May 26, 2022

The United States has been one of the countries most affected by the COVID-19 pandemic. The Hispanic community and other minoritized racial/ethnic groups have been disproportionately affected throughout the country. Although inequities in COVID-19 outcomes have received substantial attention in academic research, most studies have focused on disparities measured at the state level. Urban areas face different public health challenges unique to their spatial and contextual composition. These challenges, heightened by the ongoing pandemic, further burden the disadvantaged populations within such areas. Examining differences in COVID-19 outcomes across cities among minoritized racial/ethnic groups can help identify equitable interventions and responses to the pandemic.

A research article in the American Journal of Public Health, lead author Isabel P. De Ramos, MS, a research assistant at the UHC, examined disparities in COVID-19 incidence, hospitalization, mortality, and vaccination coverage between the Hispanic and non-Hispanic white populations of 27 of the 30 jurisdictions whose health departments were members of the Big Cities Health Coalition (BCHC). The team used data from the BCHC COVID-19 Inequities in Cities Dashboard project. The dashboard, supported by the Robert Wood Johnson Foundation, compares and tracks COVID-19 inequities across the BCHC member cities. 

Hispanic individuals had rates more than double those of white individuals in more than half of the cities with respect to incidence, in most cities with respect to hospitalizations, and in all cities with respect to mortality. Moreover, in all but 1 of the 13 cities with available vaccination data, the Hispanic population had lower vaccination rates than those of the white population. These disparities may reflect differential exposures and vulnerabilities to COVID-19 among the Hispanic population. Hispanic individuals are more likely than white individuals to work in service-related occupations and essential job sectors and live in overcrowded and/or multigenerational housing. Moreover, the Hispanic population has a higher burden of factors associated with migration and citizenship status, including a lack of culturally and linguistically appropriate medical care, insufficient health insurance coverage, and the fear of being penalized for using public benefit programs (i.e., the 2019 public charge rule) – all of which may prompt Hispanic individuals to further forgo seeking medical services and treatment during the pandemic. Structural racism and discrimination against minority populations in the U.S. alongside a history of medical mistrust due to past injustices also help explain these pervasive disparities in COVID-19 outcomes.

Inequalities in COVID-19 outcomes among the Hispanic population suggest that this population and other minoritized racial/ethnic groups may have a higher likelihood of facing adverse health outcomes as the pandemic continues, although recent trends in vaccination among the Hispanic population are encouraging. Dismantling these structural and social barriers can help fortify COVID-19 recovery efforts.

The article also includes other members of the UHC, including Mariana Lazo, Ran Li, Ana Diez-Roux, and Usama Bilal, along with faculty member at Community Health and Prevention Ana Martinez-Donate.

Read the full article.