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Utilizing Electronic Health Records to Study Racial/Ethnic and Social Vulnerability Disparities in COVID-19

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March 8, 2022

The COVID-19 pandemic has disproportionately impacted racial and ethnic minorities and people living in low socioeconomic status areas, who have suffered higher rates of test positivity, infection, hospitalization, and mortality. Multiple factors drive differences in risk of exposure to COVID-19. Occupational exposures to an infected person in the workplace have resulted from a limited ability (or inability) to work remotely, lack of access to personal protective equipment (PPE), and challenges with socially distancing in the workplace. These differences in the risk of exposure to COVID-19 place racial and ethnic minorities at a disadvantage due to racism in capitalist systems and racial residential segregation, both the products of centuries of structural racism.

In COVID-19 policy-relevant research led by Usama Bilal, MD, PhD, MPH, assistant professor, Urban Health Collaborative, the team leveraged data from the Penn Data Warehouse on all COVID-19 tests and hospitalizations from the University of Pennsylvania Health System, one of the largest health systems in the region. The study analyzed disparities in COVID-19 test positivity, hospitalization, in-hospital mortality, and COVID-19 severity indicators, all by race/ethnicity and by neighborhood social vulnerability.

The study found substantial racial and ethnic and neighborhood social vulnerability disparities in testing positivity and risk of hospitalization. For example, non-Hispanic Black individuals and Hispanic individuals in high-social vulnerability areas had 4 to 7 times higher odds of testing positive and 3 times higher odds of hospitalization than non-Hispanic white individuals in low social-vulnerability areas. The authors also found much narrower or nonexistent disparities in in-hospital mortality. The results from this study mirror previous research studies that show the main drivers of COVID-19 disparities to be differences in exposure to COVID-19.

The team included Dr. Alina Schnake-Mahl from the UHC, and Drs. John B. Jemmott, Kathleen Murphy, and Florence Momplaisir from the University of Pennsylvania and the Hospital of the University of Pennsylvania.

Read the full study.