Multiple studies document disproportionate COVID-19 infection rates and mortality among US communities of color. Acosta et al. (2021) found that American Indian or Alaska Native, Latino, Black, and Asian or Pacific Islander persons had higher rates of COVID-19 hospitalizations, intensive care unit (ICU) admissions, and hospital deaths compared to non-Hispanic whites in the first year of the pandemic, and Truman et al. (2022) found large racial-ethnic disparities in age-adjusted COVID-19 mortality rates in both 2020 and 2021. Racial residential segregation is a strong predictor of infection rates. In New York and Chicago, zip codes with high levels of Black and Latino clustering had higher infection rates even after accounting for SES differences (Anderson et al. 2021). Wiltz et al. (2022) used data from 41 health care systems to examine racial-ethnic disparities in receipt of three COVID-19 treatments: monoclonal antibodies, remdesivir, and dexamethasone. They found lower use of monoclonal antibody treatment with Hispanic patients compared to non-Hispanic patients, and with Black, Asian and Other race patients compared to whites. Racial-ethnic disparities were smaller for remdesivir and dexamethasone, because these treatments are reserved for hospitalized patients with severe COVID-19. Monoclonal antibody treatment is more discretionary (because it is indicated only for mild to moderate cases) and also more difficult to administer because it is an out-patient infusion. Non-white patients may not have sought out monoclonal antibody treatments, but it is also possible that doctors prescribed these less frequently to non-white patients.

lower education is strongly associated with higher rates of infection and death

The recent addition of questions about sexual and gender identity on national health surveys should permit a more complete examination of sexual minority health across a wider variety of health measures as new data become available.

Ten Leading Causes of Death in the United States, 1900 and 2020

Although the United States spends significantly more money on health care than any other country, it compares poorly to other nations on LE.

unique genetic make-up

determinants of health are embedded in the social structure of society (e.g., the economic and political systems; social norms, policies, and practices; and systems of social stratification).

Population growth. Population growth leads to a greater concentration of people in increasingly crowded urban environments, allowing infections to spread quickly. Increased travel. Worldwide travel increases the chances of a pathogen being contracted in one area and unwittingly transported to another. Climate change. Vector-borne diseases are spread by insects such as mosquitos or ticks. Warming temperatures allow vectors to thrive, increasing the risk of disease to human populations. Deforestation and natural habitat loss. Cleared land collects rainwater more than rainforests, providing more suitable breeding grounds for mosquitos. Loss of habitat through deforestation and human encroachment bring animals into greater contact with humans, increasing potential for disease. For example, encroachment on and fragmentation of US woodlands brought tick-carrying mice and deer into closer contact with humans, spreading Lyme disease (Akhtar 2016). The global trade in wildlife and production of animals for food. About two-thirds of emerging pathogens come from other animals. As demand for food, skins, and entertainment increases, so does the risk of infectious disease (Akhtar 2016).

has proposed that a fifth stage—the Age of Obesity and Inactivity—has been underway for the last few decades.

20 and 40 years

Increased travel.

epidemiological transition, Omran (1971) divided the mortality experience of humankind into three stages—the Age of Pestilence and Famine, the Age of Receding Pandemics, and the Age of Degenerative and Human-Made Diseases.