Colorado’s Latinos, Asian Americans saw greatest increase in death rates in 2020, mostly from COVID-19
Last year was particularly deadly for people of color in Colorado.
The death rate was up for all racial and ethnic groups across the state in 2020, and the COVID-19 pandemic was the major factor.
For white Coloradans, however, the total increase in the death rate was smaller than the rate of death from the virus — meaning a decline in deaths from cancer, heart disease, strokes and suicides offset some of the impact of COVID-19.
Overall mortality for the white, non-Hispanic group rose less than 8% compared to the five-year average, when adjusted for population age.
The rest of Colorado’s population wasn’t so fortunate. Death rates in 2020, adjusted for age, rose 34% for Latinos and for Asian Americans and Pacific Islanders; 31% for Black Coloradans; and 17% for American Indians and Alaskan Natives.
COVID-19 was the biggest culprit, though all groups also saw increases in unintentional injuries, a category that includes drug overdoses. Suicide also increased for every group but white Coloradans, and deaths from Alzheimer’s disease were up for every group except American Indians.
The disparate toll isn’t only a Colorado problem. A nationwide study using electronic health records found patients of color were also more likely to need care in a hospital and to die of COVID-19 than white patients with the same age, sex, underlying health conditions and general socioeconomic status. Asian-Americans and Latinos were hit especially hard.
Higher death rates reflect inequities that existed before COVID-19, not something about the virus itself, said Sarah McAfee, director of communications at the Center for Health Progress. People who are white were more likely to be able to insulate themselves from the virus by working from home and to have a financial cushion if they lost a job, while people of color are overrepresented in frontline jobs and may have nothing to fall back on after an economic setback, she said.
“Those who have the financial resources and the privilege of adapting their lives more easily are going to do better,” she said.
Frontline workers bearing the brunt
Colorado’s Latino and Asian American communities experienced similar tolls from COVID-19, with the virus accounting for just over 70% of the increase in death rates, compared to the five-year average. Both also saw cancer deaths fall, while deaths from the other causes of death in the top 10 increased.
Normally, the percentage of patients in intensive-care units who are people of color roughly reflects the overall racial makeup of the community, said Dr. Fernando Holguin, professor of epidemiology and director of the Colorado School of Public Health’s Latino Research and Policy Center.
That wasn’t the case in the COVID-19 units last year, where a disproportionate number of the sickest patients were Latino or Black, he said.
“Sometimes in the ICU, 90% of the patients were Hispanic,” he said.
Latinos are more likely than white Coloradans to work frontline jobs, rely on public transit and live in crowded housing, which increases the odds a working-age person will pass the virus to more vulnerable relatives, Holguin said. Mexican Americans are particularly likely to have diabetes or obesity, and Denver’s Latino population disproportionately lives in polluted areas, which raises the odds of developing poor health, he said.
Harry Budisidharta, executive director of the Asian Pacific Development Center, said he suspects similar factors led to the disproportionate toll on Asian Americans, but it’s difficult to tell because the Asian and Pacific Islander label applies to such a diverse group of people.
For example, recent refugees often work in frontline jobs and live in cramped conditions, making it easier for COVID-19 to spread through families, while more established families may have been able to protect themselves by working from home, Budisidharta said. The victims of one of Colorado’s first identified outbreaks, at the JBS Greeley meatpacking plant, were primarily Asian and Latino immigrants.
“If the son got COVID in his job at the meatpacking plant, the grandparents and the kids are almost certainly going to get it,” he said.
Asian Americans are overrepresented in frontline health care jobs, which explains some, but not all, of the disparity, according to a recent study in Health Affairs. Some Asian subgroups also are more likely to smoke or have conditions like obesity, which also may contribute to their higher death rates, the study said.
Some states, like California, break down their statistics by national origin, allowing them to tease out disparities within the Asian American community, Budisidharta said. So far, Colorado hasn’t done that, so people trying to figure out who is being hurt most have to use the California data as a starting point and figure out if what they’ve found applies here, he said.
“There is such a lack of health data regarding our community,” he said.
Economic turmoil may have pushed up non-COVID deaths
While COVID-19 caused a significant increase in deaths for all ethnic groups, it explains less of the toll on Black Coloradans.
Black people had the second-highest rate of COVID-19 deaths compared to population in Colorado, behind Latinos, but the virus accounted for only about 45% of the Black population’s excess deaths — meaning that despite huge numbers of deaths from the virus, other causes pushed up mortality even more.
Black Coloradans saw the largest increase in death rates from unintentional injuries, heart disease, Alzheimer’s disease and diabetes, compared to population. (In some cases, the percentage increase was larger for other groups, which started with fewer deaths from those causes.)
Black and Latino Coloradans were disproportionately likely to lose their jobs in the early stages of the pandemic, which negatively affects health in multiple ways, Holguin said.
Without income, people may not be able to afford healthy food, medications to manage their conditions, or care if they get sick. Some people cope in healthy ways, but others may turn to alcohol or drugs, or develop depression, which limits their ability to try to solve problems, he said.
“When you lose wages or a job, the amount of stress is immense,” he said.
Holguin is optimistic that communities of color will begin to recover as more people are vaccinated, and the economy returns to normal, but said it may take longer than for white communities, because families of color are less likely to have jobs that allowed them to build up financial reserves.
“Their cushion for any disaster is very, very thin,” he said.
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