Abstract MP38: The Implications of COVID-19 Pandemic for The Black-White Diabetes Mortality Gap: Has The Disparity’s Dynamic Changed?

Abstract

Background: Previous studies have investigated racial disparities in diabetes mellitus, including the existence of diabetes mortality gap between African Americans and whites. However, it remains unknown whether the coronavirus SARS-CoV-2 (COVID-19) pandemic changed the magnitude of earlier documented Black-White gap in diabetes mortality. Study Objective: To investigate the dynamic change in the magnitude of the Black-White diabetes mortality gap in relation to COVID-19 pandemic. Methods: Diabetes mortality rates in relation to race, adjusting for major covariates, were analyzed using the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) database on underlying causes of death in the United States. Diabetes mortality was analyzed for the three years preceding the pandemic (2017-2019; defined as pre-COVID era diabetes mortality) and the first three years of the pandemic (March 2020 to February 2023; defined as COVID-era diabetes mortality). Diabetes deaths were identified in the CDC WONDER database using the ICD-10 codes E10-E11. To adjust for multiple covariates, general linear modeling (GLM) analysis was conducted (SAS, ver. 9.4). Results: Both African Americans and whites experienced an increase in diabetes mortality rates from the pre-COVID-era to COVID-era period: from 11.0/100,000 to 15.1/100,000 (crude mortality rates) and from 12.4/100,000 to 15.9/100,000 age-adjusted mortality rates) in African Americans; from 10.9/100,000 to 14.1/100,000 (crude mortality rates) and from 8.3/100,000 to 10.3/100,000 age-adjusted mortality rates) in whites. However, when comparing the magnitude of the change in diabetes mortality rates between the pre-COVID and COVID-era periods, the multivariate-adjusted diabetes mortality rate increase in African Americans was 4.26/100,000 greater than in whites (p=0.028). Conclusions: COVID-19 pandemic had a statistically significant impact on the magnitude of racial gap in diabetes mortality. Further research investigating the underlying mechanisms of these findings is warranted.