Evidence on COVID-19 Mortality and Disparities Using a Novel Measure, COVID excess mortality percentage: Evidence from Indiana, Wisconsin, and Illinois

Authors

Vladimir Atanasov, William & Mary, Mason School of Business, Williamsburg, Virginia, United States of America.
Natalia Barreto, University of Illinois, Champaign-Urbana, Illinois, United States of America.
Lorenzo Franchi, Northwestern University, Evanston, Illinois, United States of America.
Jeff Whittle, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America.
John Meurer, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America.
Benjamin W. Weston, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America.
Qian Eric Luo, George Washington University, Washington, DC, United States of America.
Andy Ye Yuan, Northwestern University, Pritzker School of Law, Evanston, Illinois, United States of America.
Ruohao Zhang, Pennsylvania State University, State College, Pennsylvania, United States of America.
Bernard Black, Northwestern University, Pritzker School of Law and Kellogg School of Management, Evanston, Illinois, United States of America.

Document Type

Journal Article

Publication Date

1-1-2024

Journal

PloS one

Volume

19

Issue

1

DOI

10.1371/journal.pone.0295936

Abstract

COVID-19 mortality rates increase rapidly with age, are higher among men than women, and vary across racial/ethnic groups, but this is also true for other natural causes of death. Prior research on COVID-19 mortality rates and racial/ethnic disparities in those rates has not considered to what extent disparities reflect COVID-19-specific factors, versus preexisting health differences. This study examines both questions. We study the COVID-19-related increase in mortality risk and racial/ethnic disparities in COVID-19 mortality, and how both vary with age, gender, and time period. We use a novel measure validated in prior work, the COVID Excess Mortality Percentage (CEMP), defined as the COVID-19 mortality rate (Covid-MR), divided by the non-COVID natural mortality rate during the same time period (non-Covid NMR), converted to a percentage. The CEMP denominator uses Non-COVID NMR to adjust COVID-19 mortality risk for underlying population health. The CEMP measure generates insights which differ from those using two common measures-the COVID-MR and the all-cause excess mortality rate. By studying both CEMP and COVID-MRMR, we can separate the effects of background health from Covid-specific factors affecting COVID-19 mortality. We study how CEMP and COVID-MR vary by age, gender, race/ethnicity, and time period, using data on all adult decedents from natural causes in Indiana and Wisconsin over April 2020-June 2022 and Illinois over April 2020-December 2021. CEMP levels for racial and ethnic minority groups can be very high relative to White levels, especially for Hispanics in 2020 and the first-half of 2021. For example, during 2020, CEMP for Hispanics aged 18-59 was 68.9% versus 7.2% for non-Hispanic Whites; a ratio of 9.57:1. CEMP disparities are substantial but less extreme for other demographic groups. Disparities were generally lower after age 60 and declined over our sample period. Differences in socio-economic status and education explain only a small part of these disparities.

APA Citation

Atanasov, Vladimir; Barreto, Natalia; Franchi, Lorenzo; Whittle, Jeff; Meurer, John; Weston, Benjamin W.; Luo, Qian Eric; Yuan, Andy Ye; Zhang, Ruohao; and Black, Bernard, "Evidence on COVID-19 Mortality and Disparities Using a Novel Measure, COVID excess mortality percentage: Evidence from Indiana, Wisconsin, and Illinois" (2024). GW Authored Works. Paper 4101.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4101

Department

Health Policy and Management