The COVID-19 wave that hit in early 2020 increased mortality more for low-income U.S. residents than for higher-income people — but it also led to a big increase in high-income people’s death rate.
Sarah Miller, an economist at the University of Michigan business school, and two colleagues have published a detailed analysis of COVID-19′s mortality impact in the August issue of Health Affairs, an academic journal that focuses on health care delivery and health care finance issues.
Here’s what happened to the death rate from all causes, between the second quarter of 2019 and the second quarter of 2020, for U.S. residents in households in three different income categories:
- Under 100% of the federal poverty level (FPL): Increased 27%, to 152 deaths per 100,000 people
- 100% to 400% of FPL (over): Increased 16%, to 89 deaths per 100,000 people
- Over 400% of FPL (over): Increased 13%, to 51 deaths per 100,000 people
By using figures on all-cause mortality, rather than solely on COVID-19 deaths, the researchers avoided statistical problems related to U.S. health care organizations’ early problems with testing for the virus that causes the disease.
The researchers also reflected the impact of COVID-19 on health care organizations’ ability to provide care, and on patients’ efforts to seek timely care.
The researchers’ based their analysis on data from the Census Bureau’s American Community Survey and individual mortality data from the Social Security Administration.
Race, Ethnicity and Pandemic Mortality
The researchers note that race and ethnicity had a strong correlation with increases in mortality.
For white people in households with income over 400% of the federal poverty level, for example, the death rate increased 9.2% between the second quarter of 2019 and the second quarter of 2020.
For Black people in households in that income category, the death rate increased 47% over the same period.
For Hispanic people in high-income households, the death rate rose 12%, to 42 deaths per 100,000 lives.
Pandemic Mortality and Occupation
The researchers also analyzed changes in COVID-19 mortality by occupation category.
Mortality fell 1.4% for people in the military, to 46 deaths per 100,000 lives, and increased by less than 10% for some other occupational categories, such as cleaning and maintenance.
The death rate increased 11%, to 39 deaths per 100,000 lives, for health care practitioners and technical support personnel, and 21%, to 47 deaths per 100,000 lives, for personal care and service workers.
The biggest increase was for installation, maintenance and repair workers: those who had to go onsite to fix things faced a 38% increase in their mortality rate, to 89 deaths per 100,000 lives.
(Image: Diego M. Radzinschi/ALM)