--- title: "Disparities among marginalized groups in COVID-19 pandemic | Sutter Health" description: "We examined hospitalizations and ICU transfers by race/ethnicity and pandemic period using logistic regression." url: "https://www.sutterhealth.org/research/publications/disparities-among-marginalized-groups-in-covid-19-pandemic-1055312827" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Disparities among marginalized groups in COVID-19 pandemic # Disparities among racially/ethnically marginalized groups in the COVID-19 pandemic persist regardless of statewide shelter-in-place policies: an analysis from northern california Kristen M J Azar, Stephen H Lockhart, Zijun Shen, Robert Romanelli, Stephanie Brown, Kelly Smits, & Alice R Pressman _Am J Epidemiol: kwab191. doi: 10.1093/aje/kwab191. Online ahead of print._ 2021-07-02 ## Abstract To measure COVID-19 disparities among racial/ethnically marginalized groups in hospitalization and ICU (Intensive Care Unit)-transfer pre/post implementation of the California statewide shelter-in-place (SIP) policy. A retrospective cohort study was conducted at a healthcare system in California. COVID-19 patients from 1/1/20-8/31/20 were identified from electronic health records. We examined hospitalizations and ICU transfers by race/ethnicity and pandemic period using logistic regression. Among 16,520 people with COVID-19 (mean \[SD\] age, 46.6 \[18.4\] years; 54.2% women); during the Post-SIP period, patients were on average younger and a larger proportion were Hispanic. In adjusted models, odds of hospitalization were 20% lower post-SIP compared to SIP, yet all non-White groups had higher odds (ORs 1.6-2.1) compared to Non-Hispanic White, regardless of period. Among hospitalized patients, odds of ICU transfer were 33% lower post-SIP versus SIP. Hispanic and Asian patients had higher odds compared to Non-Hispanic. Disparities in hospitalization persisted while ICU risk became more pronounced for Asian and Hispanic patients in post-SIP. Policy makers should consider ways to proactively address inequities in risk when considering future population-level policy interventions for public health crises. [PubMed abstract](https://pubmed.ncbi.nlm.nih.gov/34215866/) ![Kristen M J Azar, RN, MSN, MPH](https://dyn.mktgcdn.com/p/rFmyR1kiX8JzE5-XNwup0gVC1GRaVTlH7oSDlG0Tr5A/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Kristen M J Azar, RN, MSN, MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/kristen-m-j-azar-rn-msn-mph-1049680985) ## Research topics - [COVID-19](https://www.sutterhealth.org/research-search-results?query=%22%5C%22COVID-19%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Measuring and promoting SARS-CoV-2 vaccine equity: development of a COVID-19 vaccine equity index](https://www.sutterhealth.org/research/publications/measuring-promoting-sars-cov-2-vaccine-equity-1055312863) Alice R Pressman, Stephen H Lockhart, Zijun Shen, Kristen M J Azar Health Equity.;5(1):476-483. doi: 10.1089/heq.2021.0047. eCollection 2021. 2021 Jul 13 - Publication ### [The learning health system in crisis: lessons from the novel coronavirus disease pandemic](https://www.sutterhealth.org/research/publications/lessons-from-the-novel-coronavirus-disease-pandemic-1055312887) Robert J Romanelli, Kristen M J Azar, Sylvia Sudat, Dorothy Hung, Dominick L Frosch, Alice R Pressman Mayo Clin Proc Innov Qual Outcomes. doi: 10.1016/j.mayocpiqo.2020.10.004. Online ahead of print 2020 Oct 29 - Publication ### [Unreported SARS-CoV-2 Home Testing and Test Positivity](https://www.sutterhealth.org/research/publications/unreported-sars-cov-2-home-testing-test-positivity-1055312922) JAMA Network Open 2023 Jan 23 - Publication ### [Duration of Behavioral Policy Interventions and Incidence of COVID-19 by Social Vulnerability of US Counties, April-December 2020](https://www.sutterhealth.org/research/publications/duration-of-behavioral-policy-interventions-covid-19-1055312817) Public Health Reports 2021 Oct 06 - Publication ### [Racial and sociodemographic predictors of COVID-19 compared with influenza, appendicitis, and all-cause hospitalization: retrospective cohort analysis](https://www.sutterhealth.org/research/publications/racial-predictors-covid19-compared-all-cause-hospitalization-1055312873) Ethnicity and Health 2023 Mar 12 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/disparities-among-marginalized-groups-in-covid-19-pandemic-1055312827#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Disparities among marginalized groups in COVID-19 pandemic"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/disparities-among-marginalized-groups-in-covid-19-pandemic-1055312827#medicalscholarlyarticle","name":"Disparities among racially/ethnically marginalized groups in the COVID-19 pandemic persist regardless of statewide shelter-in-place policies: an analysis from northern california","headline":"Disparities among marginalized groups in COVID-19 pandemic","abstract":"To measure COVID-19 disparities among racial/ethnically marginalized groups in hospitalization and ICU (Intensive Care Unit)-transfer pre/post implementation of the California statewide shelter-in-place (SIP) policy. A retrospective cohort study was conducted at a healthcare system in California. COVID-19 patients from 1/1/20-8/31/20 were identified from electronic health records. We examined hospitalizations and ICU transfers by race/ethnicity and pandemic period using logistic regression. Among 16,520 people with COVID-19 (mean [SD] age, 46.6 [18.4] years; 54.2% women); during the Post-SIP period, patients were on average younger and a larger proportion were Hispanic. In adjusted models, odds of hospitalization were 20% lower post-SIP compared to SIP, yet all non-White groups had higher odds (ORs 1.6-2.1) compared to Non-Hispanic White, regardless of period. Among hospitalized patients, odds of ICU transfer were 33% lower post-SIP versus SIP. Hispanic and Asian patients had higher odds compared to Non-Hispanic. Disparities in hospitalization persisted while ICU risk became more pronounced for Asian and Hispanic patients in post-SIP. 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