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

• Type of Material: Article
• Authors: Jonathan M. Wortham, Center for Disease Control and Prevention; Seth A. Meador, Center for Disease Control and Prevention; Evan J. Anderson, Emory University; Kyle Peter Openo, Emory University
• Language: English
• Date: 2021-09-24
• Publisher: PLoS One
• Publication Version: Final Published Version
• Copyright Statement: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.
• License: Creative Commons Universal : Public Domain Dedication
• Final Published Version (URL): https://doi.org/10.1371%2Fjournal.pone.0257622
• Title of Journal or Parent Work: PLoS One
• Volume: 16
• Issue: 9
• Start Page: e0257622
• Grant/Funding Information: This work was supported by the CDC through an Emerging Infections Program cooperative agreement (number CK17-1701) and through a Council of State and Territorial Epidemiologists cooperative agreement (number NU38OT000297-02-00). Role of Funder/Sponsor: CDC designed and conducted the study; collected, managed, analyzed, and interpreted the data; prepared, reviewed, and approved the manuscript; and had a role in the decision to submit the manuscript for publication and journal choice, and had the right to veto publication. Disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).
• Research Categories: Biology, Virology

Abstract

Objectives Some 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. Methods Using 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. Results Among 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. Conclusions Overall, 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.