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Newton EH, Valenzuela RG, Cruz-Menoyo PM, Feliberti K, Shub TD, Trapini CZM, Espinosa de Los Reyes S, Melian CM, Peralta LD, Alcalá HE. Racial/Ethnic Differences in Non-Discretionary Risk Factors for COVID-19 Among Patients in an Early COVID-19 Hotspot. J Racial Ethn Health Disparities 2023; 10:2363-2373. [PMID: 36178630 PMCID: PMC9524304 DOI: 10.1007/s40615-022-01416-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/06/2022] [Accepted: 09/16/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Baseline disparities in non-discretionary risk factors, i.e., those not readily altered, like family size and work environment, appear to underlie the disproportionate COVID-19 infection rates seen among Hispanic persons and, at surge onsets, Black persons. No study has systematically compared such risk factors by race/ethnicity among infected individuals. METHODS Using a cross-sectional survey, we compared household, job, and socioeconomic characteristics among 260 Hispanic, non-Hispanic Black, and non-Hispanic White adults with confirmed or probable COVID-19 in New York from March to May 2020. We used logistic regression to identify independent relationships. RESULTS In bivariate analysis, we found significant differences by race/ethnicity in the following: (1) rates of household crowding (p < 0.001), which were highest for Hispanic patients (45.1%) and lowest for White patients (0.9%); (2) rates of non-healthcare frontline work (p < 0.001), which were highest for Hispanic patients (71.0% of those employed) and lowest for White patients (31.4%); (3) rates of working close to people (p < 0.001), which were highest for Black patients (69.4%) and lowest for Hispanic patients (32.3%); and (4) rates of frontline healthcare work (p = 0.004), which were higher for Black (44.9%) and White (44.3%) patients than Hispanic patients (19.4%). Adjusting for covariates eliminated most differences but not that for household crowding. CONCLUSIONS Non-discretionary COVID-19 risk factors among patients in the initial surge differed substantially by race/ethnicity. Socioeconomic factors explained most differences, but household crowding was independently associated with Hispanic ethnicity. Our findings highlight the ongoing need for universal safeguards for US frontline workers, including mandated paid sick leave and expanded affordable housing options.
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Affiliation(s)
- Erika H Newton
- Department of Emergency Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, HSC L4-050, New York, NY, 11794-8350, USA.
| | - Rolando G Valenzuela
- Department of Emergency Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, HSC L4-050, New York, NY, 11794-8350, USA
| | - Priscilla M Cruz-Menoyo
- Department of Emergency Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, HSC L4-050, New York, NY, 11794-8350, USA
| | - Kimberly Feliberti
- Department of Emergency Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, HSC L4-050, New York, NY, 11794-8350, USA
- AdventHealth Celebration, Celebration, Orlando, FL, USA
| | - Timothy D Shub
- Department of Emergency Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, HSC L4-050, New York, NY, 11794-8350, USA
| | - Cadence Z M Trapini
- Renaissance School of Medicine at Stony, Brook University, Stony Brook, New York, NY, USA
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA
| | | | - Christina M Melian
- Renaissance School of Medicine at Stony, Brook University, Stony Brook, New York, NY, USA
| | - Leslie D Peralta
- Renaissance School of Medicine at Stony, Brook University, Stony Brook, New York, NY, USA
| | - Héctor E Alcalá
- Department of Family, Population and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, New York, NY, USA
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
- Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
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