Racial impact of COVID may be less than thought

ONE OF THE BIG TAKEAWAYS from the coronavirus pandemic so far has been that the virus has exposed racial inequities in society, with the impact falling hardest on blacks and Hispanics, who tend to live crowded together in poorer communities and work at jobs that require them to leave their homes and ride public transit.

But new, updated information released by the Baker administration suggests that impact may not be as great as previously thought. Blacks and Hispanics in Massachusetts appear to be contracting COVID-19 at higher rates than their population numbers would suggest, but their death rates from the virus are below what could be expected, according to the updated information.

Part of the problem in analyzing the racial impact of COVID-19 has been big gaps in the state’s demographic data. As of Saturday, the racial breakdown of COVID-19 cases and deaths had a large percentage of victims whose race was unknown or missing – 41.2 percent missing for deaths and 39.1 percent for cases.

On Sunday, however, the percentage of unknowns for deaths plummeted to 2.1 percent while dipping slightly to 36.3 percent for cases. State officials said the dramatic decline in the racial makeup of those who died occurred because staff from the Department of Public Health cross-checked cases using death certificates and vital records to determine the race and ethnicity of people who died from COVID-19.

The available evidence for cases continues to suggest that the impact falls disproportionately on blacks and Hispanics. Census data indicate Hispanics account for 12.3 percent of the state’s population, but the state’s COVID dashboard on Monday indicated Hispanics account for 18.6 percent of cases. Blacks account for 8.9 percent of the state’s population, and 9.3 percent of the cases.

Yet that disproportionate impact with cases disappears with the new, more complete death data. Hispanics account for just 6.7 percent of COVID-19 deaths, well below what their population numbers would suggest, and blacks account for 8.3 percent.

Whites, who represent 71.4 percent of the state’s population, account for 29 percent of cases and 73.3 percent of deaths.

Asians are the most surprising demographic of all. They represent 7.1 percent of the state’s population, but only 2 percent of COVID-19 cases and 2.6 percent of deaths.

Baker administration officials released the information on Sunday with no fanfare and on Monday declined to comment on what the discrepancy between demographic data on cases and deaths means.

The state’s new data on COVID-19 deaths appears to run counter to what Harvard epidemiologists found in an analysis of COVID-19 deaths from January 1 to April 12. A Boston Globe report in May on the research said the results were unambiguous. “As the death rate increased across the state in early April, it surged nearly 40 percent higher in cities and towns with the largest concentrations of people of color compared to those with the least. The mortality rate increased nearly 14 percent more in municipalities with the most crowded housing compared to those with the least. And in cities and towns with the most poverty, the death rate increased 9 percent more than those with the least poverty.”

At about the same time, CommonWealth reported on how the racial impact of COVID-19 cases and deaths appeared to diverge, but that was before the state updated the death information. At the time, there was a lot of speculation that the high rate of COVID-19 deaths in nursing homes, whose residents are overwhelmingly white, may have skewed the death data toward whites. According to state figures, nearly 63 percent of all COVID-19 deaths in the state have occurred in nursing homes.

Carlene Pavlos, the executive director of the Massachusetts Public Health Association, raised that possibility in an email on Monday. “As a reminder, we know that the population in Massachusetts’ nursing homes is predominantly White – and nursing home cases are overrepresented in the death data. So, it would be helpful to have the data further broken down to display nursing home deaths by race/ethnicity and deaths in the community by race ethnicity. This is something that Seattle/King County Washington has done,” her email said.

She made one other point. “While we are glad that DPH has done the work to get the race/ethnicity data for deaths, to get a true picture of the epidemic we need to have demographic information on testing, cases, hospitalizations, and deaths,” she said, noting that legislation signed into law by Gov. Charlie Baker on Sunday will provide that.