COVID-19 Deaths: Income Inequality Influences State Mortality Rate

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According to a recent study conducted at the University of California, Los Angeles (UCLA), income inequality influenced the number of COVID-19 patients and deaths in a given area. 

The study was published recently in the Journal of Internal Medicine on June 24, 2020. Researchers went through data extracted from various sources between January 22 and April 13, 2020. Details were taken from the 2018 American Community Survey on income distribution. State incomes were measured according to the Gini index devised to evaluate income status. 

When it came to the measuring COVID-19 related mortality rates of 50 American states, researchers used the COVID-19 Dashboard updated by the Center for Systems Science and Engineering at Johns Hopkins University.

How did the researchers arrive at their conclusion? They performed a Spearman rank-order correlation test between the number of deaths per 100,000 population and the state income according to the Gini index.

Next, multivariable regression was applied to the analysis, along with adjusting variables for the elderly population, race, gender, poverty and median household income. The other factors taken into account included lockdown policies, number of tests, doctors and beds per capita. 

The purpose of the study was to understand how to make policies that can protect vulnerable populations during the pandemic. From the findings, the researchers realized that social inequalities, income inequality in particular, was the reason for high mortality rate due to COVID-19 in certain states.  

Coronavirus COVID-19 New York, USA - Mask People line up outside Elmhurst Hospital to get tested due to coronavirus outbreak on March 24, 2020 in Queens, New York City. Eduardo Munoz Alvarez/Getty Images

“Inequality may compound these disparities further through economic segregation, decreased social mobility, and lower access to medical care. Given that low-income individuals are more likely to be in essential occupations with a high exposure risk and have less access to healthcare, income inequality may exacerbate the impact of the COVID-19 outbreak,” the researchers explained.  

New York state reported a mortality rate 125 higher than Utah which had the lowest mortality rate during the study’s time period. The following are the top three states with high mortality rates that have a large number of African American and Hispanic populations. 

  • New York state: 51.7 deaths per 100,000 population
  • Louisiana: 19 deaths per 100,000 population
  • Connecticut: 16.9 deaths per 100,000 population

The following are the states with the lowest mortality rates in the United States: 

  • Utah: 0.41deaths per 100,000 population
  • South Dakota: 0.7 deaths per 100,000 population
  • North Dakota: 1 death per 100,000 population

Study’s Limitation

“Our study has limitations. First, as is the case with observational studies, there is a possibility of residual confounding, including from comorbidities. However, we included the proportion of the population 65+ years which may be a proxy of underlying health risks of the populations.” the paper said.  

“Second, the use of state-level data precluded us from making any inferences about individual-level associations between inequality and COVID-19 infections,” the researchers said. 

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