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Race, Ethnicity, and Age Trends in Persons Who Died from COVID-19 – United States, May-August 2020

Our take —

This study uses data from the US National Vital Statistics System to describe the sociodemographic characteristics of all 114,411 deaths due to COVID-19 reported from May through August, 2020. It found that deaths rose in the South from May to August, making up the majority of deaths by August. Hispanic (24.2% of deaths) and Black individuals (18.7% of deaths) were overrepresented among deaths compared to the general population, with Hispanic people in particular making up an increased proportion of deaths over the study period. The largest limitation is the delay in reporting which may mean these results are not reflective of real-time deaths, but it highlights important disparities, and their increase from May to August, for policymakers and stakeholders.

Study design

Ecological

Study population and setting

The study objective was to examine potential racial/ethnic disparities in deaths from COVID-19. Deaths were reported to the National Vital Statistics System from May 1 to August 31, 2020, across the US, including all states and Washington DC, and excluding residents of US territories or US citizens in foreign countries. Age of death, race/ethnicity, sex, region of residence (South, Northeast, Midwest, West) and place of death (e.g. such as healthcare setting, hospice, nursing home or long-term care facility) were also reported. Death due to COVID-19 was recorded if COVID-19 was an underlying cause of the chain of events leading to death (92% of COVID-19 deaths), or a contributing cause of death (8% of COVID-19 deaths). In total, 114,411 COVID-19-associated deaths were identified.

Summary of Main Findings

Out of 114,411 COVID-19 deaths during the study period, the highest number occurred in May 2020 (37,940, 33.2%). Overall, the majority of those decreased were male (53.3%, 60,961), White (51.3%, 58,692) and 65 years of older (78.2%, 89, 469). Additionally, 24.2% were Hispanic (N=27,687) and 18.7% were Black (N=21,394), which are greater proportions than their proportion of the general population by 5.5% and 6.0% respectively. Deaths among Hispanic people increased by 10.1 percentage-points over the study period, reaching roughly 25% of all COVID-19 deaths by August 2020. The plurality of average deaths across the study period occurred in the South (45.7%, 52,285), though in May the South represented just over 20% of deaths compared to August where it made up over 60%. For place of death, the majority died in an inpatient healthcare facility (64.3%, 73,566) followed by a nursing home or long-term care facility (22.0%, 25,170). From May to August, the proportion of deaths due to COVID-19 increased in the South, while it noticeably reduced in the Northeast. The percentage of deaths among people >=65 years remained relatively stable from May to August.

Study Strengths

Using data from the NVSS, the study was able to collect data on all deaths to identify and describe those in the US who died from COVID-19. They also had relatively detailed data, including many different categories for the place of death, and were able to show changes over time in the proportion of deaths between census regions and in racial/ethnic groups.

Limitations

The study did not have data on comorbid conditions or other contributing factors to death, which may have revealed further trends among racial/ethnic groups at increased risk for some of these conditions (such as diabetes, hypertension, etc.). The NVSS data may have delays in reporting, which would mean these numbers do not represent the deaths that occurred in these months, but only the reporting of deaths which may not track to real-time data. Additionally, the paper does not relate to deaths indirectly caused by the pandemic, such as individuals avoiding or delaying medical care. Another limitation was the dates of data available, from May through August 2020, which does not capture all deaths since the beginning of the pandemic.

Value added

This study examines death data from the entire US during the pandemic, highlighting important health disparities across racial/ethnic groups and geographic regions.

This review was posted on: 2 November 2020