4 Burden of Disease: Race
Infections by Race / Ethnicity
Interpreting racial differences in infection rates is complex because observed patterns often reflect multiple overlapping social and structural factors.
Adjusting for both age and race is a way for us to ask:
“If all counties had the same age structure and racial composition, what would infection rates look like?”
Race-adjusted rates help reduce the influence of differing racial compositions across counties, but they cannot explain why a population group shows elevated risk. Higher rates may reflect individual-level vulnerabilities, structural inequities such as racism or unequal access to resources, county-level environmental or social conditions, or the interaction among these factors.
For example, after adjusting for both age and race across counties:
Counties with the largest Hispanic populations experienced the highest rates of severe infections on average.
This finding signals an important disparity, but the adjusted rate alone cannot identify its underlying causes. One possible explanation is that many of these counties are located near major urban areas with very high numbers of cases, such as Los Angeles, Sacramento, and San Bernardino counties, which may increase exposure risk.
Additional analysis would be needed to determine whether this pattern reflects geographic proximity, social determinants of health, barriers to prevention and treatment, or a combination of factors.
County Adjusted Infection Rates by Hispanic Population
The severe infection rates were adjusted jointly for both age distributions and racial composition (reported as rates per 100,000 population).
Statewide Proportion of Infections by Race
Statewide Proportion of Infections by Race
| Race | Severe Infections | Infections |
|---|---|---|
| White NH | 50.0% | 39.1% |
| Black NH | 5.6% | 6.0% |
| Hispanic | 28.7% | 39.5% |
| Asian NH | 13.1% | 12.0% |
| MR NH | 1.8% | 2.6% |
| AIAN NH | 0.5% | 0.5% |
| NHPI NH | 0.3% | 0.4% |
Distribution of Severe Infections Across Counties
| Race | Median | Range | SD |
|---|---|---|---|
| AIAN NH | 0.7% | 0% - 25% | 3.4% |
| Asian NH | 4.4% | 0% - 37.2% | 8.1% |
| Black NH | 1.3% | 0% - 13.3% | 3.1% |
| Hispanic | 16.0% | 0% - 74.4% | 14.9% |
| MR NH | 1.7% | 0% - 4.3% | 1.0% |
| NHPI NH | 0.1% | 0% - 1.2% | 0.3% |
| White NH | 65.6% | 20.7% - 94.8% | 18.3% |
White NH = White, Non-Hispanic
Black NH = Black, Non-Hispanic
AIAN NH = American Indian or Alaska Native, Non-Hispanic
Asian NH = Asian, Non-Hispanic
NHPI NH = Native Hawaiian or Pacific Islander, Non-Hispanic
MR NH = Multiracial (two or more of the above races), Non-Hispanic
Hispanic = Hispanic (any race)
Unknown = Unknown