Trends in racial and ethnic disparities in coronavirus disease 2019 (COVID-19) outcomes among nursing home residents

Infect Control Hosp Epidemiol. 2022 Aug;43(8):997-1003. doi: 10.1017/ice.2021.246. Epub 2021 Jun 16.


Objectives: To evaluate trends in racial and ethnic disparities in weekly cumulative rates of coronavirus disease 2019 (COVID-19) cases and deaths in Connecticut nursing homes.

Design: Longitudinal analysis of nursing-home COVID-19 reports and other databases. Multivariable negative binomial models were used to estimate disparities in COVID-19 incidence and fatality rates across nursing-home groups with varying proportions of racial and ethnic minority residents, defined as low-, medium-, medium-high-, and high-proportion groups. Trends in such disparities were estimated from week 1 (April 13) to week 10 (ending on June 19, 2020).

Setting: The study was conducted across 211 nursing homes.

Results: The average number of cases ranged from 6.1 cases per facility for the low-proportion group to 11.7 cases per facility for the high-proportion group in week 1, and from 26.7 to 58.5 cases per facility in week 10. Compared to the low-proportion group, the adjusted incidence rate ratios (IRRs) for the high-proportion group were 1.18 (95% confidence interval [CI], 0.77-1.80; P > .10) in week 1 and 1.54 (95% CI, 1.05-2.25; P < .05) in week 10, showing a 30% (95% CI, 5%-62%) relative increase (P < .05). The average weekly number of COVID-19-related deaths ranged from 0 to 0.3 deaths per facility for different groups in week 1, and from 7.6 to 13.3 deaths per facility in week 10. Adjusted disparities in fatalities similarly increased over time.

Conclusions: Connecticut nursing homes caring for predominately racial and ethnic minority residents tended to have higher COVID-19 incidence and fatality rates. These across-facility disparities increased during the early periods of the pandemic.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • COVID-19*
  • Ethnicity
  • Humans
  • Minority Groups
  • Nursing Homes
  • Racial Groups
  • United States