The data presented in the findings show that there were significant disparities in health and health care prior to the COVID-19 pandemic. Many of these underlying disparities placed people of color at increased risk for negative health and economic impacts from the pandemic. Moreover, the pandemic has exacerbated many of these disparities and may contribute to widening disparities in the future.

Age-adjusted data from the Centers for Disease Control and Prevention (CDC) show that, overall, people of color are at higher risk for COVID-19 infection, hospitalization, and death compared to their White counterparts. As of late November 2021, Black and Hispanic people were more than 2.5 times as likely as White people to be hospitalized for COVID-19, while AIAN were over 3 times as likely to be hospitalized (Figure 40). Moreover, AIAN, Hispanic, and Black people were roughly twice as likely as White people to die from COVID-19.

Data over time show some narrowing in disparities in cases and deaths for Black and Hispanic people, although recent trends suggest disparities may be reemerging (Figure 41). After earlier periods of sharp disparities, infection rates across White, Black, and Hispanic people came closer together by September 2021. Death rates for Black and White people were also similar as of September 2021, while they were lower for Hispanic people. In contrast, infection and death rates for AIAN people have remained higher compared to other groups, while rates for Asian people have been lower. As of early December 2021, infection rates remained highest for AIAN people, followed by White, Hispanic, and Black people, while Asian people remained at lowest risk of infection. However, by mid to late December 2021, disparities in infection rates reemerged for Black and Hispanic people as the Omicron variant spread. Additionally, a sharp increase in the infection rates for Asian people led to higher rates of infection among this group compared to White people, a reversal in the trend overall. In contrast, death rates for Hispanic and Black people remain similar and have declined through mid-December 2021, with the highest death rates among White and AIAN people.

Beyond these direct health impacts, analysis also shows that people of color also are facing greater social and economic challenges during the pandemic. Consistent with patterns prior to the pandemic, Black and Hispanic adults fare worse than White adults across nearly all examined measures of social and economic factors, including difficulty paying household expenditures, no confidence in their ability to make next month’s housing payment, and food insufficiency. Further, they were more likely to report living in a household that experienced a recent loss of employment income.

Despite being disproportionately affected by the pandemic, Black and Hispanic people have been less likely than White people to receive COVID-19 vaccines, although these differences have narrowed over time. Survey data suggest that these initial gaps in vaccination for Black and Hispanic people were, in part, driven by increased barriers to accessing vaccinations, reflecting broader underlying disparities in access to care and social and economic inequities. The increasing equity in vaccination rates likely reflects a combination of efforts focused on increasing vaccination rates among people of color through outreach and education and reducing access and logistical barriers to vaccination, increased interest in getting the vaccine due to the spread of the Delta and Omicron variants, and increases in vaccinations among younger adults and adolescents who include higher shares of people of color compared to other adults. Despite this progress, the ongoing disparities in rates highlight the importance of continued efforts to increase vaccination rates and to address gaps in vaccination both geographically and across racial/ethnic groups. Moreover, it will be important to prevent disparities in uptake of booster shots and among children between ages 5 to 11, the latest group to become eligible for the vaccine.

Social Determinants of Health Methods

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