Study examines racial and ethnic disparities among COVID-19 cases in Massachusetts

Disparities evident along multiple dimensions including race and ethnicity, foreign-born non-citizen status, household size, and job type

Boston – In spring of 2020, Massachusetts had one of the highest incidences of COVID-19 in the United States. Early reports suggested that Black and Latinx residents were disproportionately affected, with Black and Latinx people together compromising 55 percent of COVID-19 cases. However, the specific factors underlying these stark disparities remained unclear.

In a new study published in Health Affairs, researchers at Beth Israel Deaconess Medical Center (BIDMC) and the Harvard T.H. Chan School of Public Health examined the association between specific demographic, economic, and occupational factors and COVID-19 case rates across 351 Massachusetts cities and towns between January 1 and May 6, 2020. The team that found a 10 percent increase in the Black population was associated with an increase of 312 COVID-19 cases per 100,000 people, while a 10 percent increase in the Latinx population was linked to an increase of 285 cases per 100,000 people.

"Our study demonstrates the extent to which Massachusetts’ Black and Latinx communities have been disproportionately affected by COVID-19,” said co-first author Rishi Wadhera, MD, MPP, MPhil, an investigator in the Smith Center for Outcomes Research in Cardiology at BIDMC. “We also found that a higher proportion of non-citizens or food service workers living within a community, as well as larger household sizes, were each independently associated with higher COVID-19 case rates. Although these factors explained the higher burden of COVID-19 in Latinx communities, they did not for Black communities, suggesting that other structural inequities may be at play.”

The researchers conclude that further research into the social and economic factors underlying COVID-19-related disparities and new policies to address risk factors and institutional racism will be critical to controlling the pandemic and improving health equity.

Co-authors included Robert W. Yeh, MD, MSc, MBA of BIDMC; Jose Figueroa, MD, MPH, Benjamin Sommers, MD, PhD, and Dennis Lee of Harvard T.H. Chan School of Public Health.

This work was partially funded by the Robert Wood Johnson Foundation Policies for Action.