Color of Coronavirus:
frequently asked questions
+ 1. Where is the data obtained from?
The APM Research Lab independently compiles these mortality data for Washington, D.C. and all states directly from state health department websites or contacts. At the time of this writing, only North Dakota and West Virginia did not yet publicly release COVID-19 mortality data by race and ethnicity on their state health department websites. For these two states, we have supplemented our data file using data reported to the National Center for Health Statistics, a division of the CDC. Note that these data have some time lag and often have suppressed data (i.e., data hidden for privacy’s sake), especially for groups other than Whites. Nonetheless, their inclusion improves the picture of COVID-19 mortality for the entire United States.
In the case where a state is publicly releasing its mortality data, but the CDC data was found to be more robust, we have also opted to use the CDC data. (See more details about which states.) The result is the most comprehensive and up-to-date portrait of COVID-19 mortality by race and ethnicity for the U.S.
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+ 2. How long have you been collecting, analyzing and publishing these data?
We first published the Color of Coronavirus project on April 9, 2020, and we have been updating the data ever since. We issued 25 updates in 2020 but have lengthened our data collection intervals over time. We now collect and publish data every four weeks.
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+ 3. How often is the data updated?
We collect data every fourth Tuesday (Dec. 8, 2020; Jan. 5, 2021; Feb. 2, 2021; March 2, 2021; etc.) and publish the findings two days later, on Thursday (Dec. 10, 2020; Jan. 7, 2021; Feb. 4, 2021; March 4, 2021; etc.). Our next update is always listed at the top of our Color of Coronavirus project page.
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+ 4. Why are Black, Indigenous, Latino and Pacific Islanders experiencing such high mortality rates compared to White and Asian Americans?
This is a complex question. Black, Indigenous and other populations of color are at increased risk of dying from COVID-19 due to compounding societal disadvantages and unfair treatments that collectively imperil their lives to a greater degree—what is often termed structural racism.
Among them is uneven access to COVID testing and health care more broadly, with all other populations of color having higher rates of un-insurance and under-insurance compared to Asians and Whites. Populations of color are more to live in neighborhoods without a health clinic and, especially early in the pandemic, in many cases were less likely to have ready access to testing. An assessment of 50 million patients by the Epic Health Research Network and the Kaiser Family Foundation found that Latino, Black, and Asian patients were more likely to receive their COVID-19 test in an inpatient setting, after developing more severe symptoms.
In addition, there are differences in access to jobs that permit working from home or that have paid sick days. Americans of color are more likely to be an essential or service worker in a high-risk setting, such working in manufacturing or delivery services or as a nursing care provider. There are differences in types of housing that permit greater distancing between family members or neighbors in dense multi-unit buildings (or a second home), as well as access to private transportation instead of public transportation where the risks are greater, or even access to water for handwashing (not a given on some reservations or in families struggling with poverty who have experienced shut-offs).
Compared to Whites, Americans of color as a group have higher rates of underlying conditions that can prove more deadly with COVID-19—such as asthma, diabetes, high blood pressure and obesity. And we know that poorer health status results from complex interplay between stress, experiences of racism, neighborhood safety, poverty, housing instability, fewer family and community assets, food access and environmental exposures over a lifetime—i.e., the social determinants of health. We have seen no evidence that racial and ethnic disparities are due to genetic or biological differences.
As researchers at the Kaiser Family Foundation have concluded, "The higher hospitalization and death rates among patients of color, in part, reflect higher infection rates and higher rates of underlying health conditions as well as social and economic inequities and barriers to care. However, the persistence of disparities after controlling for COVID-19 infection, certain sociodemographic factors, and underlying health conditions show that differences in these underlying factors do not fully explain the disparities in hospitalization and death. This finding suggests that other factors, including racism and discrimination, are negatively affecting their health outcomes through additional avenues."
This CDC webpage also outlines some of the reasons why Black, Indigenous and other populations of color are at increased risk of dying from COVID-19.
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+ 5. What else can be done to create more equitable health for all U.S. residents?
While this is a complex question, we invite you to read the responses of our panel of 10 thought-leaders responding to the Color of Coronavirus data and what should be done about it.
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+ 6. How has the Color of Coronavirus changed over time?
Initially, in early April 2020, only seven states were reporting their COVID-19 mortality statistics by race and ethnicity. Over time, more states issued data in this way and improved their data reporting capabilities. However, even now, states do not uniformly report the same racial and ethnic categories for these data.
As the CDC began publishing COVID-19 mortality data from the National Center for Health Statistics with racial details (albeit with data lag and a degree of data suppression), we began examining it against the state-level offerings. In the case where a state is publicly releasing its mortality data, but the CDC data was found to be more robust (e.g. publishing Indigenous data when states do not), we have also opted to use the CDC data. (See question 1).
In our Jan. 7, 2021 release, we updated the denominators to 2019 (latest) American Community Survey for all Americans, as well as Asian, Black, Latino and White groups. Due to a high degree of data unreliability (large margins of error) in some states, we chose to use 2015-2019 (five-year estimates) for our denominators for Indigenous people and Pacific Islanders. Because of this denominator change, rates appearing on our January 2021 update and thereafter should not be directly compared to rates published previously.
We have been gratified that Color of Coronavirus has received more than 1 million page views in its first nine months, and been widely cited by local, national and international media outlets, in addition to being used by researchers, practitioners and policymakers.
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+ 7. Where can I see data about mortality trends for 2020?
Please see our December 2020 update or our 2020 year-in-review.
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+ 8. Are the mortality rates out of the whole population, or just those who have contracted the virus?
Our Color of Coronavirus rates—both actual (crude) and age-adjusted—are presented per 100,000 people of each race or ethnicity. They are not, therefore, “case fatality rates,” based only from those who have contracted the virus. Instead, our rates show, at a population level, the impact of the losses on the total group. When a racial group is shown to be more likely to die, we do not demonstrate the degree to which whether members of that group were more likely to have contracted the virus and/or more likely to experience poor outcomes once infected. However, we know from other research that both are occurring. With the exception of Asians, all other populations of color are more likely to contract COVID-19, to be hospitalized, and to die from it once infected than White Americans.
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+ 9. Why is the data for Indigenous and Pacific Islanders not available for all states?
We regret that this is the case. We are limited to analyzing the data as reported by state health departments. Some states report Indigenous and Pacific Islander deaths as “Other.” Some states also report Asian and Pacific Islander deaths jointly. We encourage you to contact your health department to advocate for the collection and distribution of more complete and disaggregated data. In the case of states where we use CDC data, if deaths are fewer than 10 for any given race or age group, the data are also suppressed (not shown).
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+ 10. Are Latinos counted in other race groups as well?
States vary in their treatment of Latino ethnicity. Some report Latino deaths and then make all other race groups non-Hispanic, such that Latinos only appear once, regardless of their racial identity. Other some states have overlapping race and ethnicity groups (e.g. a person identified as a Black Latino would appear in both groups). The latter treatment will result in double-counting, so that summing the deaths in all racial and ethnic groups will be more than the total number of deaths of known race. We have noted the state’s method in our complete data file as well as in the notes below the state-specific bar graphs.
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+ 11. Can I use the data in my research or reporting?
In most cases, yes. Permissions about reprinting our work, as a part of American Public Media, are detailed here. Please include the required citation: “APM Research Lab, Color of Coronavirus” and the following hyperlink: https://www.apmresearchlab.org/covid/deaths-by-race. For all related questions about use, please email us at info@apmresearchlab.org.
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+ 12. How can I obtain your data file?
Please complete this webform to make a one-time or recurring request for our latest data file. Data files are generally available within one week’s time after a release. Please allow up to a week to receive the file (in .xlsx format) following your request. The data may not be used for commercial purposes. Data are provided as-is, with no warranty.
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+ 13. Who funds this work?
This project is funded almost entirely through generous donor support. In addition, the project is partially supported by the Saint Paul and Minnesota Foundations through a partnership with their national Frontline Families Fund initiative.
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+ 14. How can I support your work?
We would deeply appreciate your support of this project so that we can continue and expand it. Donate securely online to the APM Research Lab now. If you or your organization is interested in partnership or sponsorship opportunities, please contact our Development Officer Alexandrea Kouame by email or phone: 651-290-1023.
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+ 15. How can I help families who have lost a loved one to COVID-19?
While there are many avenues to offer support, APM Research Lab is a research partner of the national Frontline Families Fund initiative, which provides financial support and educational scholarships to the families of healthcare workers who have lost their lives to COVID-19. We encourage you to donate to the Frontline Families Fund or seek help from it if a member of your family was an American health care worker who lost their life to COVID-19.
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+ 16. Where can I read more about this topic?
We encourage you to read some of the excellent reporting that features our Color of Coronavirus data on our In The News page or search for a particular media outlet here.