68% of COVID-19 Deaths Occurred in Adults in Low Socioeconomic Positions

The unfortunate truth of the COVID-19 pandemic is that racial and ethnic groups that were already societally marginalized experienced disproportionately high mortality rates. However, there has been less research examining how socioeconomic position impacts the risk of COVID-19 mortality.

One study, published in the International Journal of Environmental Research and Public Health, sought to determine the combined effects of socioeconomic position, race/ethnicity, and gender on COVID-19 mortality burden. A secondary study objective was to explore whether the option to work remotely was correlated with COVID-19 mortality.

The investigators utilized annual mortality studies, which contained a specialized government calculation of COVID-19-related deaths in 2020. The mortalities were stratified by socioeconomic position (measured by education level), race/ethnicity, and gender. The study population included US COVID-19 decedents from 2020. They ranged in age from 25-64 years.

Socioeconomic position was defined as low, intermediate, or high, race/ethnicity included Hispanic, Black, Asian, Indigenous, multiracial, and non-Hispanic white, and gender was split into male or female. The investigators used census data of the occupations held by the deceased adults in 2020 to determine the possibility of remote work.

For the 36 sociodemographic groups, the investigators found the age-adjusted COVID-19 death rates. Adults with high socioeconomic status were the low-risk referent group for the risk calculations. It is significant to note that a higher number of Hispanic, Black, and Indigenous people were in a low socioeconomic position in 2020 than white people.

COVID-19 mortality was found to be 5 times higher for adults in low socioeconomic positions (72.2 deaths per 100000) than for those in high socioeconomic positions (14.6 deaths per 100000). The joint characteristics of low socioeconomic status, Hispanic ethnicity, and male gender carried a COVID-19 mortality risk that was 27 times higher (178.0 deaths per 100000). At 6.5 deaths per 100000, COVID-19 mortality risk was lowest for white women with high socioeconomic standing.

Using regression modeling, the investigators found that 72% of the variance in COVID-19 mortality rates could be attributed to having a job that was neve remote. The study authors concluded that COVID-19 management efforts should prioritize adults of low socioeconomic status, such as the working class. Special attentions should be paid to “never remote” jobs, such as blue collar, retail, and service workers, whose inflexible and unsafe working conditions increase the risk of COVID-19 mortality.