A recent study found racial and ethnic disparities beyond underlying health conditions play a significant role in the disproportionate impact of COVID-19 on communities of color.

The COVID-19 pandemic has intensified health inequities and social risk factors among racial and ethnic minorities and continues to cause a disproportionate rate of hospitalizations and deaths among the vulnerable populations. Researchers have linked the large disparities to findings that black and Hispanic adults are more likely to have an underlying health condition and, therefore, have a heightened risk for severe COVID-19 illness. But a recent study, released as a Fast Track Ahead of Print article by Health Affairs, argues other key factors should be considered as well.

Study authors, Thomas M. Selden and Terceira A. Berdahl, explored prepandemic data from the Medical Expenditure Panel Survey (MEPS), sponsored by the Agency for Healthcare Research and Quality, to better understand other possible explanations for the racial and ethnic disparities. While the MEPS data supported the link between racial and ethnic disparities and underlying health conditions, the study authors also found the data to strongly underscore that COVID-19 disparities stem from factors including workers’ exposure, within-household transmission, and COVID-19 relevant job characteristics.

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Racial-ethnic minorities in the U.S. often reside in households with more members in comparison to white households, challenging social distancing and exposing workers’ risks to COVID-19 exposure to their entire household, explained Selden and Berdahl. MEPS data found the average household size among whites to be 2.8 persons, in comparison to 3.1 persons for Black Americans and 3.8 for Hispanics.

Disparities in essential workers and work from home abilities also play a key role, according to study authors. Blacks Americans (16.3 percent) were substantially more likely than whites (10.4 percent) to work in the health sector and were also overrepresented in public safety, while Hispanics were heavily overrepresented in the food sector. Additionally, 22.8 percent of white essential workers were able to work from home compared to only 13.3 percent of Black workers and 12.5 percent of Hispanics.

Additional findings regarding employment risks and household composition include:

  • More Black women (24.6 percent) work in health sector employment than white women (17.2 percent), with similar findings for Black men (7.1 percent) compared to white men (4.4 percent).
  • Disparities in essential workers who can work at home were larger among men (25.6 percent white men and 12.9 percent Black men) and higher among white women (19.7 percent) than Black women (13.5 percent).
  • The number of high-risk Black Americans who live in households with at least one worker in the health sector (15.1 percent) was higher than whites (9.3 percent).
  • The number of high-risk Black Americans who live in households with at least one worker who was unable to work at home (56.5 percent) was higher than high-risk whites (46.6 percent).
  • The frequency of living with at least one worker in the health sector was lower for Hispanics than Black Americans, but the overall frequency of living with at least one worker who cannot work from home was even higher (64.5 percent).