Residents of Connecticut nursing homes that serve the highest proportions of racial and ethnic minorities were more than 50% more likely to contract COVID-19 and more than twice as likely to die in the early weeks of the pandemic, compared to those in homes with predominantly white populations, according to a study published in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA), reported the society.
“The widened across-facility disparities in COVID-19 morbidity and mortality during the early pandemic period are just another manifestation of the structural inequalities in nursing home care that have existed for decades,” wrote the researchers from the University of Rochester Medical Center, Rochester, New York.
Researchers analyzed weekly cases and death reports between April 13 and June 19, 2020, from 211 nursing homes in Connecticut, which was one of the few states to provide weekly counts early in the pandemic. Only four nursing homes in the state were excluded due to missing data on the racial and ethnic makeup of residents. The weekly case and death reports were analyzed for nursing home characteristics, such as number of beds, ownership, percent of Medicare residents, and staffing levels, as well as county COVID-19 case and death data.
Disparities between nursing homes with high and low proportions of minorities increased as the pandemic progressed. In Week 1, predominantly white facilities averaged 6.1 cases and no deaths, while facilities with high proportions of minority residents reported 11.7 cases and 0.3 deaths per facility. By Week 10, those facilities with few minority residents averaged 26.7 cases and 7.6 deaths, compared to 58.5 cases and 13.3 deaths per facility with high minority populations.
By Week 10, the COVID-19 incidence rate was 54% higher and the death rate was 117% higher in nursing homes with high proportions of minority residents compared to those with fewer minorities, with the disparities persisting even when accounting for differences in county infection rates and nursing home characteristics.
