Breaking research published in AACC's The Journal of Applied Laboratory Medicine has found that, at the start of the pandemic, the two demographic groups most likely to get COVID-19 were low socioeconomic status Black people and high socioeconomic status White people. This indicates that the impact of socioeconomic status on COVID-19 prevalence is race-specific, an insight that could help to guide efforts to overcome gaps in COVID-19 vaccine distribution.

Since the beginning of the COVID-19 pandemic in the U.S., racial disparities have been evident in both COVID-19 prevalence and access to pandemic-related healthcare services. Racial and ethnic minority groups are disproportionately represented among COVID-19 cases, but are disproportionately underrepresented among those who've received the vaccine. Given that race is a sociocultural construct, it is therefore important to understand how different sociocultural factors contribute to these inequities so that the U.S. can implement informed policies and programs to mitigate them. As the country struggles to reach herd immunity through vaccination, it is crucial to achieve a deeper understanding of the causes of disparities at the start of the pandemic, as it is likely that these same causes are hindering COVID-19 vaccination efforts in the present.

To shed light on this issue, a team of researchers led by Dina N. Greene, PhD, of Washington Kaiser Permanente in Seattle, analyzed the SARS-CoV-2 test results and demographics of 126,452 patients at eight different healthcare institutions in both urban and rural areas across the U.S. From this analysis, they found that from February – May 2020, Black patients made up 38.2% of all positive test results but only 22% of all tests, while White patients made up 54.5% of all tests but only 27.7% of positive test results. The researchers also found that socioeconomic status was a significant predictor for contracting SARS-CoV-2. Surprisingly, however, socioeconomic status had the opposite effect on White and Black patients, with higher socioeconomic status increasing the odds of a positive test for White patients, but decreasing the odds for Black patients.

The study authors speculate that one potential explanation for this finding is a lack of concern among affluent White people due to the perception that they're insulated from harm. As an example of this, the researchers cite a poll of 8,000 California voters in the Sacramento region during the first months of the pandemic. This poll found that almost one-third of White respondents never feared for their physical safety during California's initial lockdown order, which is more than three times greater than the number of Black respondents who felt that way.

"The emerging work around race, economics, and COVID-19 underscores the complexity of these factors and the need for equitable economic opportunities," said Greene. "We show that in the early stage of the pandemic, two groups were more likely to test positive: 1) low [socioeconomic status] Blacks and 2) high [socioeconomic status] Whites. Apart from the highest [socioeconomic status] category, White race predicted lower SARS-CoV-2 positivity … underscoring a growing body of evidence that non-White race was a risk factor for contraction of SARS-CoV-2."

About AACC

Dedicated to achieving better health through laboratory medicine, AACC brings together more than 50,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, pharmaceutical lab equipment management, and other areas of progressing laboratory science. Since 1948, AACC has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. 

Launched by AACC in 2016, The Journal of Applied Laboratory Medicine (jalm.org) is an international, peer-reviewed publication showcasing the applied research in clinical laboratory science that is driving innovation forward in healthcare.