Black, Latino Residents Have Higher Case of Hospitalization and Death Rates in Pandemic

By LA County Health Department

The tragedy of the pandemic is not just the 32,000 lives lost, but also the huge disproportionality, most pronounced during the surges, which suggests that the factors contributing to the gaps are related to much more than individual choices.

With high transmission and increased cases, the county must do everything it can to protect those experiencing higher case, hospitalization, and death rates, including workers who have multiple exposures to others during their workday, people living in communities with high concentrations of poverty, and Black and Latino residents.

During each of the four surges, the disproportionality in case rates was exacerbated with case rates generally between two and four times higher among Black and Brown residents. At the peak of the summer 2020 surge, case rates among Latino residents were nearly four times higher than white residents.

Black and Latino residents also saw hospitalization rates that were three to four times higher than rates for White and Asian residents in the latest Omicron surge. The same trends are noted when looking at death rates, with Black and Latino residents seeing rates that are two to three times higher than white and Asian residents during this last winter surge.

Disproportionality is also apparent when looking at case, death, and hospitalization rates by vaccination status and poverty level.

Fully vaccinated residents in the wealthiest communities were more than two times less likely to be hospitalized than those vaccinated and living in communities with high rates of poverty.  In fact, those vaccinated living in communities with significant poverty were almost as likely to be hospitalized as those unvaccinated living in the wealthiest communities.

It is also important to note that those unvaccinated living in communities with high poverty are 11 times more likely to get infected than those unvaccinated living in the wealthiest communities.

There is also a similar gradient around deaths.

Those unvaccinated living in high poverty communities are almost 12 times more likely to die than unvaccinated living in wealthier communities.  And among those vaccinated, those living in communities of high poverty are two times more likely to die than those in the wealthiest communities.

These huge differences in case, hospitalization, and death reflect in part exposures, community conditions, and health status. Where people live and work really matters; many essential workers never stayed home, and then returned to very densely populated communities and overcrowded housing.

LA County has a collective obligation to Public Health’s post-surge plan, and expansive mitigation strategies allow us to consider taking public health measures that protect our most vulnerable residents — including those who are of older age; have underlying health conditions; live in communities with high poverty rates; are Black and Brown; are unvaccinated/not fully vaccinated; and face many exposures at work and in the community.

Appropriate strategies include continuing to ensure barrier-free access to testing, vaccinations, therapeutics, and PPE, and connecting residents and workers with services that address food, income and housing insecurity.

Resources are needed to support the network of trusted community-based and faith-based organizations in hard-hit communities that are the backbone of our public health response, including the  promotoras and community health workers.

And worksites need to be as safe as possible by ensuring adequate ventilation, implementing infection control standards, offering paid leave for those seeking health care, and complying with Public Health safety measures.

“We continue to extend our deepest sympathies to everyone mourning the loss of a loved one, and offer our wishes for peace and healing,” said Dr. Barbara Ferrer, PhD, MPH, MEd, Director of Public Health.

“As LA County continues in this different phase of the pandemic, Public Health’s goal has not changed, and we will work with partners to reduce serious illness and deaths from COVID-19,” Ferrer said. “It is simply not appropriate to tolerate disproportionality that results in higher rates of illness, death, and long-term disability among some residents and workers when there are collective prevention strategies that can mitigate spread and serious illness.”