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

 

by ELISABETH GAWTHROP | September 14, 2022

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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).

The United States’ official COVID-19 death toll has now surpassed 1,045,000 deaths. Our ongoing Color of Coronavirus project monitors how and where COVID-19 mortality is inequitably impacting certain communities — to 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 graphics below and through our GitHub.

In this month's update, we are starting with a new section comparing death rates over time to get a better sense of where we’ve come from and where we stand now in the battle against COVID-19. Our usual updates on the pandemic’s cumulative death toll are still included below.

Racial disparities in COVID-19 mortality have narrowed in 2022

First, looking at age-adjusted mortality rates, disparities persist among racial and ethnic groups — but they have narrowed so far in 2022 compared to the first two years of the pandemic. Indigenous Americans had the highest COVID-19 mortality rates for 2020, and they also have the highest so far in 2022. Pacific Islander Americans had the highest rate in 2021. Latino Americans had the second-highest mortality rate in 2020, and Black Americans, along with Pacific Islander Americans, currently have the second-highest rate so far in 2022. In all three years, Asian Americans have had the lowest COVID mortality rate and white Americans the second-lowest.

The most obvious example of the narrowing death rates between racial and ethnic groups over these three time periods is to compare the single largest group, white Americans, to the group with the highest cumulative mortality rate, Indigenous Americans. In 2020 the age-adjusted COVID-19 mortality rate among Indigenous Americans was 2.6 times that of white Americans. In 2021 that ratio fell to 2.1, and so far in 2022 it has fallen further to 1.6.

Similarly, but less dramatically, the ratio between the age-adjusted COVID-19 death rate of the group with the consistently lowest rate, Asian Americans, and Latino Americans has fallen from 2.5 in 2020 and 2021 to 2.0 so far in 2022.

Ideally we would be able to use age-adjusted rates for all analyses, since different racial groups have widely differing proportions of their populations in the older age ranges which are more vulnerable to COVID-19 mortality. Data availability, however, limits our ability to do so. Thus, the following figures are crude rates, but should be viewed more for looking at how an individual group is trending relative to itself over time, rather than for comparing absolute numbers among the different groups.

The next figure uses the same data as the graph we show every month of cumulative crude rates, but here we tally each month individually instead to show the month-to-month variation more clearly.

The monthly mortality rates show that while Black, Indigenous and white Americans all had a similar peak crude mortality rate during the early 2022 omicron wave, Indigenous Americans had much higher rates in the months leading up to that peak as well as a slower decline in rates following the peak. The analysis also reveals that Pacific Islander Americans had a higher mortality rate during the early delta variant period compared to the omicron period.

One final look at the changes in COVID-19 mortality rates over time shows that Asian and Latino Americans have seen the biggest drop in COVID mortality rates compared to this point last year, with both groups having about half the rate this year compared to last year. Notably, so far in 2022, white Americans have a higher crude COVID-19 mortality rate than any other major racial or ethnic group. In comparison, from January to July of 2021, Black, Pacific Islander and especially Indigenous Americans all had higher crude death rates than white Americans.

For more on the shifts in mortality rates among racial and ethnic groups since the beginning of the pandemic, see our blog post from earlier this year. And now for our usual update.

In July, the most recent month for which mortality data is nearly complete, deaths increased by 37% compared to June for Americans overall. All racial and ethnic groups saw an increase in deaths from June to July. Asian, Black and Latino Americans all had around a 50% increase, while Indigenous, Pacific Islander and white American COVID mortality increased by about a third.

As of September 3, the CDC is reporting 12,736 COVID-19 deaths in July. That translates to 411 deaths per day. This marks the third month in a row of an increasing number of deaths after a low point in April of 6,175 deaths.

Vaccinations have trended in the opposite direction since April. Around 14.9 million were vaccinated in April, and that number has steadily decreased since. In August, 4.7 million vaccinations were administered, down from 7.3 million in July. For more on the latest vaccination rates in states across the country, visit our Inoculation Nation page.

When looking at the mortality burdens of each group as a share of their respective populations, Indigenous Americans continue to suffer the highest rates of loss — a position they have held since early November 2020 — followed by Pacific Islander and Black Americans.

KEY FINDINGS (from data through September 3, 2022):

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 1,044,391 cumulative official COVID-19 deaths in the U.S., these are the numbers of lives lost by group: Asian (32,721), Black (147,540), Indigenous (11,427), Latino (164,604), Pacific Islander (2,205) and white Americans (678,998). Additionally, 6,896 deaths are recorded as “other” race.

  • These are the documented, nationwide (U.S. states + D.C.) crude mortality impacts from COVID-19 data for all race groups since the start of the pandemic.

    • 1 in 213 Indigenous Americans have died (or 470 deaths per 100,000)

    • 1 in 278 Pacific Islander Americans have died (or 359 deaths per 100,000)

    • 1 in 281 Black Americans have died (or 356 deaths per 100,000)

    • 1 in 290 white Americans have died (or 345 deaths per 100,000)

    • 1 in 372 Latino Americans have died (or 268 deaths per 100,000)

    • 1 in 592 Asian Americans have died (or 169 deaths per 100,000)

  • Indigenous Americans have the highest crude COVID-19 mortality rates nationwide — about 2.8 times as high as the rate for Asian Americans, who have the lowest crude rates. 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.

  • 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 between crude and age-adjusted rates. Age adjusting allows for more apples-to-apples comparison among racial and ethnic groups.

Age adjusting is a common and important tool that health researchers use when diseases carry varying levels of risk depending on age. 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.

EXAMINE THE DATA:

1. TRENDS: EXPLORE DATA FOR THE U.S. OR A SINGLE STATE OVER TIME

Crude mortality rate or Number of reported deaths

2. TOTALS: EXPLORE DATA FOR THE U.S. OR A SINGLE STATE

Crude mortality rates and age-adjusted mortality rates or Number of reported deaths

3. EXPLORE DATA BY GROUP 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

  • 32,721 Asian Americans are known to have lost their lives to COVID-19 through September 3, 2022. There were 469 new deaths reported among Asian Americans for the last full month of data (July 2022), which is a 49% increase from the preceding month (315). 

  • 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 169 have died from the coronavirus, a mortality rate lower than all other racial or ethnic groups.

  • In seven 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 (207 per 100,000), followed by white Americans (282).

  • Once adjusted for age, the highest COVID-19 mortality rates for Asian Americans are in Nevada (378), Minnesota (373), Wisconsin (340), New York (339) and Arizona (258).

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

  • 147,540 Black Americans are known to have lost their lives to COVID-19 through September 3, 2022. There were 1,298 new deaths reported among Black Americans for the last full month of data (July 2022), which is a 52% increase from the preceding month (853).

  • Nationwide, Black Americans have experienced 14.1% of all deaths, while they represent 12.6% of the population.

Crude mortality rate

  • For every 100,000 Black Americans, about 356 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 (462 per 100,000) is about 2.2 times that of the group with the lowest age-adjusted mortality rate, which is Asian Americans (207 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 68% higher than the same measure for white Americans.

  • Once adjusted for age, the highest COVID-19 mortality rates for Black Americans are in Mississippi (613), Iowa (594), Nevada (573), New Jersey (571) and Michigan (559).

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 11,427 Indigenous Americans are known to have lost their lives to COVID-19 through September 3, 2022. There were 76 new deaths reported among Indigenous Americans for the last full month of data (July 2022), which is a 33% increase compared to June deaths (57). 

  • 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 470 have died from the coronavirus. This is about 2.8 times the rate of Asian Americans, who have had the lowest rate, and about 30% more than Pacific Islander Americans, who have the next-highest rate after Indigenous Americans.

  • In 30 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 (576 per 100,000).

  • Once adjusted for age, the highest COVID-19 mortality rates for Indigenous Americans are in North Dakota (1,414), New Mexico (1,248), Montana (1,245), South Dakota (1,132) and Arizona (1,117).

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

  • 164,604 Latino Americans are known to have lost their lives to COVID-19 through September 3, 2022. There were 1151 new deaths reported among Latino Americans for the last full month of data (July 2022), which is up 50% from the number of deaths reported in June (767).

  • Nationwide, Latino Americans have experienced 15.9% of all deaths, while they represent 18.6% of the population.

Crude mortality rate

  • For every 100,000 Latino Americans, about 268 have died from the coronavirus. This is about 62% more than the rate of Asian Americans, who have had the lowest rate, and about 20% less than white Americans.

  • 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 268 per 100,000 to 488 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 74% higher than white Americans.

  • Once adjusted for age, the highest COVID-19 mortality rates for Latino Americans are in  Arizona (643), District of Columbia (627), Texas (623), Oklahoma (592) and New York (542).

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

  • 2,205 Pacific Islander Americans are known to have lost their lives to COVID-19 through September 3, 2022. There were 19 new deaths reported among Pacific Islander Americans for the last full month of data (July 2022), which is up 36% from the deaths reported in June (14).

  • Nationwide, Pacific Islander Americans have experienced 0.21% of all deaths, while they represent 0.19% of the population.

Crude mortality rate

  • For every 100,000 Pacific Islander Americans, about 359 have died from the coronavirus. This is similar to Black Americans, more than double that of Asian Americans and about 24% 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 (482 per 100,000), just under Latino Americans (488).

  • Washington (887), California (577) and Hawaii (251) 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

  • 678,998 white Americans are known to have lost their lives to COVID-19 through September 3, 2022. There were 9,677 new deaths reported among white Americans for the last full month of data (July 2022), which is a 34% increase from the preceding month (7,227).

  • Nationwide, white Americans have experienced 65% of all deaths, while they represent 59.7% of the population.

Crude mortality rate

  • For every 100,000 white Americans, about 345 have died from the coronavirus. This is somewhat less than Black and Pacific Islander Americans, and about double that of Asian Americans, who have the lowest crude mortality rate. Indigenous Americans have the highest rate, about 37% more than white Americans.

  • In 45 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 (282 per 100,000) that is lower than the crude rate (345).

  • Once adjusted for age, the highest COVID-19 mortality rates for white Americans are in Mississippi (421), Oklahoma (407), Kentucky (404), Tennessee (390) and Alabama (375).

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.

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
    Race and Ethnicity Groups
    Our labels of each race/ethnicity 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 race/ethnicity group, while the indirect method takes the total number of COVID-19 deaths within a race/ethnicity group and applies mortality rates by age group from the national level (all races) to the age distribution of that race/ethnicity 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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