Disproportionate Burden of COVID-19 Infection among Hispanic Patients during the First COVID-19 Surge in South Texas

Meredith G. Hosek, Aditi Sharma, Mary Nunn, Sydney T. Tran, Madeleine O. Bousquet, Zachary T. Allen, Farah A.L. Allawi, Robert Geller, Andrew McCracken, Carmen G. Sanchez, Anna G. Taranova, Roberto Villarreal, Martin Goros, Jonathan Gelfond, Barbara S. Taylor

Research output: Contribution to journalArticlepeer-review


Introduction: The morbidity and mortality of the COVID-19 pandemic have disproportionately burdened Hispanic populations in the United States. While health equity research is typically conducted in populations where Hispanics are the minority, this project analyzes COVID-19 racioethnic transmission trends over the first 6 months of the pandemic within a large majority-minority city in South Texas. Methods: Patients diagnosed with COVID-19 across inpatient, emergency department, and outpatient settings of a large county health system were included in a clinical registry. For 4644 COVID-19-positive patients between March 16 and August 31, 2020, demographic and clinical data were abstracted from the registry. Race/ethnicity trends over time were compared for patients with and without COVID-19 diagnoses. Logistic regressions identified predictors of inpatient diagnosis by age, race/ethnicity, and testing delay. Results: The proportion of patients with COVID-19 identifying as Hispanic increased rapidly during the pandemic's first months: from 55.6% in March to 85.7% in June. A significantly greater proportion of patients identified as Hispanic within the COVID-19 cohort compared to other diagnoses cohort. Testing delay was 11.6% longer for Hispanic patients, with each day of testing delay associated with 7% increased odds of inpatient COVID-19 diagnosis. Conclusion: These findings highlight the disproportionate impact of COVID-19 on Hispanic populations even within a majority-minority community. In the United States, Hispanic persons are more likely to work frontline jobs, live in multigenerational homes in poverty, and be uninsured. The burden of COVID-19 cases within Bexar County's largest hospital system reflects this systemic inequity. Identifying racioethnic health disparities supports efforts toward mitigating structural factors that predispose minority groups to illness and death.

Original languageEnglish (US)
Pages (from-to)546-553
Number of pages8
JournalHealth Equity
Issue number1
StatePublished - Jul 1 2022


  • COVID-19
  • COVID-19 transmission
  • Hispanic health
  • South Texas
  • ethnic disparity
  • health disparity

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Health Information Management
  • Health Policy


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