Long after calls for more data on the disproportionate number of Covid-19 infections and deaths among Black Americans and Hispanic Americans, the Centers for Disease Control and Prevention on Friday released limited additional information, which revealed non-white and Hispanic Americans under age 65 are dying in greater numbers than white people in that age group.
The agency reported that more than a third of deaths among Hispanic Americans (34.9%) and almost a third of deaths among non-white Americans (29.5%) were in people younger than 65. That compares to 13.2% among white people under that age.
Non-white Americans (median age 31) are younger as a whole than white Americans (median age 44), but Covid-19 deaths among those under age 65 exceeded their proportion of the population. The researchers found that 33.9% of people under 65 who died were Hispanic, yet they account for just 20% of the under-65 population in the U.S. Similarly, Black, Asian, and other non-white people accounted for 40.2% of deaths under 65, though they make up just 23% of those under 65 nationally. Black people accounted for 30% of deaths under age 65; Asian people and multiracial people accounted for 6.1% and 4.1%, respectively.
Those numbers are in line with both clinical and social factors tied to Covid-19 infections and deaths, said Utibe Essien, a physician and assistant professor of medicine at the University of Pittsburgh. He published a paper in May detailing the lack of comprehensive race, ethnicity, and language data related to Covid-19 testing, infection, and death rates.
Black Americans tend to be younger when they have chronic risk factors — cardiovascular disease, diabetes, obesity, chronic pulmonary disease — most likely to be associated with Covid-19 infection and severe infection. It’s been known for decades that the rate of premature cardiovascular deaths is higher in Black Americans than white Americans.
“We have been worried about the lack of age-adjusted data,” Essien said. “Now that we have more age-adjusted data, we really are seeing that disparity.”
As for social factors, Black and Hispanic individuals are more likely to be essential workers and less likely to have had the choice of working from home over the last four months, he said.
For its report, the CDC culled data from public health records of 52,166 deaths in 47 jurisdictions between Feb. 12 and May 18 around the country. It requested more demographic and clinical information on 10,457 deaths between Feb. 12 and April 24 from 16 locations, such as race and ethnicity as well as underlying medical conditions and place of death.
During the shorter time period, 93.9% of deaths were in New York and neighboring New Jersey and Connecticut, plus the state of Washington, reflecting widespread circulation of the virus in those states earlier this year. Coronavirus cases are now flaring in other hot spots around the country, such as Arizona, Texas, Florida, and California, including higher case counts among young people than earlier in the pandemic.
Where people included in the CDC report died was also different: Younger people were more likely to be at home or in a hospital emergency room versus older people in hospitals or long-term care settings.
The CDC report called for more research before drawing conclusions. “Although these data did not permit assessment of interactions between race/ethnicity, underlying medical conditions, and nonbiologic factors, further studies to understand and address these racial/ethnic differences are needed to inform targeted efforts to prevent COVID-19 mortality,” it said.
The reasons for the dearth of racial and ethnic data are not clear, Essien said, noting that CDC depends on local health departments to gather and share demographic and clinical information. Some states still are not including race and ethnicity in test results, he pointed out.
“I do want to believe that the CDC is committed to this work,” he said. “A lot of these are structural factors that, of course, we can’t just snap and fix, but I hope our society and our health system are really starting to consider just how critical these are, especially during the pandemic.”