Researching Health Disparities in the Face of COVID-19
October 2, 2020
Recently, Ochsner Health physicians and researchers, Eboni G. Price-Haywood, MD, MPH; Jeffrey Burton, PhD; Daniel Fort, PhD; and Leonardo Seoane, MD, published health disparity research on Hospitalization and Mortality among Black Patients and White Patients with COVID-19 in the New England Journal of Medicine.
This type of study truly showed the power of the electronic health record and work done across Ochsner Health on clinical documentation, which enabled the research team to shine a light on health disparities in our communities.
Eboni G. Price-Haywood, MD, MPH
Jeffrey Burton, PhD
Daniel Fort, PhD
Leonardo Seoane, MD
In this study, the authors analyzed medical record data from patients seen within Ochsner Health between March 1 and April 11, 2020, who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the virus that causes COVID-19) on qualitative polymerase-chain-reaction assay.
Of the 3,481 COVID-19–positive patients included in the analyses, 60% were female and 70.4% were Black non-Hispanic. Notably Blacks comprise only 31% of the Ochsner Health population. Black patients had higher incidences of obesity, diabetes, hypertension and chronic kidney disease than white patients and were more likely to be tested for COVID-19 in the emergency department. A total of 39.7% of COVID-19–positive patients (1,382 patients) were hospitalized, 76.9% of whom were Black. In risk-adjusted analyses, Black race was associated with an approximate two-fold increase in the odds of hospital admission. Additional factors associated with increased odds of admission included increasing age, having Medicare/Medicaid insurance, living in a low-income area and obesity.
Among the 326 patients who died from COVID-19, 70.6% were Black. After adjusting for sociodemographic and clinical characteristics, race was not an independent risk factor for in-hospital death. Instead, factors associated with death in the hospital included age and indicators of severe illness upon hospital admission (respiratory rate, signs of organ damage, inflammatory markers and low blood counts).
The authors concluded that racial disparities in social determinants of health that may have led to increased risk of exposure to COVID-19, delayed care and underlying chronic conditions may have increased vulnerability to worse outcomes.