ArticleJournal of racial and ethnic health disparities2025
The Association Between Race and Risk of COVID-19 Hospitalization: Examining the Contribution of Social Determinants of Health.
Article in Journal of racial and ethnic health disparities, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Funding
Abstract
introductionCOVID-19 disproportionately affected Black Americans, and social determinants of health (SDOH) likely contributed to this disparity, yet their impact remains unclear. This study investigated the association between race and COVID-19-related hospitalization, assessing the added explanatory value of SDOH and clinical factors.
methodsIn this observational study, we invited 22,895 adult (≥ 18 years) Kaiser Permanente Georgia (KPGA) members with a COVID-19 diagnosis between Jan. 2020 and Jun. 2021 to take a survey of which 482 participated (response rate = 2.1%). We included non-Hispanic Black or non-Hispanic White KPGA members with complete data (n = 306). Surveys were linked to KPGA's electronic medical records. Multivariable logistic regression assessed the relationship between race (non-Hispanic Black compared with White) and likelihood of 30-day hospitalization post-COVID-19 diagnosis adjusting for clinical factors (demographics, comorbidities) and SDOH (neighborhood SDOH, pre-COVID-19 health behaviors, and COVID-19 social impacts). Max-scaled R-squares and likelihood ratio tests assessed model variation and covariate significance.
resultsOur study population was 39.2% Black, 32.4% male, and mean age was 52.3 ± 13.3 years. Overall, 20.0% of Black and 12.4% of White members were hospitalized within 30 days of COVID-19 diagnosis. While not statistically significant, Black (compared with White) members were 72% (aOR: 1.72 [95% CI: 0.75 3.91]) more likely to be hospitalized. Race, clinical factors, and SDOH explained 1.8%, 18.6%, and 14.4% of the variation in hospitalization risk, respectively, and cumulatively explained 34.8%.
conclusionNo significant racial differences in 30-day hospitalization were observed; however, we found that clinical factors and SDOH explained similar variation in hospitalization risk.
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