Disparities in Underlying Health Conditions and COVID-19 Infection and Mortality in Louisiana, USA

Background Louisiana is ranked among the top 10 states with the highest COVID-19 death rate in the USA, and African Americans (AA) that account 32.2% (1.5 million) of the state's population have been impacted differentially with higher rates of chronic health conditions such as hypertension, obesity, and diabetes. These conditions can compromise immune systems and increase susceptibility to COVID-19. Prior health disparity and COVID-19 studies in Louisiana are limited to comprehensively evaluate the risk of underlying health conditions on COVID-19 incidence and death in minority communities and thus the study aims to address this research gap. Methods Negative binomial regression analyses were used to correlate risk factors with COVID-19 incidence and death rates using SAS software. Spatial distribution and burden of COVID-19 incidence and mortality rates were mapped using ArcGIS Pro. Results We found that AA COVID-19 death was three times higher than other races, and mortality rate was ten times higher in counties with more than 40% AA. Highest AA case and death counts were found in Orleans County; mortality rate in Bienville; and incidence rate in East Feliciana. Hypertension, diabetes, and obesity were significantly correlated with both COVID-19 incidence and mortality rates in AA. Greater odds of incidence and death rates also found in counties with higher AA population density with higher burden of underlying health conditions. Furthermore, living in poverty, being 65 years and older significantly influenced COVID-19 cases and deaths in the state. Conclusions The study highlights the need to reduce the burden of health disparities in underserved communities, and help to inform the public, scientific communities, and policy makers to plan effective responses to reduce the risks of COVID-19 infection, death, and other potential infectious diseases at the state.