TY - JOUR
T1 - Racial/Ethnic, Biomedical, and Sociodemographic Risk Factors for COVID-19 Positivity and Hospitalization in the San Francisco Bay Area
AU - Cho, Wendy K.Tam
AU - Hwang, David G.
N1 - Funding Information:
This research was supported in part by unrestricted grants to DGH from All May See (formerly That Man May See) and to DGH from Research to Prevent Blindness.
Funding Information:
The authors wish to thank Ashly Dyke for assistance with the literature review. This work used the Extreme Science and Engineering Discovery Environment (XSEDE), which is supported by National Science Foundation grant number ACI-1548562. Computing resources were granted through the HPC Consortium for access to Pittsburgh Supercomputer Center’s Bridges, Bridges-2, and Bridges-AI.
Publisher Copyright:
© 2022, W. Montague Cobb-NMA Health Institute.
PY - 2022
Y1 - 2022
N2 - Background: The COVID-19 pandemic has uncovered clinically meaningful racial/ethnic disparities in COVID-19-related health outcomes. Current understanding of the basis for such an observation remains incomplete, with both biomedical and social/contextual variables proposed as potential factors. Purpose: Using a logistic regression model, we examined the relative contributions ofrace/ethnicity, biomedical, and socioeconomic factors to COVID-19 test positivity and hospitalizationrates in a large academic health care system in the San Francisco Bay Area prior tothe advent of vaccination and other pharmaceutical interventions for COVID-19. Results: Whereas socioeconomic factors, particularly those contributing to increased social vulnerability, were associated with test positivity for COVID-19, biomedical factors and disease co-morbidities were the major factors associated with increased risk of COVID-19 hospitalization. Hispanic individuals had a higher rate of COVID-19 positivity, while Asian persons had higher rates of COVID-19 hospitalization. The excess hospitalization risk attributed to Asian race was not explained by differences in the examined biomedical or sociodemographic variables. Diabetes was an important risk factor for COVID-19 hospitalization, particularly among Asian patients, for whom diabetes tended to be more frequently undiagnosed and higher in severity. Conclusion: We observed that biomedical, racial/ethnic, and socioeconomic factors all contributed in varying but distinct ways to COVID-19 test positivity and hospitalization rates in a large, multi-racial, socioeconomically diverse metropolitan area of the United States. The impact of a number of these factors differed according to race/ethnicity. Improving overall COVID-19 health outcomes and addressing racial and ethnic disparities in COVID-19 outcomes will likely require a comprehensive approach that incorporates strategies that target both individual-specific and group contextual factors.
AB - Background: The COVID-19 pandemic has uncovered clinically meaningful racial/ethnic disparities in COVID-19-related health outcomes. Current understanding of the basis for such an observation remains incomplete, with both biomedical and social/contextual variables proposed as potential factors. Purpose: Using a logistic regression model, we examined the relative contributions ofrace/ethnicity, biomedical, and socioeconomic factors to COVID-19 test positivity and hospitalizationrates in a large academic health care system in the San Francisco Bay Area prior tothe advent of vaccination and other pharmaceutical interventions for COVID-19. Results: Whereas socioeconomic factors, particularly those contributing to increased social vulnerability, were associated with test positivity for COVID-19, biomedical factors and disease co-morbidities were the major factors associated with increased risk of COVID-19 hospitalization. Hispanic individuals had a higher rate of COVID-19 positivity, while Asian persons had higher rates of COVID-19 hospitalization. The excess hospitalization risk attributed to Asian race was not explained by differences in the examined biomedical or sociodemographic variables. Diabetes was an important risk factor for COVID-19 hospitalization, particularly among Asian patients, for whom diabetes tended to be more frequently undiagnosed and higher in severity. Conclusion: We observed that biomedical, racial/ethnic, and socioeconomic factors all contributed in varying but distinct ways to COVID-19 test positivity and hospitalization rates in a large, multi-racial, socioeconomically diverse metropolitan area of the United States. The impact of a number of these factors differed according to race/ethnicity. Improving overall COVID-19 health outcomes and addressing racial and ethnic disparities in COVID-19 outcomes will likely require a comprehensive approach that incorporates strategies that target both individual-specific and group contextual factors.
KW - Asian
KW - COVID-19
KW - Diabetes mellitus
KW - Racial health disparities
KW - Risk factors
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U2 - 10.1007/s40615-022-01351-1
DO - 10.1007/s40615-022-01351-1
M3 - Article
C2 - 35852709
AN - SCOPUS:85134550090
SN - 2197-3792
JO - Journal of racial and ethnic health disparities
JF - Journal of racial and ethnic health disparities
ER -