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Disparities in COVID-19 Illness

Disparities in COVID-19 Illness

Racial and Ethnic Health Disparities

Updated Dec. 10, 2020

Conditions in the places where people live, learn, work, play, and worship affect a wide range of health risks and outcomes, such as COVID-19 infection, severe illness, and death. These conditions are known as social determinants of health. Long-standing systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of getting sick from COVID-19.

Cases by race and ethnicity

The highest percent of COVID-19 cases are among non-Hispanic White people. However, racial and ethnic minority groups are disproportionately represented among COVID-19 cases. The percent of cases for racial and ethnic minority groups are higher than the percent of these populations within the total U.S. population. Comparing the percent of cases and the percent of the total U.S. population by race and ethnicity provides an indication of disparities. This comparison is not exact because not all geographic areas report COVID-19 case data by race and ethnicity. Non-Hispanic White people represent a majority of the U.S. population (60%), followed by Hispanic or Latino people (18%), non-Hispanic Black people (12%), non-Hispanic Asian people (6%), non-Hispanic people who identify with more than one race (3%), American Indian or Alaska Native people (1%), and Native Hawaiian or other Pacific Islander people (less than 1%).1 Among people aged less than 50 years, and notably among children aged less than 18 years, a noticeably higher percent of COVID-19 cases are among Hispanic or Latino people compared with the percent of the total U.S. population. Hispanic or Latino children represent 25% of the U.S. population aged less than 18 years.2

In the graph below, select an age group from drop-down menu to see the how the distribution of cases varies by racial and ethnic group overall, as well as for specific age groups. These data represent only the geographic areas that report data on race and ethnicity. Every geographic area has a different racial and ethnic composition, so these data are not generalizable to the entire U.S. population. Percentages displayed in the charts below represent the percent of cases for which race and ethnicity are known.

Data source: National COVID-19 Case Surveillance.

Data are based on COVID-19 case-level data reported by state and territorial jurisdictions to CDC with known information about race and ethnicity. Race and ethnicity are known for approximately half of case reports. The data represent confirmed and probable COVID-19 cases as reported to CDC and are updated daily. More information on case report data can be found at About CDC COVID-19 Data.

To protect U.S. residents from serious infectious diseases and other health threats, public health authorities conduct national case surveillance to monitor more than 120 diseases and conditions, including COVID-19. Note that the COVID-19 pandemic has put unprecedented strain on public health data systems, affecting the completeness of some demographic information, such as race and ethnicity. CDC is working with state and jurisdictional health departments to provide more complete information on race and ethnicity for reported cases. The percent of cases that include race and ethnicity data is increasing. More information about National COVID-19 Case Surveillance can be found in FAQ: COVID-19 Data and Surveillance.

Proportion of people tested for SARS-CoV-2 (COVID-19) who had a positive test result

Recent studies have consistently found that among those tested for COVID-19, non-Hispanic Black, Hispanic or Latino, and people who identify with more than one race and are non-Hispanic were more likely to have positive test results as compared with non-Hispanic White or non-Hispanic Asian people. Comparing percent of COVID-19 test results that were positive (percent positive) among racial and ethnic populations can be helpful for understanding the spread of COVID-19 in the community. It is important to continue to monitor access, testing, and results to understand trends in transmission and groups that may be disproportionately affected by COVID-19. It is important to understand why people are getting tested and to recognize if reasons change over time or are different for particular groups. For example, people who have easier access to testing may be more likely to get tested sooner after onset of symptoms or known exposure or more often. People who do not have easy access to testing may wait until they are sicker before getting tested.

Proportion of people tested for SARS-CoV-2 who had a positive test result
Race or Ethnicity Group Percent Test Positive

Median [Range]

# of Studies Reporting
Asian 7.2% [0–8.7%] 33,4,5
Black 13.8% [6.8–24.3%] 43,4,5,6
Hispanic or Latino 11.9% [6.8–42.6%] 43,4,5,6
Other race 13.5% [4.0–21.7%] 43,4,5,6
White 7.0% [1.7–8.8%] 43,4,5,6

Among peer-reviewed studies published between January 1, 2020 and August 5, 2020, the percent positivity for COVID-19 tests by race or ethnicity group and number of studies reporting indicate 7.2% median (0-8.7% range) among 3 studies reporting for Asian persons; 13.8% median (6.8-24.3% range) among 4 studies reporting for Black persons; 11.9% median (6.8-42.6% range) among 4 studies reporting for Hispanic or Latino persons; 13.5% median (4.0-21.7% range) among 4 studies reporting for persons  other race; and 7.0% median (1.7-8.8% range) among 4 studies reporting for White persons.

Notes: Percent positive is defined as the proportion of those tested who had a positive test result. Studies reporting data on percent positive included people of all ages. These studies analyzed race and ethnicity differently; three studies analyzed the variables separately (racial categories could be Hispanic or Latino or non-Hispanic), and two studies analyzed the variables in a single variable (racial categories were non-Hispanic). Data were inadequate to assess potential differences in percent COVID-19 test positivity among American Indian and Alaska Native people, Native Hawaiian and other Pacific Islander people, and people who identify with more than one race; these people would be included together in the “other race” category in the study results. Studies were identified through a search of the peer-reviewed publications from January 1, 2020 through August 5, 2020.

To stop the spread of COVID-19, we need to work together to address inequities in the social determinants of health that affect risk for exposure to COVID-19 for racial and ethnic minority groups. Learn more about what we can do to move towards health equity.

Other Resources

References
  1. U.S. Census Bureau. American Community Survey (ACS) Demographic and Housing Estimate (ACS), 2018: ACS 1-Year Estimates Data Profiles [online]. 2019 [cited 2020 Jun 24]. Available from URL: https://data.census.gov/cedsci/table?q=Race%20and%20Ethnicity&t=Hispanic%20or%20Latino&tid=ACSDP1Y2018.DP05&hidePreview=falseexternal icon
  2. U.S. Census Bureau. American Community Survey (ACS), 2018 Annual Estimates of the Resident Population by Sex, Age, Race, and Hispanic Origin for the United States: April 1, 2010 to July 1, 2019 (NC-EST2019-ASR6H) [online]. 2019 [cited 2020 Aug 27]. Available from URL: https://www.census.gov/data/tables/time-series/demo/popest/2010s-national-detail.htmlexternal icon
  3. Adegunsoye A, Ventura IB, Liarski VM. Association of Black Race with Outcomes in COVID-19 Disease: A Retrospective Cohort Study. Annals of the American Thoracic Society. 2020. DOI: https://doi.org/10.1513/AnnalsATS.202006-583RLexternal icon.
  4. Bandi S, Nevid MZ, Nahdavinia M. African American Children are at Higher Risk for COVID-19 Infection. Pediatric Allergy and Immunology. 2020. DOI: https://doi.org/10.1111/pai.13298external icon.
  5. Jehi L. Ji X, Milinovich A, et al. Individualizing Risk Prediction for Positive COVID-19 Testing. Chest Infections. 2020. DOI: https://doi.org/10.1016/j.chest.2020.05.580external icon.
  6. Martinez DA, Hinson JS, Klein EY, et al. SARS-CoV-2 Positivity Rate for Latinos in the Baltimore-Washington, DC Region. JAMA. 2020;324(4):392-395. DOI: https://doi.org/10.1001/jama.2020.11374external icon.