Effects of Social Class, Ethnicity and Gender on the Burden of Death from COVID-19

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New research examines the joint effects of social class, race or ethnicity, and gender on the burden of death from coronavirus disease 2019 (COVID-19).

Study: SSocial class, race / ethnicity and COVID-19 mortality among working-age adults in the United States. Image Credit: Sagittarius_13 / Shutterstock

Researchers in the study determined whether remote work opportunities correlated with deaths from COVID-19 for socio-demographic groups.

They found that the lower socio-economic position, Hispanic men who worked were more affected by deaths from COVID-19.

The most pressing implications of this study highlight immediate actions to protect blue collar workers, services and retailers from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus).

The study is currently available on the medRxiv* preprint server pending peer review.

Background

Since December 2019, COVID-19 caused by SARS-CoV-2 has killed more than 5.18 million people worldwide.

The infection is easily transmitted, indicating that social environments play a vital role in viral spread and the resulting morbidity and mortality.

Social class privilege creates the deployment of strategies to avoid, reduce or prevent exposure to SARS-CoV-2. The key elements here are the privileges of living in larger houses with few people, in a less densely populated area, without using public transport, access to high quality health care, better working conditions. , etc. All of this attenuates viral transmission.

While reports of substantial racial / ethnic disparities in COVID-19 mortality are documented, social class disparities and COVID-19 mortality among working-age adults have yet to be investigated.

The key question raised in this study is:

Did death rates from COVID-19 in non-elderly adults vary significantly by social class, race / ethnicity and gender in 2020? “

Study results

The researchers reported that this study is the first national survey of social class disparities in COVID-19 mortality among working-age adults. Taking advantage of the death certificate tabulation released by the U.S. National Center for Health Statistics (NCHS) in February 2021, researchers calculated age-adjusted COVID-19 death rates simultaneously stratified by social class , race / ethnicity and gender.

The researchers included six racial / ethnic groups: White, Hispanic, Black, Asian, Native (American Indian, Native Alaskan, Hawaiian, and other Pacific Islanders), and multiracial. The indigenous type has been grouped together due to the small number of deaths in certain age and social class strata.

The target population for this study included adults aged 25 to 64 who resided in the United States in 2020.

Using educational attainment as an indicator of social class, the researchers defined the working class – no college, some colleges – including associate’s and other 2-year degrees, and college graduates – baccalaureate and more.

Thus, in this study, the researchers analyzed the provisional death tolls for 2020 classified according to four socio-demographic variables:

1) the level of education as described above;

2) race and ethnicity;

3) sex (male, female, unknown);

and 4) age group (25-39 years, 40-54 years, 55-64 years).

To calculate the population denominators stratified by these variables, they used the 2020 Annual Social and Economic Supplement (ASEC) to the Current Population Survey (CPS). The final analytical data set included 69,001 COVID-19-related deaths among adults aged 25 to 64 in the 2020 calendar year.

By constructing a social class pyramid for each of the race / ethnicity groups, the researchers showed that Hispanic, black and native men were predominantly working class. 68% of those who died from COVID-19 were from the working class. Only 12% were college students.

The study showed that age-adjusted COVID-19 death rates were five times higher among the working class than among adult college graduates aged 25 to 64. While women had lower COVID-19 death rates than men, the number of deaths was highest among working-class men.

Looking at COVID-19 social class and mortality by Hispanic race and ethnicity, researchers observed that death rates were highest for Indigenous, Hispanic, and black adults and lowest for multiracial, Asian and Asian adults. white.

However, although Hispanic and black women experienced lower death rates than Hispanic and black men, respectively, they experienced higher death rates than white men in all social classes.

For low-level jobs and “never far away” work by social class, gender and race / ethnicity, most working-class adults (predominantly non-white males) were employed in the lowest-level jobs (collars). blueprints, service, and retail).

The results of the study revealed that those most affected were working-class adults, with physical, chemical and biological hazards in their workplaces.

Conclusion

Based on the results of this study, there is a call for the need to protect the working class – that is, those without a college education – from the SARS-CoV-2 virus.

Hispanic, black and Indigenous working-class men suffered the heaviest death burden from COVID-19, while white college graduate women experienced the lowest death rate.

The researchers concluded that the experts’ recommendations included strengthening federal and state labor laws, empowering the Occupational Safety and Health Administration (OSHA), adopting the Comprehensive Framework for Occupational Health workers and direct actions for unions to organize for better protection of workers’ safety.

*Important Notice

medRxiv publishes preliminary scientific reports which are not peer reviewed and, therefore, should not be considered conclusive, guide clinical practice / health-related behavior, or treated as established information.


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