The Centers for Disease Control and Prevention quietly revised its estimates for the disproportionately deadly toll that Covid-19 is taking on communities of color, now reflecting a much higher burden than previously acknowledged.
The nation’s top health agency revised the analysis after Sen. Elizabeth Warren, D-Mass., called on the CDC to adjust the data by age. In a November letter to CDC Director Dr. Robert Redfield, Warren said “by failing to adjust COVID-19 mortality rates by age in its public data releases, the CDC may not be providing an accurate assessment of the increased risk of death and serious illness for communities of color relative to White Americans of the same age.”
After adjusting for age, which is a standard means of measuring disease impact, Hispanic and Black Americans are shown to die at a rate of almost three times that of White Americans, the CDC now says. The agency previously said Hispanic and Black Americans were dying at a rate of about one and two times higher than Caucasians, respectively.
The updated analysis also shows that American Indians or Alaska Natives have died at a rate 2.6 times that of White Americans. The CDC previously put that figure at 1.4 times as high as White Americans.
The CDC’s previous infographic, which downplayed the disproportionate burden on communities of color, was widely shared, including in the agency’s “Framework for Equitable Allocation of COVID-19 Vaccine.” The CDC appears to have updated the analysis on Nov. 30.
Representatives for the CDC did not return CNBC’s request for comment.
“I’m glad the CDC responded to my request and adjusted its official COVID-19 race/ethnicity mortality rates for age,” Warren said in a statement to CNBC. “This is a critical update that can help us better understand the true effect of COVID-19 on communities across the nation and begin to address the systemic inequity that exists in our health care system.”
Adjusting for age has such an impact on the analysis because “people of color are, on average, significantly younger than non-Hispanic white Americans,” as Warren put it in her letter to Redfield. Older people are more likely to die of Covid than younger people.
By not adjusting for age, Warren said the CDC did “not tell the full story.”
“The fact that the average age among communities of color is much younger than that of non-Hispanic white Americans makes the disproportionate number of deaths among communities of color all the more disturbing,” she wrote to Redfield. “To date, the CDC has not consistently articulated risks and has not provided full and complete information on the degree to which age and race or ethnicity interact to inflate the risk of COVID-19 mortality for communities of color.”
Dr. Leana Wen, former Baltimore health commissioner, praised Warren and other advocates who pushed for the CDC to make the change. She also applauded the agency for revising the analysis, even in if it did come so late into the pandemic. Wen, an emergency room physician and public health professor at George Washington University, added that without adjusting for age, it’s like “comparing apples to oranges.”
There are underlying factors in society that are causing the disproportionate impact on people of color, Wen said Friday.
“I hope that people will see that it’s not the virus that’s doing the discriminating,” she said in a phone interview. “It’s our systems.”
She explained that people of color are more likely to have jobs that deem them essential workers, for example, which increases their risk of exposure to the virus. She also said people of color are more likely to live in multi-generational housing, which could let the virus spread more easily from younger to older people.
And Black Americans, Wen said, are more likely to live in “food deserts” than White Americans, which leads to all kinds of health issues that increase one’s vulnerability to the virus.
“It’s important for us to understand why it is that Covid-19 has unveiled and unmasked these underlying disparities,” she said. “There are short-term things that could be done. For example, targeting testing to areas that are the hardest hit, ensuring that resources, including vaccines, are targeted to these same communities, as well, while longer term, committing to to working on the social determinants of health.”
Dr. Thomas Tsai, a surgeon and health policy researcher at Harvard University, applauded the CDC for publishing the new age-adjusted analysis. He said that both the raw analysis and the new one should be published, as both are useful for researchers.
Tsai added that he’s concerned that the same disparities that have been evident in the pandemic so far will also be evident in the distribution of a vaccine.
“We need to make sure that our forecasting models and policy planning models, both for testing as well as for vaccine delivery, don’t run the danger of perpetuating existing structural inequalities in our health-care system,” he said in a phone interview. “You don’t want to under allocate vaccines to Black and Hispanic populations.”