• Kate Strully, Tse-Chuan Yang, and Han Liu.
• Department of Sociology, University at Albany, SUNY, Albany, NY. Electronic address: kstrully@albany.edu.
• Ann Epidemiol. 2021 Jan 1; 53: 56-62.e2.

PurposeTo evaluate associations between counties' COVID-19 cases and racial-ethnic and nativity composition, considering heterogeneity across Latin American-origin subgroups and regions of the United States.MethodsUsing county-level data and multilevel negative binomial models, we evaluate associations between COVID-19 cases and percentages of residents that are foreign-born, Latinx, Black, or Asian, presenting estimates for all counties combined and stratifying across regions. Given varying risk factors among Latinx, we also evaluate associations for percentages of residents from specific Latin American-origin groups.ResultsPercentage of foreign-born residents is positively associated with COVID-19 case rate (IRR = 1.106; 95% CI: 1.074-1.139). Adjusted associations for percentage Latinx are nonsignificant for all counties combined, but this obscures heterogeneity. Counties with more Central Americans have higher case rates (IRR = 1.130; 95% CI: 1.067-1.197). And, in the Northeast and Midwest, counties with more Puerto Ricans have higher case rates. Associations with percentage Asians are nonsignificant after adjusting for percentage foreign-born. With the confirmation of prior evidence, the percentage of Black residents is positively and robustly associated with COVID-19 case rate (IRR = 1.031; 95% CI: 1.025-1.036).ConclusionsCounties with more immigrants, as well as more Central American or Black residents, have more COVID-19 cases. In the Northeast and Midwest, counties with more Puerto Rican residents also have more COVID-19 cases.Copyright © 2020 Elsevier Inc. All rights reserved.

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