• Mireille Jacobson, Tom Y Chang, Manisha Shah, Rajiv Pramanik, and Samir B Shah.
• Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California; Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California. Electronic address: mireillj@usc.edu.
• Am J Prev Med. 2021 Nov 1; 61 (5): 644651644-651.

IntroductionSocioeconomic differences may confound racial and ethnic differences in SARS-CoV-2 testing and COVID-19 outcomes.MethodsA retrospective cohort study was conducted of racial/ethnic differences in SARS-CoV-2 testing and positive tests and COVID-19 hospitalizations and deaths among adults impaneled at a Northern California regional medical center and enrolled in the county Medicaid managed care plan (N=84,346) as of March 1, 2020. Logistic regressions adjusted for demographics, comorbidities, and neighborhood characteristics.ResultsNearly 30% of enrollees were ever tested for SARS-CoV-2, and 4% tested positive. A total of 19.7 per 10,000 were hospitalized for and 9.4 per 10,000 died of COVID-19. Those identified as Asian, Black, or of other/unknown race had lower testing rates, whereas those identified as Latino had higher testing rates than Whites. Enrollees of Asian or other/unknown race had slightly higher odds of a positive test, and Latinos had much higher odds of a positive test (OR=3.77, 95% CI=3.41, 4.17) than Whites. The odds of hospitalization (OR=2.85, 95% CI=1.85, 4.40) and death (OR=4.75, 95% CI=2.23, 10.12) were higher for Latino than for White patients, even after adjusting for demographics, comorbidities, and neighborhood characteristics.ConclusionsIn a Medicaid managed care population, where socioeconomic differences may be reduced, the odds of a positive SARS-CoV-2 test, COVID-19 hospitalization, and COVID-19 death were higher for Latino but not Black patients than for White patients. Racial/ethnic disparities depend on local context. The substantially higher risk facing Latinos should be a key consideration in California's strategies to mitigate disease transmission and harm.Copyright © 2021 American Journal of Preventive Medicine. All rights reserved.

29 keywords...

hide…