Racial Disparities in COVID-19 Severity Are Partially Mediated by Chronic Stress—Evidence from a Large Integrated Healthcare System
Montoya MM, Gander JC, Suglia S, McDonald B, Patel SA, Davis T, Patzer RE, Jagannathan R, Teunis L, Harding JL
Black Americans have experienced a disproportionate burden of severe COVID-19. This study aimed to investigate whether chronic stress mediates the relationship between race and severe COVID-19. We identified KPGA members diagnosed with COVID-19 from January 1, 2020‒September 30, 2021, and examined certain health measures noted in the electronic medical record that can be indicative of chronic stress (e.g., cholesterol, blood pressure). Compared to White members, Black members had an 18% excess risk of chronic stress and a 24% excess risk of severe COVID-19. Chronic stress explained about a quarter of the racial disparity in severe COVID-19 outcomes. Effective management of the effects of life stressors may alleviate some of the excess burden of COVID-19 in underrepresented racial and ethnic populations.