• Jessica L McCain, Xinyue Wang, Kate Connell, and Jayne Morgan.
• Piedmont Healthcare, Executive Director of the COVID Task Force, 1800 Howell Mill Road, Piedmont Healthcare, Inc., Atlanta, GA 30318.
• J Natl Med Assoc. 2022 Apr 1; 114 (2): 218226218-226.

ImportanceThe increased COVID-19 mortality for Black individuals over White individuals may be explained by the known racial disparities in access to insurance.ObjectiveTo determine whether racial disparities in COVID-19 mortality still exist when Blacks and Whites are equally insured.DesignRoutinely collected data on race, mortality, type of insurance, known risk factors, and lab results from the EPIC Patient Management System were analyzed using a multivariable logistic regression model.SettingPiedmont Healthcare is the largest hospital system in Georgia. Due to its multiple locations across the state of Georgia, it receives a relatively equitably insured population.ParticipantsAll patients hospitalized with a positive COVID-19 status between March 1 and November 30, 2020.Main OutcomesWe hypothesized that Black patients would not have higher odds of mortality than White patients, and that type of insurance would predict COVID-19 mortality.Results6,881 (3,674 Black, 3,207 White; 48% male, mean age = 60) patients were included. Race was not a significant predictor of COVID-19 mortality (p>0.05). When controlling for age and insurance, the mortality rate for Black patients was not statistically significant from that for White patients (p>0.05). Compared to those relying on Medicare, patients with commercial (OR=0.68, 95% CI: 0.48-0.96) or out-of-pocket (self-pay) insurance (OR=0.22, 95% CI: 0.03-0.88) had lower odds of mortality.ConclusionsNational trends of racial disparities in COVID-19 mortality may be partially explained by disparities in insurance.Copyright © 2022 National Medical Association. Published by Elsevier Inc. All rights reserved.

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