Trends in Disparities in COVID Hospitalizations Among Community-Dwelling
Residents of Two Counties in Connecticut, Before and After Vaccine
Introduction, March 2020 - September 2021
Abstract
Background. Prior to the introduction of vaccines, COVID-19
hospitalizations of non-institutionalized persons in Connecticut
disproportionately affected communities of color and individuals of low
socioeconomic status (SES). Whether the magnitude of these disparities
changed 7-9 months after vaccine rollout during the Delta wave is not
well documented. Methods. All initially hospitalized patients with
laboratory-confirmed COVID-19 during July-September 2021, were obtained
from the Connecticut COVID-NET database, including patients’ geocoded
residential addresses. Census tract measures of poverty and crowding
were determined by linking geocoded residential addresses to the
2014-2018 American Community Survey. Age-adjusted incidence and relative
rates of COVID-19 hospitalization were calculated and compared to those
from July-December 2020. Vaccination levels by age and race/ethnicity at
the beginning and end of the study period were obtained from
Connecticut’s COVID vaccine registry and age-adjusted average values
were determined. Results. There were 708 COVID-19 hospitalizations among
community residents of the two counties, July-September 2021.
Age-adjusted incidence was highest among non-Hispanic Blacks and
Hispanic/Latinx compared to non-Hispanic Whites ((RR 4.10 (95% CI
3.41-4.94) and 3.47 (95% CI 2.89-4.16)). While RR decreased
significantly among Hispanic/Latinx and among the lowest SES groups, it
increased among non-Hispanic Blacks (from RR 3.1 (95% CI 2.83-3.32) to
RR 4.10). Average age-adjusted vaccination rates among those
>12 years were lowest among non-Hispanic Blacks compared to
Hispanic/Latinx and non-Hispanic Whites (50.6% vs 64.7% and 66.6%).
Conclusions. While racial/ethnic and SES disparities in COVID-19
hospitalization have mostly decreased over time, disparities among
non-Hispanic Blacks increased, possibly due to differences in
vaccination rates.