COVID-19 And Racial/Ethnic Disparities In Health Risk, Employment, And Household Composition

Health Aff (Millwood). 2020 Sep;39(9):1624-1632. doi: 10.1377/hlthaff.2020.00897. Epub 2020 Jul 14.


We used data from the Medical Expenditure Panel Survey to explore potential explanations for racial/ethnic disparities in coronavirus disease 2019 (COVID-19) hospitalizations and mortality. Black adults in every age group were more likely than White adults to have health risks associated with severe COVID-19 illness. However, Whites were older, on average, than Blacks. Thus, when all factors were considered, Whites tended to be at higher overall risk compared with Blacks, with Asians and Hispanics having much lower overall levels of risk compared with either Whites or Blacks. We explored additional explanations for COVID-19 disparities-namely, differences in job characteristics and how they interact with household composition. Blacks at high risk for severe illness were 1.6 times as likely as Whites to live in households containing health-sector workers. Among Hispanic adults at high risk for severe illness, 64.5 percent lived in households with at least one worker who was unable to work from home, versus 56.5 percent among Black adults and only 46.6 percent among White adults.

Keywords: Blood pressure; Body mass index; COVID-19; Cancer; Diabetes; Diseases; Employment; Ethnic disparities; Health conditions; Health disparities; Health policy; Health status; Medical Expenditure Panel Survey; Mortality; Pandemics; Racial disparities; coronavirus.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • COVID-19
  • Communicable Disease Control / organization & administration*
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / prevention & control
  • Cross-Sectional Studies
  • Databases, Factual
  • Employment / statistics & numerical data
  • Ethnicity / statistics & numerical data
  • Family Characteristics / ethnology*
  • Female
  • Health Status Disparities
  • Healthcare Disparities / economics*
  • Healthcare Disparities / ethnology*
  • Humans
  • Male
  • Middle Aged
  • Pandemics / prevention & control
  • Pandemics / statistics & numerical data*
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / prevention & control
  • Racial Groups / statistics & numerical data
  • Risk Assessment
  • United States
  • Vulnerable Populations