Provisional COVID-19 age-adjusted death rates, by race and ethnicity — United States, 2020–2021
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Provisional COVID-19 age-adjusted death rates, by race and ethnicity — United States, 2020–2021

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      What is already known about this topic? In 2020, racial and ethnic disparities in COVID-19 age-adjusted death rates (AADR) were reported among U.S. residents. What is added by this report? From 2020 to 2021, disparities in AADR ratios from COVID-19 decreased significantly by 14.0%–40.2% for most racial and ethnic groups, including non-Hispanic White persons, who accounted for 59.6%–65.2% of all decedents; and increased nonsignificantly (7.2%) for non-Hispanic Native Hawaiian and other Pacific Islander persons (0.2%–0.3% of all decedents) compared with non-Hispanic multiracial persons. What are the implications for public health practice? Providing effective preventive interventions, including vaccination and clinical care, to all communities in proportion to their need for these interventions is necessary to reduce racial and ethnic disparities in COVID-19 deaths Disparities in COVID-19 death rates by race and ethnicity have been reported in the United States (1,2). In response to these disparities, preventive, medical care, and social service assistance programs were implemented to lessen disparities in COVID-19 outcomes, including grants to support state, tribal, local, and territorial health department responses (3). The potential impact of such efforts on annual changes in racial and ethnic disparities in mortality rates that identify COVID-19 as the underlying cause of death has not been previously reported. This analysis used U.S. provisional mortality data from death certificates collected by CDC’s National Vital Statistics System (NVSS) to estimate changes in COVID-19–related age-adjusted death rates (AADRs) by race and ethnicity during 2020–2021. Compared with non-Hispanic multiracial persons (the group with the lowest death rate), significant decreases in AADR ratios occurred during 2020–2021 among non-Hispanic American Indian or Alaska Native (AI/AN) persons (34.0%), non-Hispanic Asian (Asian) persons (37.6%), non-Hispanic Black or African American (Black) persons (40.2%), Hispanic persons (37.1%), and non-Hispanic White (White) persons (14%); a non-statistically significant 7.2% increase in AADR ratio occurred among non-Hispanic Native Hawaiian or other Pacific Islander (NH/OPI) persons. Despite reductions in AADR disparities from 2020 to 2021, large disparities in AADR by race and ethnicity remained in 2021. Providing effective preventive interventions, including vaccination and clinical care, to all communities in proportion to their need for these interventions is necessary to reduce racial and ethnic disparities in COVID-19 deaths. CDC WONDER* mortality data from 2020 (final) and 2021 (provisional) reported to NVSS as of February 6, 2022, was used to assess annual changes in COVID-19 deaths among U.S. residents of any age during January 2020–December 2021. Cause of death codes from the International Classification of Diseases, Tenth Revision (ICD-10) were used to classify diseases as underlying causes of death† (4). COVID-19 deaths were defined as deaths for which COVID-19 was listed on the death certificate as a confirmed or presumed underlying cause of death (ICD-10 code U07.1). AADRs and their SEs were downloaded using CDC WONDER Provisional Multiple Cause of Death data file “2018–last month” for numbers of decedents, mid-year resident populations, and crude death rates. The data included COVID-19 deaths by sex (female and male), age group (≤24, 25–44, 45–64, 65–74, and ≥75 years) and race and ethnicity (AI/AN, Asian, Black, Hispanic, NH/OPI, and White persons, and persons who were listed as non-Hispanic more than one race [multiracial]). Deaths that occurred among residents of U.S. territories and foreign countries were excluded. Suggested citation for this article: Truman BI, Chang M, Moonesinghe R. Provisional COVID-19 Age-Adjusted Death Rates, by Race and Ethnicity — United States, 2020–2021. MMWR Morb Mortal Wkly Rep. ePub: 22 April 2022. mm7117e2.htm?s_cid=mm7117e2_w mm7117e2-H.pdf
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