Hispanic immigrants of working age — 20 to 54 years old — are over 11 times more likely to die of COVID-19 than U.S.-born men and women who are not Hispanic, according to a USC study of California death certificate data from 2020.

The study, published March 29 in the Annals of Epidemiology, highlights California’s urgent need to bring vaccinations, treatments and other interventions to a demographic that comprises the backbone of the state’s agricultural and service industries. Unions and advocacy groups are racing to convince immigrants, both documented and undocumented, to get vaccines, Politico reports.

“We’ve known since early on that people of color are more likely to die of COVID. The CDC says that Hispanics, overall, are 2.3 times more likely to die than non-Hispanics,” said Erika Garcia, PhD, MPH, assistant professor of preventive medicine at the Keck School of Medicine of USC and the study’s first author. “Yet when we looked at this specific, working-age group, we were astonished to see much higher disparities.”

When the researchers looked at young, foreign-born Hispanic individuals, they found COVID deaths as a proportion of the typical total deaths was 11.6 times higher than that of young, U.S.-born, non-Hispanic individuals. The disparities persisted, even after accounting for education level, which served as a proxy for socioeconomic status in the study.

USC study exposes COVID death disparities

Examining death certificates, researchers identified 10,200 COVID-19 deaths in California occurring between February and July 2020. Death certificate data, rather than hospital system or insurance company data, allowed the researchers to capture COVID deaths among historically marginalized groups, including immigrants, who might be underrepresented in health care or insurance systems.

Overall, those who died were primarily age 65 or above, male, Hispanic, foreign-born and had an education level of high school or below. When the researchers drilled deeper into the data, they found disparities were larger among younger-aged Asian/Pacific Islanders, Blacks, Hispanics and whites.

For example, among Black men and women 20-54 years old, the COVID death rate was nearly five times that of whites. Among Hispanics of the same age, both U.S.-born and foreign-born, the COVID death rate was 8.5 times that of whites.

“While they are experiencing lower COVID-19 mortality overall, younger populations should not be left out of public health interventions,” Garcia said. “There are complex risk structures that differ not only between groups but also within a group, which need to be considered in public health guidelines and policies.

“For example, people of color are more likely to be employed in industries with more exposure to infections and close proximity to others — this is an important risk factor for individuals of working age.”

In addition to Garcia, the study’s authors include Sandrah Eckel, Zhanghua Chen and Frank Gilliland, all of the Department of Preventive Medicine at the Keck School of Medicine; and Kenan Li of the Spatial Sciences Institute at the USC Dornsife College of Letters, Arts and Sciences.

The research was supported by the National Institute of Environmental Health Sciences (P30ES007048), the Hastings Foundation, and by the Keck School of Medicine’s COVID-19 Research Fund through a gift from the W.M. Keck Foundation. For more information on the latest COVID-19 research conducted at the Department of Preventive Medicine, please visit the COVID-19 Pandemic Research Center.

— Leigh Hopper