--- title: "Racial predictors COVID19 compared all-cause hospitalization | Sutter Health" description: "Racial and sociodemographic predictors of COVID-19 compared with influenza, appendicitis, and all-cause hospitalization: retrospective cohort analysis" url: "https://www.sutterhealth.org/research/publications/racial-predictors-covid19-compared-all-cause-hospitalization-1055312873" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Racial predictors COVID19 compared all-cause hospitalization # Racial and sociodemographic predictors of COVID-19 compared with influenza, appendicitis, and all-cause hospitalization: retrospective cohort analysis _Ethnicity and Health_ 2023-03-12 ## Abstract Objective:To determine whether inequities in COVID-19 infection and hospitalization differ from those for common medical conditions: influenza, appendicitis, and all-cause hospitalization. Design:Retrospective study based on electronic health records of three healthcare systems in San Francisco (university, public, and community) examining (1) racial/ethnic distribution in cases and hospitalization among patients with diagnosed COVID-19 (March-August 2020) and patients with diagnosed influenza, diagnosed appendicitis, or all-cause hospitalization (August 2017-March 2020), and (2) sociodemographic predictors of hospitalization among those with diagnosed COVID-19 and influenza. Results:Patients 18 years or older with diagnosed COVID-19 (N= 3934), diagnosed influenza (N= 5932), diagnosed appendicitis (N= 1235), or all-cause hospitalization (N= 62,707) were included in the study. The age-adjusted racial/ethnic distribution of patients with diagnosed COVID-19 differed from that of patients with diagnosed influenza or appendicitis for all healthcare systems, as did hospitalization from these conditions compared to any cause. For example, in the public healthcare system, 68% of patients with diagnosed COVID-19 were Latine, compared with 43% of patients with diagnosed influenza, and 48% of patients with diagnosed appendicitis (p< 0.05). In multivariable logistic regressions, COVID-19 hospitalizations were associated with male sex, Asian and Pacific Islander race/ethnicity, Spanish language, and public insurance in the university healthcare system, and Latine race/ethnicity and obesity in the community healthcare system. Influenza hospitalizations were associated with Asian and Pacific Islander and other race/ethnicity in the university healthcare system, obesity in the community healthcare system, and Chinese language and public insurance in both the university and community healthcare systems. Conclusions:Racial/ethnic and sociodemographic inequities in diagnosed COVID-19 and hospitalization differed from those for diagnosed influenza and other medical conditions, with consistently higher odds among Latine and Spanish-speaking patients. This work highlights the need for disease-specific public health efforts in at-risk communities in addition to structural upstream interventions. [PubMed abstract](https://doi.org/10.1080/13557858.2023.2179021) ![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 ### [Disparities among racially/ethnically marginalized groups in the COVID-19 pandemic persist regardless of statewide shelter-in-place policies: an analysis from northern california](https://www.sutterhealth.org/research/publications/disparities-among-marginalized-groups-in-covid-19-pandemic-1055312827) 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 Jul 02 - 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 ### [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 ### [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 ### [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 [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/racial-predictors-covid19-compared-all-cause-hospitalization-1055312873#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":"Racial predictors COVID19 compared all-cause hospitalization"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/racial-predictors-covid19-compared-all-cause-hospitalization-1055312873#medicalscholarlyarticle","name":"Racial and sociodemographic predictors of COVID-19 compared with influenza, appendicitis, and all-cause hospitalization: retrospective cohort analysis","headline":"Racial predictors COVID19 compared all-cause hospitalization","abstract":"Objective:To determine whether inequities in COVID-19 infection and hospitalization differ from those for common medical conditions: influenza, appendicitis, and all-cause hospitalization. Design:Retrospective study based on electronic health records of three healthcare systems in San Francisco (university, public, and community) examining (1) racial/ethnic distribution in cases and hospitalization among patients with diagnosed COVID-19 (March-August 2020) and patients with diagnosed influenza, diagnosed appendicitis, or all-cause hospitalization (August 2017-March 2020), and (2) sociodemographic predictors of hospitalization among those with diagnosed COVID-19 and influenza. Results:Patients 18 years or older with diagnosed COVID-19 (N= 3934), diagnosed influenza (N= 5932), diagnosed appendicitis (N= 1235), or all-cause hospitalization (N= 62,707) were included in the study. The age-adjusted racial/ethnic distribution of patients with diagnosed COVID-19 differed from that of patients with diagnosed influenza or appendicitis for all healthcare systems, as did hospitalization from these conditions compared to any cause. For example, in the public healthcare system, 68% of patients with diagnosed COVID-19 were Latine, compared with 43% of patients with diagnosed influenza, and 48% of patients with diagnosed appendicitis (p\u003c 0.05). In multivariable logistic regressions, COVID-19 hospitalizations were associated with male sex, Asian and Pacific Islander race/ethnicity, Spanish language, and public insurance in the university healthcare system, and Latine race/ethnicity and obesity in the community healthcare system. Influenza hospitalizations were associated with Asian and Pacific Islander and other race/ethnicity in the university healthcare system, obesity in the community healthcare system, and Chinese language and public insurance in both the university and community healthcare systems. Conclusions:Racial/ethnic and sociodemographic inequities in diagnosed COVID-19 and hospitalization differed from those for diagnosed influenza and other medical conditions, with consistently higher odds among Latine and Spanish-speaking patients. This work highlights the need for disease-specific public health efforts in at-risk communities in addition to structural upstream interventions.","description":"Racial and sociodemographic predictors of COVID-19 compared with influenza, appendicitis, and all-cause hospitalization: retrospective cohort analysis","keywords":["COVID-19"],"datePublished":"2023-03-12","url":"https://www.sutterhealth.org/research/publications/racial-predictors-covid19-compared-all-cause-hospitalization-1055312873","inLanguage":"en-US","isPartOf":{"@type":"Periodical","name":"Ethnicity and Health"},"about":[{"@type":"DefinedTerm","name":"COVID-19","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22COVID-19%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/racial-predictors-covid19-compared-all-cause-hospitalization-1055312873","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/racial-predictors-covid19-compared-all-cause-hospitalization-1055312873#breadcrumblist"}}} ```