A longitudinal study of convergence between Black and White COVID-19 mortality: A county fixed effects approach.
| dc.contributor.author | Lawton, Ralph | |
| dc.contributor.author | Zheng, Kevin | |
| dc.contributor.author | Zheng, Daniel | |
| dc.contributor.author | Huang, Erich | |
| dc.date.accessioned | 2024-05-22T22:35:46Z | |
| dc.date.available | 2024-05-22T22:35:46Z | |
| dc.date.issued | 2021-09 | |
| dc.description.abstract | BackgroundNon-Hispanic Black populations have suffered much greater per capita COVID-19 mortality than White populations. Previous work has shown that rates of Black and White mortality have converged over time. Understanding of COVID-19 disparities over time is complicated by geographic changes in prevalence, and some prior research has claimed that regional shifts in COVID-19 prevalence may explain the convergence.MethodsUsing county-level COVID-19 mortality data stratified by race, we investigate the trajectory of Black and White per capita mortality from June 2020-January 2021. We use a county fixed-effects model to estimate changes within counties, then extend our models to leverage county-level variation in prevalence to study the effects of prevalence versus time trajectories in mortality disparities.FindingsOver this period, cumulative mortality rose by 61% and 90% for Black and White populations respectively, decreasing the mortality ratio by 0.4 (25.8%). These trends persisted when a county-level fixed-effects model was applied. Results revealed that county-level changes in prevalence nearly fully explain changes in mortality disparities over time.InterpretationResults suggest mechanisms underpinning convergence in Black/White mortality are not driven by fixed county-level characteristics or changes in the regional dispersion of COVID-19, but instead by changes within counties. Further, declines in the Black/White mortality ratio over time appear primarily linked to county-level changes in COVID-19 prevalence rather than other county-level factors that may vary with time. Research into COVID-19 disparities should focus on mechanisms that operate within-counties and are consistent with a prevalence-disparity relationship.FundingThis work was supported by the National Center for Advancing Translational Sciences [E.H.: UL1TR002553]. | |
| dc.identifier | S2667-193X(21)00003-X | |
| dc.identifier.issn | 2667-193X | |
| dc.identifier.issn | 2667-193X | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Elsevier BV | |
| dc.relation.ispartof | Lancet regional health. Americas | |
| dc.relation.isversionof | 10.1016/j.lana.2021.100011 | |
| dc.rights.uri | ||
| dc.subject | COVID-19 | |
| dc.subject | Demography | |
| dc.subject | Disparities | |
| dc.subject | Longitudinal | |
| dc.subject | Mortality | |
| dc.subject | Race | |
| dc.title | A longitudinal study of convergence between Black and White COVID-19 mortality: A county fixed effects approach. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Huang, Erich|0000-0001-5547-9408 | |
| pubs.begin-page | 100011 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Surgery | |
| pubs.publication-status | Published | |
| pubs.volume | 1 |
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