Higher COVID-19 mortality among Black patients linked to unequal hospital quality

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The COVID-19 death rate for Black patients would be 10% lower if they had access to the same hospitals as white patients, a new study shows. Researchers from the Perelman School of Medicine and OptumLabs, part of UnitedHealth Group, analyzed data from tens of thousands of hospitalized COVID-19 patients and found that Black patients died at higher rates than white patients. But the study, published in JAMA Network Open, determined that didn’t have to be the case if more Black patients were able to get care at different hospitals, University of Pennsylvania notes.

Our study reveals that Black patients have worse outcomes largely because they tend to go to worse-performing hospitals,” says the study’s first author, David Asch, the executive director of Penn Medicine’s Center for Health Care Innovation. “Because patients tend to go to hospitals near where they live, these new findings tell a story of racial residential segregation and reflect our country’s racial history that has been highlighted by the pandemic.”

For many years, housing segregation was explicitly practiced in the United States. “Redlining,” a term for the systematic refusal of home financing in majority Black neighborhoods, resulted in the economic stagnation of communities and limitations of upward mobility among the people who live in them. Redlining has cast a long shadow into the decades since it was explicitly made illegal: A recent study showed that three of every four redlined neighborhoods still experience economic hardship, which often includes a lack of access to social resources—including medical care.

Recently, Asch and fellow researchers published another study showing the interwoven nature of where patients get care and whether they survive hospitalization with COVID-19. The study showed that the one factor most explaining differences in hospital mortality rates was the level of virus in a hospital’s surrounding community: If there were high COVID-19 case rates in the community, hospital mortality rates were worse.

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