The pandemic is taking an outsize toll on minority populations, particularly Latinos, who often have poorer access to health care. A funeral in Brooklyn, N.Y., in March.
Photo: John Minchillo/Associated PressCovid-19 is known to be particularly risky for the elderly. For many minorities, the disease is killing them in the prime of their lives.
Among people in the U.S. who died between their mid-40s and mid-70s since the pandemic began, the virus is responsible for about 9% of deaths. For Latino people who died in that age range, the virus has killed nearly 25%, according to a Wall Street Journal analysis of death-certificate data collected by federal authorities.
The data show how deaths from the coronavirus are skewing younger for many minorities, a stark disparity that offers a clear picture of the pandemic’s outsize impact on vulnerable populations.
This is especially the case for Latino people, in part because their high representation in jobs ranging from health aides to meatpacking have made it harder for them to dodge the virus, and because they often have poorer access to care, according to public-health experts.
“Latinos tend to be very, very poorly connected to the formal medical and public-health infrastructure,” said David Hayes-Bautista, who directs the Center for the Study of Latino Health and Culture at the University of California, Los Angeles’s medical school. As a consequence, the population has historically been hit hard by communicable diseases, he said.
Data from death certificates are collected by the National Center for Health Statistics, or NCHS, a branch of the Centers for Disease Control and Prevention. Death certificates don’t track Covid-19 deaths as quickly as the more preliminary state and local reports that feed real-time trackers, like the Johns Hopkins University dashboard, but the certificates contain demographic details the faster data sometimes miss. The Journal analyzed the intersection of both race and age in these data to drill deeper into the impact on various demographic groups, which the NCHS is also analyzing more closely.
By early August, the NCHS recorded about 151,000 Covid-19 deaths from death certificates, compared with 168,700 deaths recently reported by Johns Hopkins.
For America’s white population, death-certificate data show the rate of deaths attributed to Covid-19 steadily rising with age, hewing closely to the expected trend for a virus that is particularly risky for older people with health complications. That is partly because white people have the highest median age of any racial group.
In contrast, minorities in the U.S. are likely to die younger from Covid-19. Just 3% of white people who die are under 55, but 8% of Asians, 11% of Black people, 18% of Latinos and 24% of American Indians are under that age. A study by Harvard researchers shows that this magnifies the pandemic’s toll in the cumulative effect on potential life expectancy, a key public-health measure.
Public-health experts are still exploring the reasons for these age disparities as the pandemic unfolds. Many also say they anticipated minorities would be particularly affected, including at younger ages, because of their general health profiles and unequal access to care.
Low-wage jobs that require work outside the home are considered a prime risk factor for exposure. Cramped living conditions, including multiple generations in a single home, and higher reliance on public transit can also increase exposure. Higher rates for some groups of chronic illnesses that can complicate Covid-19, like diabetes, can worsen the outlook for those infected.
Medics in Houston load a possible Covid-19 patient into an ambulance.
Photo: John Moore/Getty Images“What we know is Latinos are overrepresented in low-wage occupations, essential occupations from farm working to meatpacking to the service sector to restaurants and grocery stores,” said Jeffrey Reynoso, executive director at the Latino Coalition for a Healthy California.
Even as minority deaths skew younger, death certificates show people in minority groups are dying at higher rates from Covid-19 than the white population at almost any age. Among people aged 55 to 64, for instance, minority death rates are two to five times the white rate.
The higher rates of Covid-19 deaths among minority groups are even starker when adjusting for the different age profiles of racial groups in the U.S. This analysis adjusts for the fact that white people are significantly older, and that minorities tend to be younger, for example.
The death-certificate data from around the U.S. show a significant surge in deaths above levels the NCHS tabulated for comparable weeks in recent years. These so-called excess deaths are a measure epidemiologists use to track major events like the impact of the pandemic. The increase was most pronounced during the week ended April 11, when the 78,700 deaths due to all causes were 42% above the typical rate, according to the NCHS.
Deaths have remained elevated ever since, though not at the levels seen when the pandemic was hitting hardest in places like New York City in the spring. Trends in the most recent weeks are less clear due to the time it takes to collect death-certificate information, which bubbles up to the NCHS from thousands of medical examiners and coroners around the country.
Death certificates from Covid-19 also reveal a sharp distinction between Black and white Americans. Black people represented 22% of Covid-19 deaths by early August, though they represent only about 13% of the U.S. population. By contrast, white people represent 60% of the population and just 52% of Covid-19 deaths.
“There were just inequities in care to begin with that created a bad foundation,” said Denise Brooks-Williams, an executive with the Henry Ford Health System in Michigan. She serves on a state task force Gov. Gretchen Whitmer formed in April to study racial disparities and provide advice.
However, these numbers change when weighting the population data to account for where Covid-19 has actually hit the hardest, which is a method the CDC has used to zero in on the impact on those places. One effect of the weighted data is it shows a smaller disproportionate impact among Black people.
The CDC began presenting these adjustments to the population data because, in the early stages of the pandemic, deadly outbreaks were hitting a small number of places, said Robert Anderson, chief of the NCHS’s mortality statistics branch. This statistical number-crunching has drawn criticism from some public-health experts who say it discounts the health and economic vulnerabilities that allowed outbreaks to hit so hard in Black communities in the first place.
“There’s a reason it hit New York, Chicago, LA in large numbers,” said Georges Benjamin, executive director of the American Public Health Association, regarding the virus. “There’s a reason small rural communities got hit later.”
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Based merely on population size, the federal data indicate that Latino people haven’t died in disproportionate numbers. But because the Latino population is on average younger than the rest of the population, adjusting for that difference shows they are dying at disproportionate rates.
This trend has been on clear display in California. Latino people in the state make up about 41.5% of the population between ages 35 and 49, for example, but 77% of the deaths for that age group. California Latinos die from Covid-19 in disproportionate numbers regardless of age.
Latino people in the U.S. otherwise outlive whites and die prematurely less often, even though they face issues like greater poverty and less access to health care. This is often described as a paradox because poorer socioeconomic status often translates to poorer health. For many, the pandemic has upended that trend.
Write to Jon Kamp at jon.kamp@wsj.com
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