Some Observations on Higher African-American COVID-19 Death Rates in the USA

The literature on the impact of COVID-19 on communities has overwhelmingly concluded that minority communities, especially African-Americans, have disproportionately borne the brunt of the virus in the USA. But figures on deaths and infections from March 2021 show that disparities have been narrowing down – the death rates (Total Deaths divided by Population) of African-Americans and Whites have been converging. In this study we aim to assess the impact of the pandemic on African-Americans vis-a-vis the Whites by decomposing the nationwide statistics across states and seeking causes of disparities in the case-fatality ratio (Total Deaths divided by Total Infections) and the incidence rate (Total Deaths divided by Population). Using weighted-logistic regression, we also try to find factors that have a strong association, and can explain the interstate disparities. Towards the end of the first wave of the pandemic in the USA, the death rates of African-Americans were significantly higher in most of the states owing to large disparities in the incidence rates among African-Americans. The Whites had higher case-fatality ratios in most of the states but this was not able to counteract the effect of higher incidence rates. However, towards the end of the second wave, the differences in case-fatality ratios had a bigger effect on the differences in the death rates, as a result of which death rates were higher among Whites in most of the states. Despite the convergence, the results tell us that the incidence rate among African-Americans were significantly higher in 80% of the states, and there were large interstate disparities in the difference in the death rates.Lastly, from the regression analysis, we find that African-American poverty rates, and the share of African-Americans in the state have a strong positive association with the incidence rate and the death rate of African-Americans. The key contribution of the paper is to develop a framework to understand the issues of racial health disparity pertaining to COVID-19, and subsequently, to prescribe the correct policy response. In assessing disparities, the results demonstrate that it was a ‘public health’ problem amongst the African-Americans whereas it was a ‘healthcare’ problem among the Whites.