Surprising racial twist in COVID-19 data

Equity gaps in virus cases not found in deaths

A SURPRISING RACIAL and ethnic dynamic appears to be emerging in the coronavirus data gathered by the Massachusetts Department of Public Health.

Hispanic and black people are suffering from COVID-19 infections at much higher rates than whites, according to the available data. The data has led many to conclude that the coronavirus is a disease that disproportionally impacts low-income and minority communities packed in tight quarters and unable to work from home. Many analysts have said the disease is revealing the vast underlying racial and economic inequities in our society.

Yet those inequities are not apparent when it comes to coronavirus deaths. The available state data indicate blacks, Hispanics, and whites are dying from COVID-19 at fairly similar rates.

Carlene Pavlos, executive director of the Massachusetts Public Health Association, released an analysis in April that concluded Latinx residents were becoming infected by the coronavirus at three times the rate of whites. The rate for blacks was two-and-a-half times that of whites. Asian residents were the only minority group that bucked the trend, contracting COVID-19 at 60 percent of the rate of whites.

Pavlos said the case data reveals an underlying problem in society. “The inequities in cases speak to inequities in housing, transportation, access to paid leave and sick time, ability to work from home and more,” she said in an email. “This pandemic is exposing these inequities and our state’s willingness to tolerate them.  Inequity is not inevitable – it is the result of policies and practices.  We can change these things and to do so, we should be acting with urgency.”

At CommonWealth’s request, Pavlos performed the same analysis for COVID-19 deaths, which yielded a very different outcome. She found Hispanics and Latinx people were at lower risk of death than whites while blacks had a slightly elevated risk of death compared to whites. For Hispanics, she said, the rate was eight-tenths that of whites; for blacks, it was 1.2 times the rate of whites. Both rates were significantly less than those for COVID-19 cases.

Pavlos and other COVID-19 researchers are severely handicapped by the paucity of available racial and ethnic data. The state’s COVID-19 dashboard indicates racial and ethnic information is missing for roughly 46 percent of COVID-19 cases and deaths, so any analysis requires extrapolations and should be viewed with some caution.

Still, the available information does indicate a striking difference between infections and deaths. As of Sunday, whites accounted for 24.5 percent of COVID-19 cases and 38.4 percent of deaths. Hispanics represented 15.3 percent of cases and 5.9 percent of deaths. Blacks were 8.3 percent of cases and 5.1 percent of deaths. Asians were 1.7 percent of both cases and deaths. Other racial and ethnics groups accounted for 4 percent of cases and 3.1 percent of deaths.

The percentages could change and possibly change dramatically as the missing information for cases and deaths is retrieved.

What could account for the racial differences in cases and deaths?

At a press conference on Thursday, Marylou Sudders, the governor’s secretary of health and human services, suggested it could be related to the fact that 60 percent of all COVID-19 deaths occur in long-term care facilities.

Sudders did not elaborate, but Massachusetts nursing home residents are overwhelmingly white. According to federal data, 84 percent of the residents of Massachusetts nursing facilities were white as of the fourth quarter of 2019. It’s possible that the huge number of deaths in nursing facilities are driving up the overall percentage of white deaths from COVID-19 in Massachusetts.

Why nursing home residents in Massachusetts are so overwhelmingly white is unclear, but industry officials suspect it’s part cultural and part socioeconomic.

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Bruce Mohl

Editor, CommonWealth

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

The Boston Globe reported on Sunday that Harvard epidemiologists had examined the home addresses of 20,000 people who died during the first 15 weeks of 2020, roughly January 1 through April 12.  The researchers found that deaths surged 40 percent higher in “cities and towns with the largest concentrations of people of color compared to those with the least.” They also found the mortality rate increased nearly 14 percent more in communities with the most crowded housing and 9 percent more in communities with the most poverty.

The timing of the Harvard analysis may have missed the dramatic growth in nursing home deaths in Massachusetts. As of April 12, the end date for the Harvard research, the number of COVID-19 deaths in long-term care facilities was 337, compared to 416 in hospitals and other locations. As of Sunday, less than a month later, the number of people who have died in long-term care facilities had grown nine-fold to 3,001, while the deaths in hospitals and everywhere else had grown nearly five-fold to 1,978.