PLoS ONE (Jan 2021)

Census tract socioeconomic indicators and COVID-19-associated hospitalization rates-COVID-NET surveillance areas in 14 states, March 1-April 30, 2020.

  • Jonathan M Wortham,
  • Seth A Meador,
  • James L Hadler,
  • Kimberly Yousey-Hindes,
  • Isaac See,
  • Michael Whitaker,
  • Alissa O'Halloran,
  • Jennifer Milucky,
  • Shua J Chai,
  • Arthur Reingold,
  • Nisha B Alden,
  • Breanna Kawasaki,
  • Evan J Anderson,
  • Kyle P Openo,
  • Andrew Weigel,
  • Maya L Monroe,
  • Patricia A Ryan,
  • Sue Kim,
  • Libby Reeg,
  • Ruth Lynfield,
  • Melissa McMahon,
  • Daniel M Sosin,
  • Nancy Eisenberg,
  • Adam Rowe,
  • Grant Barney,
  • Nancy M Bennett,
  • Sophrena Bushey,
  • Laurie M Billing,
  • Jess Shiltz,
  • Melissa Sutton,
  • Nicole West,
  • H Keipp Talbot,
  • William Schaffner,
  • Keegan McCaffrey,
  • Melanie Spencer,
  • Anita K Kambhampati,
  • Onika Anglin,
  • Alexandra M Piasecki,
  • Rachel Holstein,
  • Aron J Hall,
  • Alicia M Fry,
  • Shikha Garg,
  • Lindsay Kim

DOI
https://doi.org/10.1371/journal.pone.0257622
Journal volume & issue
Vol. 16, no. 9
p. e0257622

Abstract

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ObjectivesSome studies suggested more COVID-19-associated hospitalizations among racial and ethnic minorities. To inform public health practice, the COVID-19-associated Hospitalization Surveillance Network (COVID-NET) quantified associations between race/ethnicity, census tract socioeconomic indicators, and COVID-19-associated hospitalization rates.MethodsUsing data from COVID-NET population-based surveillance reported during March 1-April 30, 2020 along with socioeconomic and denominator data from the US Census Bureau, we calculated COVID-19-associated hospitalization rates by racial/ethnic and census tract-level socioeconomic strata.ResultsAmong 16,000 COVID-19-associated hospitalizations, 34.8% occurred among non-Hispanic White (White) persons, 36.3% among non-Hispanic Black (Black) persons, and 18.2% among Hispanic or Latino (Hispanic) persons. Age-adjusted COVID-19-associated hospitalization rate were 151.6 (95% Confidence Interval (CI): 147.1-156.1) in census tracts with >15.2%-83.2% of persons living below the federal poverty level (high-poverty census tracts) and 75.5 (95% CI: 72.9-78.1) in census tracts with 0%-4.9% of persons living below the federal poverty level (low-poverty census tracts). Among White, Black, and Hispanic persons living in high-poverty census tracts, age-adjusted hospitalization rates were 120.3 (95% CI: 112.3-128.2), 252.2 (95% CI: 241.4-263.0), and 341.1 (95% CI: 317.3-365.0), respectively, compared with 58.2 (95% CI: 55.4-61.1), 304.0 (95%: 282.4-325.6), and 540.3 (95% CI: 477.0-603.6), respectively, in low-poverty census tracts.ConclusionsOverall, COVID-19-associated hospitalization rates were highest in high-poverty census tracts, but rates among Black and Hispanic persons were high regardless of poverty level. Public health practitioners must ensure mitigation measures and vaccination campaigns address needs of racial/ethnic minority groups and people living in high-poverty census tracts.