COVID-19 Mortality, Diabetes, and Obesity: The Impact of Health Inequity

Early in the COVID-19 pandemic, minorities experienced the greatest burden of infection and death. These disparities were studied and related to the disproportionate distribution of comorbidities among minority, especially diabetes and obesity in non-Hispanic Blacks. Additionally, health equity has been linked to health disparities of chronic disease and COVID-19 infection. The same effect of the social determinants of health on chronic diseases in minorities is now seen in the COVID-19 pandemic. This study, which is a follow-up of research in the early stages of the pandemic, is focused on determining if the disparity in mortality is still present in the second year of the COVID-19 pandemic. Data were collected for state health departments in Georgia, Louisiana, Michigan and Mississippi on mortality due to COVID-19 infection. Mortality and case-fatality rates were collected for each state and selected counties in the study states. Mortality and case-fatality rates were determined according to race, comparing non-Hispanic Whites with non-Hispanic Blacks. The prevalence of diabetes and obesity was evaluated in relation to mortality and case-fatality rates. Results of this study indicate that the disparity between non-Hispanic Whites and non-Hispanic Blacks continues to be observed in the second year of the COVID-19 pandemic. Non-Hispanic Blacks, in the study states and counties, have higher mortality and case-fatality rates than non-Hispanic Whites. This difference ranges from nearly 1.2% greater in Georgia to 71% greater in Michigan. In the study counties with diabetes prevalence of ≥12.0% and obesity prevalence of ≥38.0% had the highest mortality rates. This study indicates that the effect of health inequities must be addressed for both chronic diseases and COVID-19.