Why are some people more at risk of being affected by coronavirus disease 2019 (COVID-19)?
Factors in a person's life or community can raise the risk of being affected by COVID-19.
Having other health conditions and barriers to medical care can change the risk of getting COVID-19 or getting very sick from COVID-19. Other factors include where a person lives, the work a person does and beliefs a person has about medical care.
COVID-19 may cause illness in some groups more than others because of how society treats the group.
Together these factors are called social determinants of health.
Discrimination
Unfair and unjust treatment based on race, age, ethnicity, gender or other traits can play a part in poor health. Discrimination affects all aspects of health starting with the world around a person. It also can affect a person's access to healthcare professionals, diagnosis of illness and treatment.
Other medical conditions
The stress of dealing with racial discrimination can take a toll on the body. Diagnosis of heart disease, obesity, diabetes, high blood pressure, and kidney or liver disease is linked to the stress of racial discrimination.
A person with any of these diseases, due to racism or other causes, has a higher risk of severe illness with COVID-19.
Access to healthcare
Members of some racial and ethnic groups are more likely to face barriers to getting healthcare. For example, some people may not have health insurance.
Based on U.S. census data, about 7% of non-Hispanic white adults and adults of Asian descent were uninsured in 2022. The rate was about 11% for Black adults and about 23% for Hispanic adults in that same year.
Location
Where people live can make it hard to avoid getting COVID-19 or to get COVID-19 treatment. People in rural areas may not have access to healthcare. And people in areas with a dense population may find it hard to stay physically apart from others.
Beliefs about medical care
Groups who distrust the healthcare system may be less likely to get a COVID-19 vaccine or get help for COVID-19 or other illnesses.
Type of work
Having an essential job that can't be done remotely can raise the risk of catching the virus that causes COVID-19. The risk also is higher if you have to come in contact with lots of people.
COVID-19 health disparities
In the early years of the COVID-19 pandemic, American Indian and Alaska Native people, non-Hispanic Black people and Hispanic people had higher rates of infection and COVID-19 deaths compared with those of non-Hispanic white people.
Black and Hispanic people in the United States also had higher chances of needing care in the hospital for COVID-19.
Early pandemic data suggested that American Indian and Alaska Native people were four times more likely to need hospital care for COVID-19 than were non-Hispanic white people.
By 2021, the rate of infection and death for non-Hispanic white people had risen and closed the gap between the groups. In April 2024, non-Hispanic white people had the highest rate of death compared with that of other race and ethnicities.
Taken together, the COVID-19 pandemic shows how disease can raise the risk of illness based on factors that can be prevented. The pandemic highlights the need to promote the health and well-being of people with a higher than average risk of disease.
July 06, 2024
- What is health equity? Centers for Disease Control and Prevention. https://www.cdc.gov/healthequity/whatis/index.html. Accessed June 4, 2024.
- Discrimination. Healthy People 2030. https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/discrimination. Accessed June 4, 2024.
- Goldman L, et al., eds. In: Goldman-Cecil Medicine. 27th ed. Elsevier; 2024. https://www.clinicalkey.com. Accessed June 4, 2024.
- People with certain medical conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Accessed April 19, 2022.
- Mackey K, et al. Racial and ethnic disparities in COVID-19 — Related infections, hospitalizations, and deaths: A systematic Review. Annals of Internal Medicine. 2020; doi:10.7326/M20-6306.
- Lundberg, et al. COVID-19 Mortality by race and ethnicity in US metropolitan and nonmetropolitan areas, March 2020 to February 2022. Journal of the American Medical Association Network Open. 2023; doi:10.1001/jamanetworkopen.2023.11098.
- COVID-19 Monthly death rates per 100,000 population by age group, race and ethnicity, and sex. Centers for Disease Control and Prevention. https://covid.cdc.gov/covid-data-tracker/#demographicsovertime. Accessed June 4, 2024.
- Keisler-Starkey K, et al. Health insurance coverage in the United States: 2022. U.S. Census Bureau. https://www.census.gov/library/publications/2023/demo/p60-281.html. Accessed June 17, 2024.