The Centers for Disease Control and Prevention have tacitly revised their estimates for the disproportionately fatal toll Covid-19 is taking on color communities, now reflecting a much higher burden than previously recognized.
The country’s top health authority revised the analysis after Senator Elizabeth Warren, D-Mass., Asked the CDC to adjust the data by age. In a letter to CDC director Dr. November’s Robert Redfield told Warren, “Because the COVID-19 death rate has not been adjusted for age in its public data releases, the CDC may not provide an accurate estimate of the increased risk of death and serious illness for color communities compared to white American peers.”
CNBC first received and reported Warren’s letter to Redfield.
Adjusted for age, which is a standard means of measuring the effects of disease, it is shown that Hispanic and black Americans are nearly three times more likely to die than white Americans, according to the CDC. The agency previously said that Hispanic and black Americans were about once and twice more likely to die than Caucasians.
The updated analysis also shows that Alaskan Indians or native Americans died 2.6 times as often as white Americans. The CDC had previously estimated that number to be 1.4 times that of white Americans.
The CDC’s earlier infographic downplaying the disproportionate burden on color communities was widely used, including in the agency’s “Framework for the Fair Allocation of COVID-19 Vaccines”. The CDC appears to have updated the analysis on November 30th.
CDC officials have not returned CNBC’s request for comment.
“I’m glad the CDC responded to my request and adjusted their official COVID-19 death rates for race / ethnicity for age,” Warren said in a statement to CNBC. “This is an important update that can help us better understand the real impact of COVID-19 on communities across the country and address the systemic inequality in our health care system.”
Adjusting for age has such an impact on the analysis that “people of color are on average significantly younger than non-Hispanic white Americans,” as Warren put it in her letter to Redfield. Older people die more often from Covid than younger ones.
Warren said the CDC “didn’t tell the full story” by not adjusting for age.
“The fact that the median age among color communities is much younger than that of non-Hispanic white Americans makes the disproportionate number of deaths among color communities all the more worrying,” she wrote to Redfield. “To date, the CDC has not consistently articulated risks and has not provided complete information on how age, race or ethnicity interact to increase the risk of COVID-19 mortality for color communities.”
Dr. Leana Wen, former Baltimore health commissioner, commended Warren and other supporters who urged the CDC to make the change. She also applauded the agency for revising the analysis, even if the pandemic came so late. Wen, an emergency physician and public health professor at George Washington University, added that without adjusting for age, it’s like “comparing apples to oranges”.
There are underlying factors in society that are causing the disproportionate impact on people of color, Wen said on Friday.
“I hope people will see that it is not the virus that is causing the discrimination,” she said in a telephone interview. “It’s our systems.”
She explained that people of color are more likely to have jobs that they consider essential workers, for example, increasing their risk of exposure to the virus. She also said people of color were more likely to live in multigenerational homes, which could make the virus more likely to spread from younger to older people.
And black Americans, Wen said, are more likely to live in “food deserts” than white Americans, leading to all kinds of health problems that increase susceptibility to the virus.
“It is important for us to understand why Covid-19 uncovered and debunked these underlying differences,” she said. “There are short-term things that could be done. For example, targeting tests on the hardest hit areas to make sure resources, including vaccines, are destined for the same communities and longer-term commitments to work on the social determinants of health . “
Dr. Thomas Tsai, surgeon and health policy researcher at Harvard University, applauded the CDC for publishing the new age-adjusted analysis. He said both the raw analysis and the new one should be published as both are useful to researchers.
Tsai added that he is concerned that the same differences seen so far in the pandemic will show up in the distribution of a vaccine.
“We need to ensure that our forecasting and planning models for both testing and vaccine delivery do not run the risk of perpetuating existing structural inequalities in our health system,” he said in a telephone interview. “You don’t want to be under-running vaccines for Black and Hispanic populations.”