Thread by @MarissaReitsma

1/N Our study highlighting racial/ethnic disparities in COVID-19 exposure and outcomes in CA was published in @Health_Affairs

tl;dr: Latino populations faced 8x exposure risks, 3x case rates, and 1.5x mortality rates compared to White populations.

doi.org/10.1377/hlthaf…

2/N Collaborating with colleagues @CAPublicHealth, we analyzed comprehensive statewide COVID-19 test (n=15,421,862), case (n=817,947), and mortality (n=17,815) data from Mar. 22 – Oct. 3 2020, by racial/ethnic group and Public Use Microdata Area.

3/N We constructed a joint measure of exposure: living with an essential worker in a home with fewer rooms than household members (a proxy for ability to safely self-isolate if infected). We analyzed this exposure alongside test, case, and test positivity rates.

4/N Latinos in California were 8.1 times more likely to live in a household facing these greater exposure risks, were 3 times more likely to be infected with COVID-19, and were 1.5 times more likely to die of COVID-19, compared to White populations.
doi.org/10.1377/hlthaf…

5/N Based on COVID-19 outcomes spanning Mar-Oct 2020, Black populations (5% of California’s total population) faced elevated case rates (1.7x) and mortality rates (1.7x) compared to White populations.
doi.org/10.1377/hlthaf…

6/N High test positivity rates among Latinos were observed across all regions of California and across all months in our study period. Disparities in test positivity persisted even as testing rates improved.

7/N Analyzing 15+ million COVID-19 tests, Latinos were tested at a lower rate compared to White populations, suggesting that disparities in case rates may have been underestimated.

8/N There was geographic separation between areas with high case rates and high test rates, a pattern that is clear in Los Angeles County:

9/N Structural barriers (transportation, time off work, concerns about cost, etc.) that likely contributed to lower testing rates among the hardest hit populations also impact current vaccination efforts.

10/N Greater investment in community-based and community-led efforts to ensure equitable access to COVID-19 vaccination is needed in California and across the US, as coverage among White and Asian populations exceeds that among Black and Hispanic populations nationally.

11/N Coverage by @StanfordMed & @StanfordHP: med.stanford.edu/news/all-news/…

12/N Was great working with folks @CAPublicHealth including @_vargo @pbshete, alongside recent PhD grad, Dr. Anneke Claypool, and led by @SalomonJA and Jeremy Goldhaber-Fiebert as part of @sc_cosmo.