Inequities in health have been at the forefront of public health research, especially when disparities are further illuminated by the pandemic.
In a recent publication, Daeho Kim, Adjunct Assistant Professor of Health Services, Policy and Practice, and colleagues analyzed how COVID-19 has impacted Black and Hispanic populations living with kidney failure. They examined excess deaths—the difference between observed and expected deaths based on historical trends—to capture those deaths related to COVID-19 infection. Their national study, published in the American Journal of Kidney Disease, used data obtained from the Centers for Medicare and Medicaid to estimate excess deaths for the kidney failure population by race and ethnicity from March 1 through August 1, 2020. After applying a Poisson regression model to adjust for secular time trends and seasonality, researchers predicted the expected deaths during the COVID period.
The study found that among the US kidney failure population, excess deaths from March 1 through August 1, 2020 were 16% higher than expected. The results also showed stark racial and ethnic disparities in excess deaths. According to Dr. Kim, “72% of all excess deaths occurred among Black and Hispanic patients.” These findings are likely explained by inequities in the social determinants of health the researchers say, such as income, living conditions, access to health care, and structural racism.
Study authors advocate for more equitable pandemic mitigation efforts in the future. As Dr. Kim asserts, “our findings suggest that public health interventions, including prioritization of vaccination, must consider these racial/ethnic disparities in excess deaths and address underlying social determinants and structural racism that generate the disparities in this population.”
by Destry Jensen, MPH '22