Evidence map›Paper›PMID 34308322›Full record

ArticleEClinicalMedicine2021

Race, ethnicity, community-level socioeconomic factors, and risk of COVID-19 in the United States and the United Kingdom.

Chun-Han Lo, Long H Nguyen, David A Drew, Erica T Warner, Amit D Joshi, Mark S Graham, Adjoa Anyane-Yeboa, Fatma M Shebl, Christina M Astley, Jane C Figueiredo and 20 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04331509 (COVID-19 Symptom Tracker), which is not on this map. Cited by 46 papers.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04331509 active not recruitingnot on this map

COVID-19 Symptom Tracker

TypeobservationalSponsorKing's College LondonRan2020 to 2026Enrolled10,000,000ConditionsCOVID-19ArmsNo Intervention
3 · Its place in the literature

Who cites it

46 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Coproducing COVID-19 Health Information Resources: A Participatory Study With Older Adults From Minoritised Ethnic Communities in the UK.Health expectations : an international journal of public participation in health care and health policy · 2025
    Article
  8. Article
  9. The causal effect of natural killer cells on COVID-19 infection, hospitalization and severity.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2025
    Article
  10. Article
  11. Metabolomic heterogeneity of ageing with ethnic diversity: a step closer to healthy ageing.Metabolomics : Official journal of the Metabolomic Society · 2024
    Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. COVID-19 among Black people in Canada: a scoping review.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2024
    Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Chun-Han LoClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
Long H NguyenClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
David A DrewClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
Erica T WarnerClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
Amit D JoshiClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
Mark S GrahamSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
Adjoa Anyane-YeboaDivision of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Fatma M SheblMedical Practice Evaluation Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Christina M AstleyComputational Epidemiology Lab and Division of Endocrinology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Jane C FigueiredoDepartment of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles California, USA.
Chuan-Guo GuoClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
Wenjie MaClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
Raaj S MehtaClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
Sohee KwonClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
Mingyang SongClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
Richard DaviesZoe Limited, London, UK.
Joan CapdevilaZoe Limited, London, UK.
Carole H SudreSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
Jonathan WolfZoe Limited, London, UK.
Yvette C CozierSlone Epidemiology Center, Boston University, Boston, MA, USA.
Lynn RosenbergSlone Epidemiology Center, Boston University, Boston, MA, USA.
Lynne R WilkensEpidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.
Christopher A HaimanDepartment of Preventive Medicine, Keck School of Medicine, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
Loïc Le MarchandEpidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.
Julie R PalmerSlone Epidemiology Center, Boston University, Boston, MA, USA.
Tim D SpectorDepartment of Twin Research and Genetic Epidemiology, King's College London, London, UK.
Sebastien OurselinSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
Claire J StevesDepartment of Twin Research and Genetic Epidemiology, King's College London, London, UK.
Andrew T ChanClinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 100 Cambridge Street, 15th Floor, Boston, MA 02114, USA.
COPE Consortium

Funding

Impact of Aspirin on the Gut Microbiome and Mucosal MicroenvironmentK01DK120742 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI DREW, DAVID A · 2020 to 2024
$793k
Seasonal and Viral Determinants of Type 1 Diabetes Onset, Remission, and Glycemic ControlK23DK120899 · NIDDK · BOSTON CHILDREN'S HOSPITAL · PI ASTLEY, CHRISTINA M. · 2019 to 2021
$682k
NIDDK NIH HHS K01 DK120742NIDDK NIH HHS K23 DK120899
6 · The paper itself

Abstract

backgroundThere is limited prior investigation of the combined influence of personal and community-level socioeconomic factors on racial/ethnic disparities in individual risk of coronavirus disease 2019 (COVID-19).

methodsWe performed a cross-sectional analysis nested within a prospective cohort of 2,102,364 participants from March 29, 2020 in the United States (US) and March 24, 2020 in the United Kingdom (UK) through December 02, 2020 via the COVID Symptom Study smartphone application. We examined the contribution of community-level deprivation using the Neighborhood Deprivation Index (NDI) and the Index of Multiple Deprivation (IMD) to observe racial/ethnic disparities in COVID-19 incidence. ClinicalTrials.gov registration: NCT04331509.

findingsCompared with non-Hispanic White participants, the risk for a positive COVID-19 test was increased in the US for non-Hispanic Black (multivariable-adjusted odds ratio [OR], 1.32; 95% confidence interval [CI], 1.18-1.47) and Hispanic participants (OR, 1.42; 95% CI, 1.33-1.52) and in the UK for Black (OR, 1.17; 95% CI, 1.02-1.34), South Asian (OR, 1.39; 95% CI, 1.30-1.49), and Middle Eastern participants (OR, 1.38; 95% CI, 1.18-1.61). This elevated risk was associated with living in more deprived communities according to the NDI/IMD. After accounting for downstream mediators of COVID-19 risk, community-level deprivation still mediated 16.6% and 7.7% of the excess risk in Black compared to White participants in the US and the UK, respectively.

interpretationOur results illustrate the critical role of social determinants of health in the disproportionate COVID-19 risk experienced by racial and ethnic minorities.

Indexed as

COVID-19EpidemiologyEthnicityInequityRaceSocioeconomic factor

Identifiers

PMID34308322
PMCPMC8285255

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.