Estimated inequities in COVID-19 infection fatality rates by ethnicity for Aotearoa New Zealand

  1. Nicholas Steyn
  2. Rachelle N. Binny
  3. Kate Hannah
  4. Shaun C. Hendy
  5. Alex James
  6. Tahu Kukutai
  7. Audrey Lustig
  8. Melissa McLeod
  9. Michael J. Plank
  10. Kannan Ridings
  11. Andrew Sporle

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Abstract

There is limited evidence as to how COVID-19 infection fatality rates (IFR) may vary by ethnicity. We combine demographic and health data for ethnic groupings in Aotearoa New Zealand with international data on IFR for different age groups to estimate inequities in IFR by ethnicity. We find that, if age is the dominant factor determining IFR, estimated IFR for Māori is around 50% higher than non-Māori. If underlying health conditions are more important than age per se, then estimated IFR for Māori is more than 2.5 times that of New Zealand European, and estimated IFR for Pasifika is almost double that of New Zealand European. IFRs for Māori and Pasifika are likely to be increased above these estimates by racism within the healthcare system and other inequities not reflected in official data. IFR does not account for differences among ethnicities in COVID-19 incidence, which could be higher in Māori and Pasifika as a result of crowded housing and higher inter- generational contact rates. These factors should be included in future disease incidence modelling. The communities at the highest risk will be those with elderly populations, and Māori and Pasifika communities, where the compounded effects of underlying health conditions, socioeconomic disadvantage, and structural racism result in imbricated risk of contracting COVID-19, becoming unwell, and death.

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    SciScore for 10.1101/2020.04.20.20073437: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

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    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
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    • No protocol registration statement was detected.

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  2. Version published to 10.1101/2020.04.20.20073437v1 on medRxiv