The United States is on track to hit a grim COVID-19 milestone. Soon, over one million people will have lost their lives to the pandemic., While daily death rates have fallen, the average number of daily cases is back on the rise – increasing 49% in the past two weeks. Throughout the pandemic, these case rates and death tolls have not been evenly distributed – a pattern further expanded upon by the authors of a Research Letter recently published in JAMA Internal Medicine. The study attempts to explore the pandemic’s full, societal-level impact on mortality for racial and ethnic minority populations. The authors leveraged monthly death data for external causes of death (i.e., drug overdose, transportation, homicide, and suicide) from the Centers for Disease Control and Prevention.
Starting with a forecast of expected deaths from external causes (which was derived from monthly death count data between January 2015 and February 2020), the researchers calculated the number of “excess deaths” from March to December 2020 by subtracting their forecasted death number from the number of actual observed deaths during that period. Their findings revealed over 17,000 excess deaths from all external causes in the US. The researchers estimate these excess deaths were highest among Black and American Indian or Alaska Native individuals. Black individuals, furthermore, had the highest estimated excess homicide deaths per capita (6.7 per 100,000 population), which was more than double the rate of the next highest group (American Indian or Alaska Native individuals).  Meanwhile, excess transportation-related deaths (auto accidents, etc.) were only evident among Black and Hispanic individuals.
The researchers suggest that “the pandemic contributed to these disparities through both direct and indirect mechanisms.” Structural racism was identified as the root cause of the disparities in excess deaths from external causes. The researchers also note that discrimination against Black and American Indian or Alaska Native populations produced communities that were especially vulnerable to the consequences of the pandemic, such as unemployment, housing instability, and reduced access to health care. The authors emphasize the importance of addressing structural determinants of violence, substance abuse, and transportation deaths among racial and ethnic minority groups.
May 12, 2022 – C. St. John
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 Parker, J. E. The ‘five pandemics’ driving 1 million U.S. covid deaths. STAT. (May 10, 2022). Available at: https://www.statnews.com/2022/05/10/the-five-pandemics-driving-1-million-u-s-covid-deaths/
 The New York Times. Coronavirus in the U.S.: Latest Map and Case Count. (Updated May 10, 2022). Available at: https://www.nytimes.com/interactive/2021/us/covid-cases.html
 CDC. Health Equity Considerations and Racial and Ethnic Minority Groups. Centers for Disease Control and Prevention. (Updated January 25, 2022). Available at: https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html
 Ling, I., Del Rosario, M., & Gross, C. P. The COVID-19 Pandemic and Racial and Ethnic Disparities in Estimated Excess Mortality from External Causes. Editor’s Note. (May 9, 2022). Available at: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2791683?guestaccesskey=0e24d0b4-7d02-496b-a97b-4ac908f24fea&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=olf&utm_term=050922
 Chen, R., Aschmann, H. E., & Chen, Y.-H. Racial and Ethnic Disparities in Estimated Excess Mortality from External Causes in the US, March to December 2020. JAMA Internal Medicine. (May 9, 2022). Available at: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2791682?widget=personalizedcontent&previousarticle=2791683