New Jersey’s communities of color are experiencing disproportionate impacts of COVID-19 in diagnosis rates and mortality rates, according to an analysis from the Center for Health Analytics, Research and Transformation at the New Jersey Hospital Association.
NJHA’s analysis, based on hospital discharge data, shows that Asian and Hispanic individuals have higher age-adjusted diagnosis rates, while black patients have the highest age-adjusted mortality rate.
Age-adjusted diagnosis rates by race/ethnicity and gender showed:
- Asians had the highest age-adjusted diagnosis rate, at 25.7 per hundred population for males and 21.3 per hundred population for females.
- Hispanics had the second-highest age-adjusted diagnosis rate, at 20.3 per hundred population for males and 17.6 per hundred for females.
The most impacted communities differ when examining those with the highest age-adjusted COVID-19 mortality rate. The analysis showed:
- Black New Jerseyans have the highest COVID-19 age-adjusted mortality rate of 8.4 per hundred population for males and 7.4 per hundred population for females
- White patients followed, with a 7.9 per hundred population mortality rate for males and 5.7 per hundred population for females.
- Hispanics had the third-highest COVID-19 mortality rate, at 7.8 per hundred population for males and 5 per hundred population for women.
“The data reported by hospitals daily throughout the COVID-19 outbreak has provided glimpses of this problem, but CHART’s deeper analysis helps us learn much more about the outsized impact on our communities of color,” said Cathy Bennett, president and CEO of the New Jersey Hospital Association. “This data is a valuable starting point for us to better understand the impact of this virus – and potentially other novel viruses – for improved planning, surveillance and response in future outbreaks.”
The data was drawn from patient records submitted by hospitals through the New Jersey Hospital Discharge Data Collection System. The data contains 75,895 discharges submitted as of April 1, 2020, of which 12,581 were identified as COVID-19 cases.
In addition to the differences based on race and ethnicity, CHART’s analysis revealed disparities based on gender. Males, with the exception of the black population, were diagnosed with COVID-19 at a higher rate than females. However, black males had a significantly higher mortality rate than black females, noted Sean Hopkins, senior vice president of CHART.
While more research is needed on COVID-19’s impact on different populations, these early findings raise questions about social determinants of health and patient outcomes in this pandemic. Data from Healthy People 2020 shows that black communities experience higher poverty rates and higher uninsured rates. Housing, employment, food access, transportation and education are other social concerns with tremendous impact on health.
Those impacts influence health status. For example, the hypertension rate for black New Jerseyans is 40.9 per cent, compared with 31.3 per cent in Hispanics, 28.55 for white residents and 23.8 for Asian residents. Black New Jerseyans also have the state’s highest rates of diabetes and obesity, according to the N.J. State Health Assessment Data. Those are among the most common co-morbid conditions cited in COVID-19 deaths.
“These disparities unfortunately are revealing themselves in the COVID-19 toll we’re seeing in New Jersey,” said Sandy Cayo, RN, vice president of clinical performance and transformation. “One of the very important lessons learned in this pandemic is to plan and mitigate disease burden in minority patients and vulnerable communities.”
How does the healthcare system and its community partners begin to address these issues post-COVID-19? NJHA’s report provides a number of important considerations for the after-action analysis of the COVID-19 response. They include:
- Leveraging community partnerships through targeted outreach and health promotion
- Preparing and providing culturally and linguistically appropriate information to New Jersey’s diverse populations
- Planning for safe spaces for quarantine, mental health services and child and family resources for vulnerable groups.