Primary Submission Category: Health equity
Trends in Disparities in COVID-19 mortality among working-age Californians by worker characteristics
Authors: Elisabeth Gebreegziabher David Bui Kristin Cummings Matthew Frederick Alyssa Nguyen Seema Jain Ximena Vergara
Presenting Author: Elisabeth Gebreegziabher*
Objective– The objective of this study was to examine disparities in COVID-19 mortality by demographic characteristics and temporal trends over variants/waves of mortality among working-age Californians.
Methods– We included all COVID-19 deaths among Californians aged 18-64 years between January 2020 and May 2022. We used Current Population Survey to derive estimates for at-risk populations. The waves of COVID-19 mortality were: March 2020-June 2020 (Wave 1), July 2020-November 2020 (Wave 2), December 2020-May 2021 (Wave 3), June 2021-January 2022 (Wave 4), and February 2022-May 2022 (Wave 5). We used Poisson regression with robust standard errors to generate wave-specific mortality rate ratios (MRR) and examined the change in MRR across waves by including an interaction term between each characteristic and wave period.
Results- Individuals aged 50-64 years (MRR =28.7, 95% CI: (22.3-37.0)), males (2.0 (1.9-2.2)), Native Hawaiian (2.2 (1.5-3.2)), Latino (2.3 (2.0-2.5)), African American (2.5 (2.2-2.9)), high school educated or less (6.3 (3.6-11.1)) and unmarried people (1.6 (1.5-1.8)) had consistently higher COVID-19 mortality rates compared to their respective reference groups. The COVID-19 mortality rate for foreign-born persons was over three times higher than for US-born persons in Wave 1 and 12% less in Wave 5 (MRR=3.4 (3.0-3.8) vs. 0.88 (0.81-0.95)). While disparities by sex, race and foreign-born status narrowed in later waves, disparities by age, education level and marital status did not change substantially across waves.
Conclusion-Among workers in California, the existence of disparities in all waves could indicate remaining gaps in prevention. Males, racial minority groups, individuals with lower education level and those who were not married continued to be disproportionately affected by COVID-19 mortality. Addressing underlying social and structural issues that contribute to these disparities is critical for achieving health equity.