Health disparities and COVID-19: A retrospective study examining individual and community factors causing disproportionate COVID-19 outcomes in Cook County, Illinois

  1. Larissa H. Unruh
  2. Sadhana Dharmapuri
  3. Yinglin Xia
  4. Kenneth Soyemi

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Abstract

Early data from the COVID-19 pandemic suggests that the disease has had a disproportionate impact on communities of color with higher infection and mortality rates within those communities. This study used demographic data from the 2018 US census estimates, mortality data from the Cook County Medical Examiner’s office, and testing results from the Illinois Department of Public Health to perform bivariate and multivariate regression analyses to explore the role race plays in COVID-19 outcomes at the individual and community levels. We used the ZCTA Social Deprivation Index (SDI), a measure of ZCTA area level deprivation based on seven demographic characteristics to quantify the socio-economic variation in health outcomes and levels of disadvantage across ZCTAs. Principal findings showed that: 1) while Black individuals make up 22% of Cook County’s population, they account for 28% of the county’s COVID-19 related deaths; 2) the average age of death from COVID-19 is seven years younger for Non-White compared with White decedents; 3) residents of Minority ZCTA areas were 1.02 times as likely to test positive for COVID-19, (Incidence Rate Ratio (IRR) 1.02, [95% CI 0.95, 1.10]); 1.77 times as likely to die (IRR 1.77, [95% CI 1.17, 2.66]); and were 1.15 times as likely to be tested (IRR 1.15, [95% CI 0.99, 1.33]). There are notable differences in COVID-19 related outcomes between racial and ethnic groups at individual and community levels. This study illustrates the health disparities and underlying systemic inequalities experienced by communities of color.

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  1. Version published to 10.1371/journal.pone.0268317
  2. ScreenIT

    SciScore for 10.1101/2020.08.21.20179317: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Experimental Models: Organisms/Strains
    SentencesResources
    Minority was defined as any race or ethnic group other than Non-Hispanic White (White).
    Non-Hispanic White
    suggested: None

    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).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

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

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Rapid Reviews Infectious Diseases

    Zahid Butt

    Review 2: "Health Disparities and COVID-19: A Retrospective Study Examining Individual and Community Factors Causing Disproportionate COVID-19 Outcomes in Cook County, Illinois, March 16-May 31, 2020"

    This study provides further empirical evidence about the racial differences in COVID-19 morbidity and mortality. The preprint is potentially informative and somewhat reliable, but there are unmeasured confounders and it lacks some clarity around some data points.

  4. Rapid Reviews Infectious Diseases

    Philip Schluter

    Review 1: "Health Disparities and COVID-19: A Retrospective Study Examining Individual and Community Factors Causing Disproportionate COVID-19 Outcomes in Cook County, Illinois, March 16-May 31, 2020"

    This study provides further empirical evidence about the racial differences in COVID-19 morbidity and mortality. The preprint is potentially informative and somewhat reliable, but there are unmeasured confounders and it lacks some clarity around some data points.

  6. Version published to 10.1101/2020.08.21.20179317v1 on medRxiv