVID-19 in America,” said El-Sayed. “Because of structural racism in our society, people of color in our society tend to have lower access to resources.”
In the study, researchers note death certificate data can lag because of varying submission times between jurisdictions.
“Data are provisional, and numbers and rates might change as additional information is received,” wrote the authors.
They also noted that deaths among certain racial categories might be undercounted. Deaths among American Indian deaths and Asian deaths could be underestimated because of misclassification, the authors said.
The CDC’s analysis standardizes for age, a method essential to understanding the true breadth of COVID-19’s disproportionate impact, experts say. That’s because certain groups, such as white people, have higher life expectancies and a larger senior population, explained Elizabeth Wrigley-Field, a mortality demographer at the University of Minnesota.
“When you compare two populations’ morality, if you don’t adjust for age, your comparison is mostly telling you which population is older,” Wrigley-Field said. “Even relatively small differences in which population has more really old people in it can produce big differences in how many deaths there are.”
Roughly 92% of more than 378,000 death certificates listing COVID-19 also listed a significant health condition, such as diabetes, or a chain-event condition, like pneumonia, or both, the CDC researchers found.
“Pre-existing conditions have been used in the discourse about COVID-19 to excuse a COVID death, when actually the way we should be thinking about pre-existing conditions, is all of the ways that society made someone sick before COVID ever came along, which made them that much more susceptible to COVID and much more likely to die if they got it,” explained El-Sayed.
People of color often have more underlying health problems because of societal factors such as racism, poverty and lack of access to high-quality care, he said.
“The thing that is so striking here is how unbelievably high the morality rates really are,” Wrigley-Field said. “It sort of can’t be said enough. I’m a mortality demographer, and I’m used to looking at death rates all the time. And these are still shocking to me. It’s just a lot of extra death.”
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Reach Nada Hassanein at [email protected] or on Twitter @nhassanein_.
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