People of Color Die From COVID-19 at
Younger Age

Laird Harrison

July 13, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

People of color are dying from COVID-19 at younger ages than White people, an analysis from the Centers for Disease Control and Prevention (CDC) suggests.

Among non-White people, 29.5% of those who died were under age 65 years, compared with 13.2% of the White people who died, reported Jonathan M. Wortham, MD, and colleagues from the CDC's COVID-19 Response Team.

"Understanding the demographic and clinical characteristics of decedents could inform medical and public health interventions focused on preventing COVID-19–associated mortality," they write in an article published online July 10 in Morbidity and Mortality Weekly Report.

The researchers first analyzed standardized case-based surveillance reports on deaths of people with laboratory-confirmed COVID-19 from 47 jurisdictions. The reports were from February 12 to May 18.

Among the 52,166 people who died in these reports, 40.3% were White, 21% were Black, 13.8% were Hispanic, 3.9% were Asian, 0.3% were American Indian/Alaska Native (AI/AN), 0.1% were Native Hawaiian or other Pacific Islander (NHPI), 2.6% were multiracial or other race, and race/ethnicity was unknown for 18%.

The median decedent age was 78 years.

But information about underlying medical conditions was missing for 58.9% of these cases, so the CDC requested additional information from medical charts and death certificates. Among the 56 public health agencies contacted, 16 provided supplementary data on 10,647 deaths occurring from February 12 to April 24.

In this sample, 35% of those who died were White, 24.9% were Black, 24.4% were Hispanic, 6.3% were Asian, 0.1% were AI/AN, 0.1% were NHPI, and 2.9% were multiracial or another race. Race/ethnicity was unknown for 6.3%.

The age of death varied by race and ethnicity. The median age was 71 years among Hispanic people; 72 years among all non-White, non-Hispanic people; and 81 years among White people.

The researchers call this finding "notable." As a possible explanation, they point out that the median age of people of color in the United States is 31 years, compared with 44 years for white people.

But Hispanic people made up 33.9% of those who died of COVID-19 at younger than age 65, whereas they only make up 20% of the US population in that age group.

Likewise, non-White, non-Hispanic people made up 40.2% of those who died younger than 65, while they make up only 23% of the US population in that age group.

The researchers speculate that SARS-CoV-2 transmission is higher among Hispanics and non-White individuals than among White people. They point out that larger proportions of Hispanic and non-White individuals work in jobs that make physical distancing difficult.

They also say among those who died at younger than age 65, 7.8% died in an emergency department or at home, and the researchers speculate that people this age might have had more trouble affording an early diagnosis and treatment.

Confirming previous reports, the researchers found that about three quarters of those who died had underlying conditions such as cardiovascular disease or diabetes mellitus. They were not able to investigate the relationship of underlying conditions to race and ethnicity.

"Health care providers should be encouraged to consider the possibility of severe disease among younger persons who are Hispanic, non-white, or have underlying medical conditions," the researchers conclude.

They acknowledge several limitations to the study. In particular, more data were missing for some variables than others; the supplementary data were not from a representative sample of the United States; and different jurisdictions throughout the United States categorize COVID-19–related deaths differently, making it difficult to generalize the findings in the study across the country.

MMWR. Published online July 10, 2020. Full text

Laird Harrison writes about science, health, and culture. His work has appeared in many magazines, newspapers, and online publications. He is at work on a novel about alternate realities in literature and physics. He has taught writing at San Francisco State University, UC Berkeley Extension, and the Writers Grotto. Visit him at lairdharrison.com or follow him on Twitter @LairdH.

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