Understanding the Intersection of U.S. COVID-19 Deaths with Age, Geography, Race and Ethnic, and Socioeconomic Factors

This paper seeks to explain the movement of the first three waves of COVID-19 over time and geographical space for readers who are less familiar with how demographic factors may intersect with a cause of death characterized by large surges, or waves, of deaths. We use publicly available data from January 2020 through February 2022 from the National Center for Health Statistics for our analysis. We find that—by race and ethnicity group—the level of urbanicity associated with county of residence, the distribution of residence by U.S. geographical area, and the distribution of socioeconomic status (SES) levels by density of county within varying geographical areas may have all contributed to changing levels of differential COVID-19 mortality as the virus gradually spread throughout the country. In contrast, the age distribution of COVID-19 deaths remained roughly constant over the first three waves of COVID-19. This paper also analyzes the extent to which preliminary COVID-19 mortality outcomes reflect pre-pandemic preventable, or premature, mortality patterns by race and ethnicity and finds movement towards those pre-pandemic patterns over time. Finally, we stress that current knowledge remains nascent and present open questions for future researchers to consider.