The color of coronavirus:
COVID-19 deaths by race and ethnicity in the U.S.

 

by ELISABETH GAWTHROP | May 17, 2023

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The United States’ official COVID-19 death toll is about 1,128,000, with estimates suggesting that the true toll could be 20% higher. Our ongoing Color of Coronavirus project monitors how and where COVID-19 mortality is inequitably impacting certain communities, with an aim to help guide policy and community responses. Relying on data from the U.S. Centers for Disease Control and Prevention, we have documented the race and ethnicity for 99% of these cumulative deaths in the United States.

We highlight national trends in this report, but state-level data is also available in the interactive graphics below and through our GitHub. We’ve also created an archive page for past updates.

Jump to: Recent Trends | Key Findings | Examine the Data

RECENT TRENDS: All racial and ethnic groups in all states saw COVID deaths drop in third year of pandemic

This month, the CDC released state-level data from the first quarter of 2023. With this release, we can now examine yearly trends for the three years since the COVID-19 pandemic began.

We define year one of the pandemic as starting when COVID mortality tracking began in early 2020 and running through the end of March 2021, year two as April 2021 to March of 2022 and year three as April 2022 to March 2023.

Using these years, COVID-19 deaths decreased across all racial and ethnic groups in all states from year two to year three. Two groups, however, did have higher mortality rates in year three than year one — white Americans in Vermont and Hawaii.

Note: these claims are valid for the state-level racial and ethnic groups for which data is not suppressed. There are a number of groups with fewer than 10 deaths and thus no ability to assess yearly trends.

Thirty five states had at least one racial or ethnic group with higher mortality in year two of the pandemic compared to year one. Oregon was the only state to have higher crude mortality rates for all racial and ethnic groups. Alaska and Florida had higher crude mortality rates for five out of the six defined racial and ethnic groups. (In Florida, mortality rates went down slightly in year two for Latino Americans; in Alaska, Black American deaths numbered nine or fewer until the third year of the pandemic, so due to suppressed data we can't tell what the trend was from the first to second years.)

What about the difference between deaths directly and indirectly caused by COVID-19?

To cut through the complications around definitions of a “COVID-19 death”, we compiled excess mortality from the last six years, by state. Although it doesn’t specifically include race and ethnicity, it affirms the time-related patterns we’ve seen in the analyses for this update. At one extreme, for example, New York sees its worst wave in the spring of 2020, while at the other, Vermont’s excess mortality is consistently highest in 2022.

White Americans’ COVID-19 deaths increased from year one to year two in 23 states, and Indigenous Americans’ deaths increased in 22 states. Latino American deaths went up from year one to year two in 15 states, and for Black Americans in 10 states. Asian and Pacific Islander Americans both had an increase of deaths in eight states from the first to second year.

Due to data suppression by CDC of racial and ethnic groups in states with fewer than 10 deaths, data for Indigenous and Pacific Islander Americans is more limited, making a comparative analysis among some states more difficult. If we restrict to just white, Black, Asian and Latino Americans, we can compare among the 41 states and Washington, D.C. with available data for all three years.

Given those constraints, we calculated which racial or ethnic group had the highest crude mortality rate in each state for each year of the pandemic. We found that in the first year, Black Americans had the highest crude mortality rate in 43% of states, white Americans in 40% of states, Latino Americans in 12% and Asian Americans in 5%. By the third year, white Americans had the highest crude mortality rate in 98% of the 41 states and D.C.

As for more recent trends, March COVID-19 deaths in the United States totaled around 7,350 — a 17% decrease from the death toll in February and about half the number of deaths in January. This equates to an average of 237 people dying each day in March, but it’s about half the number of deaths seen a year ago in March.

Deaths decreased for all racial and ethnic groups except for Indigenous Americans, who had an increase of four percent, and Pacific Islander Americans, who had the same number of deaths in February and March. The largest decrease in deaths was for Black Americans (-37%).

When considering the COVID death rate in each racial and ethnic group, white Americans had the highest monthly crude mortality rate in March at 3.0 per 100,000. Indigenous Americans had the second-highest mortality rate at 2.1 per 100,000. Americans of more than one race had the lowest monthly crude mortality rate, with 0.33 per 100,000, and Latino Americans the second-lowest rate at 0.80 per 100,000.

The cumulative white crude mortality rate is now higher than all racial and ethnic groups except for Indigenous Americans (although it’s just barely above Black and Pacific Islander Americans). An important caveat, however, is that the crude mortality rate numbers are not age-adjusted. After adjusting for age, white Americans have the second-lowest mortality rate (see more below).

Finally, in light of mental health awareness month, we analyzed data from the U.S. Census Bureau’s Household Pulse Survey to get a sense of the pandemic’s toll on mental health across racial and ethnic groups, in combination with gender identities.

The Household Pulse Survey includes gender identity categories of male, female and transgender. The survey’s race and ethnicity data does not include Pacific Islander or Indigenous categories; people in those two groups are presumably grouped with the multiracial/other category. We used the method outlined by the CDC to identify the number of people who reported symptoms consistent with major anxiety and/or depressive disorder.

Given those definitions, transgender people across all racial and ethnic groups had the highest rates of anxiety and/or depression over the last year. Within each racial and ethnic group, women had higher rates of anxiety and/or depression than men. Among non-transgender people, women who are multiracial or of another race than those listed had the highest rates of anxiety and/or depression, followed by Hispanic women. Asian men had the lowest rates of anxiety and/or depression.

Now let’s turn to more about what the data tells us about national mortality trends throughout the pandemic. 

KEY FINDINGS (from data through May 10, 2023):

Note: these numbers are sourced from this CDC dataset, the total count of which sometimes differs slightly from the total count reported on the CDC’s primary mortality landing page. Also, time series data used in this report’s figures lags behind these cumulative numbers due to incompleteness of recent data. 

  • Of the approximately 1,130,000 cumulative official COVID-19 deaths in the U.S., these are the numbers of lives lost by group: Asian (35,313), Black (155,600), Indigenous (12,002), Latino (170,807), Pacific Islander (2,300) and white Americans (746,680). Additionally, (7,560) deaths are recorded as “other race”.

  • These are the documented, nationwide (U.S. states + D.C.) crude mortality rates (not age-adjusted) from COVID-19 data for all racial and ethnic groups since the start of the pandemic.

    • 1 in 203 Indigenous Americans have died (or 493 deaths per 100,000)

    • 1 in 264 white Americans have died (or 379 deaths per 100,000)

    • 1 in 266 Black Americans have died (or 376 deaths per 100,000)

    • 1 in 267 Pacific Islander Americans have died (or 375 deaths per 100,000)

    • 1 in 359 Latino Americans have died (or 279 deaths per 100,000)

    • 1 in 548 Asian Americans have died (or 182 deaths per 100,000)

  • Indigenous Americans have the highest crude COVID-19 mortality rate nationwide — about 2.7 times as high as the rate for Asian Americans, who have the lowest crude rate. And, the CDC notes that Indigenous American deaths are often undercounted, with the latest research suggesting the true mortality rate for this group could be around 34% higher than official reports.

  • Because the risk of COVID-19 mortality increases with age, it is important to consider the varying age distributions of America's racial and ethnic groups. A higher share of white Americans are in the older age brackets than any other group. And even within the same race groups, the age distribution varies by location—with retirement destination states such as Florida having a much higher share of older adults within their white population, for example. Indigenous, Latino, Pacific Islander and Black Americans all have significantly higher COVID-19 mortality rates than either white or Asian Americans once the data are adjusted to account for age distribution differences among racial and ethnic groups. Nationally, every group except for white Americans has a higher mortality rate after accounting for age, and Latino Americans see the greatest increase in mortality when converting crude rates to age-adjusted rates.

Age adjusting is a common and important tool that health researchers use when diseases carry varying levels of risk depending on age. Age adjusting allows for a more apples-to-apples comparison among racial and ethnic groups because, in the case of COVID-19, risks are higher for older populations, and racial and ethnic groups in the U.S. have differing proportions of older populations relative to the rest of their populations. As noted by the CDC, “adjusting by age is important because risk of infection, hospitalization, and death is different by age, and age distribution differs by racial and ethnic group. If the effect of age is not accounted for, racial and ethnic disparities can be underestimated or overestimated.”

We’ve included some key assumptions and caveats, as well as an explanation of age adjusting, at the bottom of the page and we’ve made our full code and methods available on our GitHub repository.

Jump to: Recent Trends | Key Findings | Examine the Data

EXAMINE THE DATA:

TRENDS OVER TIME: EXPLORE DATA FOR THE U.S. OR A SINGLE STATE SINCE THE START OF THE PANDEMIC
Crude mortality rate or Number of reported deaths

CUMULATIVE MORTALITY: EXPLORE THE MOST RECENT DATA FOR THE U.S. OR A SINGLE STATE
Crude mortality rates and age-adjusted mortality rates or Number of reported deaths

EXPLORE DATA BY RACE AND ETHNICITY AND COMPARE AMONG STATES ON A MAP
Asian Americans | Black Americans | Indigenous Americans | Latino Americans |
Native Hawaiian & Other Pacific Islander Americans | White Americans

FOCUS ON ASIAN AMERICANS

Lives lost to date

  • 35,313 Asian Americans are known to have lost their lives to COVID-19 through May 10, 2023. There were 218 new deaths reported among Asian Americans for the last full month of data (March 2023), which is an 18% decrease from the preceding month (265 deaths). 

  • Nationwide, Asian Americans have experienced 3.1% of all deaths, while they represent 5.9% of the population.

Crude mortality rate

  • For every 100,000 Asian Americans, about 182 have died from the coronavirus, a mortality rate lower than all other racial or ethnic groups.

  • In 11 states, more than 1 in 500 Asian American residents have died from COVID-19 (i.e., more than 200 per 100,000).

Age-adjusted mortality rate

  • Nationwide, Asian Americans have the lowest age-adjusted mortality rate (224 per 100,000), followed by white Americans (309).

  • Once adjusted for age, the highest COVID-19 mortality rates for Asian Americans are in Minnesota (395), Nevada (388), New York (361), Wisconsin (357) and Arizona (275).

Note: Nationwide statistics are derived from CDC reporting at the national level and are not suppressed. State level statistics are suppressed by CDC when the number of deaths is between 1-9.

FOCUS ON BLACK AMERICANS

Lives lost to date

  • 155,600 Black Americans are known to have lost their lives to COVID-19 through May 10, 2023. There were 561 new deaths reported among Black Americans for the last full month of data (March 2023), which is a 37% decrease from deaths in the preceding month (890).

  • Nationwide, Black Americans have experienced 13.8% of all deaths, while they represent 12.6% of the population.

Crude mortality rate

  • For every 100,000 Black Americans, about 376 have died from the coronavirus. This is a little more than double the rate of Asian Americans, who have had the lowest rate, and about 25% less than Indigenous Americans, who have the highest rate.

  • In 37 states and Washington, D.C., more than 1 in 500 Black residents have died (i.e., more than 200 per 100,000).

Age-adjusted mortality rate

  • Nationwide, the age-adjusted mortality rate for Black Americans (488 per 100,000) is about 2.2 times that of the group with the lowest age-adjusted mortality rate, which is Asian Americans (224 per 100,000).

  • Adjusting for age highlights a disparity in deaths between white and Black Americans in particular — the two groups have similar crude mortality rates, but the Black American age-adjusted mortality rate is around 60% higher than the same measure for white Americans.

  • Once adjusted for age, the highest COVID-19 mortality rates for Black Americans are in Mississippi (643), Iowa (629), Oklahoma (602), Nevada (597) and New Jersey (597).

Note: Nationwide statistics are derived from CDC reporting at the national level and are not suppressed. State level statistics are suppressed by CDC when the number of deaths is between 1-9.

FOCUS ON INDIGENOUS AMERICANS

The CDC notes that Indigenous American deaths are often undercounted, with the latest research suggesting the true mortality rate for this group could be around 34% higher than official reports.

Lives lost to date

  • At least 12,002 Indigenous Americans are known to have lost their lives to COVID-19 through May 10, 2023. There were 52 new deaths reported among Indigenous Americans for the last full month of data (March 2023), which is a 4% increase compared to February deaths (50). 

  • Nationwide, Indigenous Americans have experienced 1.1% of all deaths, while they represent 0.7% of the population.

Crude mortality rate

  • For every 100,000 Indigenous Americans, about 493 have died from the coronavirus. This is about 2.7 times the rate of Asian Americans, who have had the lowest rate, and about 30% more than Black, white and Pacific Islander Americans, who have the next-highest rates after Indigenous Americans.

  • In 33 states, more than 1 in 500 Indigenous American residents have died (i.e., more than 200 per 100,000). Note: there are an additional six states for which it’s possible this threshold has also been crossed but for which we cannot calculate the crude rate due to suppressed values.

Age-adjusted mortality rate

  • Nationwide, Indigenous Americans have the highest age-adjusted mortality rate (607 per 100,000).

  • Once adjusted for age, the highest COVID-19 mortality rates for Indigenous Americans are in North Dakota (1,490), New Mexico (1,311), Montana (1,303), South Dakota (1,204) and Arizona (1,155).

Note: Nationwide statistics are derived from CDC reporting at the national level and are not suppressed. State level statistics are suppressed by CDC when the number of deaths is between 1-9.

FOCUS ON LATINO AMERICANS

Lives lost to date

  • 170,807 Latino Americans are known to have lost their lives to COVID-19 through May 10, 2023. There were 488 new deaths reported among Latino Americans for the last full month of data (March 2023), which is down 19% from the number of deaths reported in February (604).

  • Nationwide, Latino Americans have experienced 15.1% of all deaths, while they represent 18.6% of the population.

Crude mortality rate

  • For every 100,000 Latino Americans, about 279 have died from the coronavirus. This marks the second-lowest crude mortality rate and is about 53% more than the rate of Asian Americans, who have the lowest rate.

  • In 16 states and Washington D.C., more than 1 in 500 Latino residents have died (i.e., more than 200 per 100,000).

Age-adjusted mortality rate

  • Nationwide, Latino Americans see the biggest increase when adjusting for age — from 279 per 100,000 to 509 per 100,000. This also means that they go from having a crude mortality rate less than that of white Americans, to an age-adjusted mortality rate that is 65% higher than white Americans.

  • Once adjusted for age, the highest COVID-19 mortality rates for Latino Americans are in Arizona (667), District of Columbia (655), Texas (645), Oklahoma (628) and Colorado (569).

Note: Nationwide statistics are derived from CDC reporting at the national level and are not suppressed. State level statistics are suppressed by CDC when the number of deaths is between 1-9.

FOCUS ON PACIFIC ISLANDER AMERICANS

Lives lost to date

  • 2,300 Pacific Islander Americans are known to have lost their lives to COVID-19 through May 10, 2023. There were 10 new deaths reported among Pacific Islander Americans for the last full month of data (March 2023), which is the same number of deaths reported for February.

  • Nationwide, Pacific Islander Americans have experienced 0.20% of all deaths, while they represent 0.19% of the population.

Crude mortality rate

  • For every 100,000 Pacific Islander Americans, about 375 have died from the coronavirus. This is just a little less than the crude mortality rate Black Americans and white Americans, more than double that of Asian Americans and about 25% less than Indigenous Americans, who have the highest crude mortality rate.

  • In 25 states, more than 1 in 500 Pacific Islander residents have died (i.e., more than 200 per 100,000). Note: there are an additional 18 states for which it’s possible this threshold has also been crossed but for which we cannot calculate the crude rate due to suppressed values.

Age-adjusted mortality rate

  • Nationwide, Pacific Islander Americans have the third-highest age-adjusted mortality rate (505 per 100,000), just under Latino Americans (509).

  • Washington (953), California (606) and Hawaii (268) are the only states for which age-adjusted rates are calculated, due to statistical requirements.

Note: Nationwide statistics are derived from CDC reporting at the national level and are not suppressed. State level statistics are suppressed by CDC when the number of deaths is between 1-9.

FOCUS ON WHITE AMERICANS

Lives lost to date

  • 746,680 white Americans are known to have lost their lives to COVID-19 through May 10, 2023. There were 5,990 new deaths reported among white Americans for the last full month of data (March 2023), which is a 14% decrease from the preceding month (6,973).

  • Nationwide, white Americans have experienced 66.1% of all deaths, while they represent 59.7% of the population.

Crude mortality rate

  • For every 100,000 white Americans, about 379 have died from the coronavirus. This is just over the crude mortality rate of Black and Pacific Islander Americans, and double that of Asian Americans, who have the lowest crude mortality rate. Indigenous Americans have the highest rate, about 31% more than white Americans.

  • In 46 states, more than 1 in 500 white residents have died (i.e., more than 200 per 100,000).

Age-adjusted mortality rate

  • Nationwide, white Americans are the only group with an age-adjusted COVID-19 mortality rate (309 per 100,000) that is lower than the crude rate (379). Adjusting for age brings the mortality rate for white Americans from the second-highest to the second-lowest.

  • Once adjusted for age, the highest COVID-19 mortality rates for white Americans are in Kentucky (457), Mississippi (456), Oklahoma (447), Tennessee (430) and West Virginia (406).

Note: Nationwide statistics are derived from CDC reporting at the national level and are not suppressed. State level statistics are suppressed by CDC when the number of deaths is between 1-9.

Editors note: This is a re-launched version of our original Color of Coronavirus project, which ran from April 2020 through March 2021. That project was based on harvesting data from the COVID-19 statistics reported separately from each state. Since that time the CDC’s National Center for Health Statistics has developed a more robust system of tracking COVID-19 mortality, based on death certificates. While not without some issues (especially a known undercounting of American Indian deaths, which we address below) this data set is even more comprehensive than was the case in our original reporting of these issues. Even as we regret that tracking COVID-19 deaths is still a relevant pursuit, we hope that you will find our work meaningful and helpful in addressing the pandemic and understanding its impacts. As always, we welcome your feedback and insights (info@apmresearchlab.org).

SOURCES
Mortality Data
  • For total counts and for calculating cumulative crude rates and age-adjusted rates: CDC/NCHS - Distribution of COVID-19 Deaths and Populations, by Jurisdiction, Age, and Race and Hispanic Origin.
  • For counts over time and for crude rates over time, monthly/national: CDC/NCHS - Provisional COVID-19 Deaths: Distribution of Deaths by Race and Hispanic Origin.
  • For counts over time and for crude rates over time quarterly/states: CDC/NCHS - AH Quarterly Excess Deaths by State, Sex, Age, and Race.
    • According to the CDC, about 91% of these deaths have COVID-19 indicated as the underlying cause of death, while for the other 9% COVID-19 is one of multiple causes of death.

    Population Data
    Mid-Year 2020 U.S. Census Data accessed via CDC-WONDER
  • National populations by race, all ages combined.
  • State-level populations by race, all ages combined.
  • For age adjustment, national population by age groups: Non-Hispanic, Hispanic.
  • For age adjustment, state populations by age groups: Non-Hispanic, Hispanic.

    • All calculations and subsequent analysis are by APM Research Lab and available on our GitHub.
    NOTES
    Racial and Ethnic Groups
    Our labels of each racial or ethnic group correspond as follows:
  • Latino — Hispanic or Latino ethnicity of any race
  • Pacific Islander — Non-Hispanic Native Hawaiian or Other Pacific Islander
  • Indigenous — Non-Hispanic American Indian or Alaska Native
  • White — Non-Hispanic white
  • Black — Non-Hispanic Black or African American
  • Asian — Non-Hispanic Asian
  • More than one race — Non-Hispanic more than one race
    • As noted above, Indigenous American deaths are known to be underreported by 34%. According to the CDC, deaths are also known to be underreported for non-Hispanic API (3%) and for Hispanic decedents (3%).
    Some CDC datasets include a "more than one race" racial category and some include an "other" category. We have included the data that indicates more than one race when available, for which there is also an overall population figure available as a denominator when calculating rates. No such denominator is available for calculating rates for the "other" category. The deaths listed in the "other" category constitute less than 1% of total reported deaths.
    Age-Adjusted Rates
    While there are many features of the novel coronavirus that are still unclear, this we know with certainty: The risk of dying from COVID-19 rises sharply with advanced age. According to the CDC, people 65-74 years old have 65 times the risk of dying from COVID-19 compared to people aged 18-29. That risk increases to 140 times higher for people in the 75-84 age bracket, and 340 times for people age 85 or older.

    Due to this steep age gradient to COVID-19 mortality, it is important to consider the varying age distributions of America's racial and ethnic groups. A higher share of white Americans are in the older age brackets than any other group. And even within the same race groups, the age distribution varies by location—with retirement destination states such as Florida having a much higher share of older adults within their white population, for example.

    To remove the role of these age differences from COVID-19 mortality rates, we have also produced age-adjusted rates. There are two main categories of methods used to produce age-adjusted rates: direct and indirect standardization. The direct method uses the age distribution of COVID-19 deaths within a racial or ethnic group, while the indirect method takes the total number of COVID-19 deaths within a racial ethnic group and applies mortality rates by age group from the national level (all races) to the age distribution of that racial or ethnic group.

    We have used the direct method where possible, but the direct method requires knowing the numbers of deaths for each age grouping for each race and, when calculating at the state level, for each state. For states with smaller populations, there are instances where not all of the age groupings reach the threshold of at least 10 to be released by CDC. For these suppressed groups/places, we have used the indirect method to calculate an age-adjusted rate.

    To evaluate the accuracy of the indirectly age-adjusted rates, we compared direct and indirect rates where possible. Most indirect rates were within 5% of the direct rates. Some were up to 10% different and two were approaching 15% different. The higher errors tended to be for groups/places with lower numbers of COVID-19 deaths. For this reason, we chose to not calculate indirect rates for groups/places with fewer than 200 COVID-19 deaths. The indirect rates tended to be higher than the direct rates, but not universally.

    All of these numbers are available for download on our GitHub, including an indication of whether the age-adjustment for a particular group/place has been directly or indirectly calculated.

    What do the results of these calculations mean? The age-adjusted rates indicate that many younger Americans who are Black, Latino, Indigenous or Pacific Islanders are dying of COVID-19—driving their mortality rates far above that of white and Asian Americans. Despite their relative youthfulness (a protective factor against COVID), their death rates are elevated.

    It is important to note that, while age-adjusted mortality rates help us remove the influence of age differences in racial groups to examine disparities in outcomes, they are not the actual mortality rates experienced by these groups.

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