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Associations of COVID-19 Hospitalizations, ICU Admissions, and Mortality with Black and White Race and Their Mediation by Air Pollution and Other Risk Factors in the Louisiana Industrial Corridor, March 2020–August 2021

Author

Listed:
  • Qingzhao Yu

    (Biostatistics Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA)

  • Wentao Cao

    (Biostatistics Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA)

  • Diana Hamer

    (Division of Academic Affairs, Our Lady of the Lake Regional Medical Center, Baton Rouge, LA 70808, USA)

  • Norman Urbanek

    (Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA)

  • Susanne Straif-Bourgeois

    (Epidemiology Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA)

  • Stephania A. Cormier

    (Department of Biological Sciences, Louisiana State University, Baton Rouge, LA 70803, USA
    Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA)

  • Tekeda Ferguson

    (Epidemiology Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA)

  • Jennifer Richmond-Bryant

    (Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA
    Center for Geospatial Analytics, North Carolina State University, Raleigh, NC 27695, USA)

Abstract

Louisiana ranks among the bottom five states for air pollution and mortality. Our objective was to investigate associations between race and Coronavirus Disease 2019 (COVID-19) hospitalizations, intensive care unit (ICU) admissions, and mortality over time and determine which air pollutants and other characteristics may mediate COVID-19-associated outcomes. In our cross-sectional study, we analyzed hospitalizations, ICU admissions, and mortality among positive SARS-CoV-2 cases within a healthcare system around the Louisiana Industrial Corridor over four waves of the pandemic from 1 March 2020 to 31 August 2021. Associations between race and each outcome were tested, and multiple mediation analysis was performed to test if other demographic, socioeconomic, or air pollution variables mediate the race–outcome relationships after adjusting for all available confounders. Race was associated with each outcome over the study duration and during most waves. Early in the pandemic, hospitalization, ICU admission, and mortality rates were greater among Black patients, but as the pandemic progressed, these rates became greater in White patients. However, Black patients were disproportionately represented in these measures. Our findings imply that air pollution might contribute to the disproportionate share of COVID-19 hospitalizations and mortality among Black residents in Louisiana.

Suggested Citation

  • Qingzhao Yu & Wentao Cao & Diana Hamer & Norman Urbanek & Susanne Straif-Bourgeois & Stephania A. Cormier & Tekeda Ferguson & Jennifer Richmond-Bryant, 2023. "Associations of COVID-19 Hospitalizations, ICU Admissions, and Mortality with Black and White Race and Their Mediation by Air Pollution and Other Risk Factors in the Louisiana Industrial Corridor, Mar," IJERPH, MDPI, vol. 20(5), pages 1-14, March.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:5:p:4611-:d:1088332
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    References listed on IDEAS

    as
    1. Mikati, I. & Benson, A.F. & Luben, T.J. & Sacks, J.D. & Richmond-Bryant, J., 2018. "Disparities in distribution of particulate matter emission sources by race and poverty status," American Journal of Public Health, American Public Health Association, vol. 108(4), pages 480-485.
    2. Christopher J. Cronin & William N. Evans, 2021. "Excess mortality from COVID and non-COVID causes in minority populations," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 118(39), pages 2101386118-, September.
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    4. Jeffrey M. Albert & Suchitra Nelson, 2011. "Generalized Causal Mediation Analysis," Biometrics, The International Biometric Society, vol. 67(3), pages 1028-1038, September.
    5. Qingzhao Yu & Bin Li, 2021. "A multivariate multiple third-variable effect analysis with an application to explore racial and ethnic disparities in obesity," Journal of Applied Statistics, Taylor & Francis Journals, vol. 48(4), pages 750-764, March.
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