Explaining Racial and Ethnic Inequities in SARS-CoV-2-Related Outcomes: Results from a Serosurvey in Chicago.

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Racial and Ethnic Health Disparities Pub Date : 2025-03-10 DOI:10.1007/s40615-025-02362-4

Christopher A Eyo, Joshua M Schrock, Christina Hayford, Daniel T Ryan, Rana Saber, Nanette Benbow, Michael E Newcomb, Alexis R Demonbreun, Elizabeth M McNally, Richard T D'Aquila, Thomas W McDade, Brian Mustanski

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Abstract

Background: Several studies have documented racial and ethnic disparities related to SARS-CoV-2/COVID-19 prevalence and associated health outcomes, but the proximal determinants underpinning these disparities remain unclear. Here, we test whether demographics, household composition, occupation type, chronic conditions, health insurance coverage, and neighborhood disadvantage account for racial and ethnic inequities in COVID-19 outcomes.

Methods: We conducted a serosurvey of adults in Chicago, IL (n = 5991) before emergency use authorization for COVID-19 vaccines in December 2020. Participants completed an online survey and provided a dried blood spot (DBS) sample for quantification of SARS-CoV-2 antibodies.

Results: Hispanic/Latino and Black participants had greater odds of being seropositive and being diagnosed with COVID-19 compared to White participants. Among seropositive participants, Hispanic/Latino and Black participants had higher antibody concentrations compared to White participants, and Hispanic/Latino participants had higher levels of symptom severity compared to White participants. Adding all variables to the model yielded a statistically significant reduction in the magnitude of Hispanic/Latino vs. White disparities in symptom severity among seropositive participants (Δ = - 59.4%, P = 0.015). We detected spatial clustering of high symptom severity in predominantly Hispanic/Latino neighborhoods and low symptom severity in predominantly White neighborhoods. Multiple inequities remained apparent after adjustment for all covariates.

Conclusions: Household composition, demographics, occupation type, chronic conditions, and neighborhood disadvantage collectively explain a substantial proportion of Hispanic/Latino vs. White inequities in symptom severity, but these factors are not sufficient to explain racial and ethnic inequities in SARS-CoV-2 seropositivity and COVID-19 case rates.

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解释sars - cov -2相关结果中的种族和民族不平等：芝加哥一项血清调查的结果。

背景：一些研究已经记录了与SARS-CoV-2/COVID-19流行率和相关健康结果相关的种族和民族差异，但支持这些差异的近期决定因素仍不清楚。在这里，我们测试了人口统计、家庭构成、职业类型、慢性病、健康保险覆盖率和社区劣势是否可以解释COVID-19结局中的种族和民族不平等。方法：在2020年12月紧急使用COVID-19疫苗之前，我们对伊利诺伊州芝加哥的成年人（n = 5991）进行了血清调查。参与者完成了一项在线调查，并提供了用于定量SARS-CoV-2抗体的干血斑（DBS）样本。结果：与白人参与者相比，西班牙裔/拉丁裔和黑人参与者血清呈阳性和被诊断为COVID-19的几率更大。在血清阳性的参与者中，西班牙裔/拉丁裔和黑人参与者的抗体浓度高于白人参与者，西班牙裔/拉丁裔参与者的症状严重程度高于白人参与者。将所有变量添加到模型中，在血清阳性参与者中，西班牙裔/拉丁裔与白人在症状严重程度上的差异程度在统计学上显著降低（Δ = - 59.4%, P = 0.015）。我们发现以西班牙裔/拉丁裔为主的社区症状严重程度高，以白人为主的社区症状严重程度低。在对所有协变量进行调整后，多重不公平仍然很明显。结论：家庭组成、人口统计、职业类型、慢性病和社区劣势共同解释了西班牙裔/拉丁裔与白人在症状严重程度上的很大一部分不平等，但这些因素不足以解释SARS-CoV-2血清阳性和COVID-19病例率方面的种族和民族不平等。

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来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.