Foreign-born Minnesotans, particularly men, were twice as likely to die from COVID-19 in 2020 compared to their U.S.-born peers, according to a new study by researchers at the Humphrey School of Public Affairs and the Minnesota Population Center.
These findings point to the need for better data and policymaking that prioritizes the well-being of immigrant communities, the authors conclude.
The COVID-19 pandemic has highlighted existing inequalities in health and health care access in the United States, particularly along racial and ethnic lines. But research quantifying the impact of COVID-19 on immigrant communities has been limited.
Kimberly Horner, a doctoral student at the Humphrey School who researches the local reception of immigrant populations, worked with colleagues at the Minnesota Population Center to evaluate COVID-19 disparities among immigrant populations in Minnesota.
They examined data from death certificates filed in Minnesota in 2020, which include information about the decedents’ country of birth, to come up with their findings. Horner described the study’s results in a recent article for the Gender Policy Report, published by the School’s Center on Women, Gender, and Public Policy.
Unpacking pandemic mortality in Minnesota
Initial comparisons of COVID-19 deaths among US-born and foreign-born Minnesotans showed what appeared to be expected rates of COVID-19 mortality. Approximately 89.5% of 2020 COVID-19 deaths in Minnesota were among U.S.-born residents, and approximately 91.6% of Minnesota residents are U.S.-born.
But this crude calculation ignores important differences in the demographic makeup of U.S.-born and foreign-born populations in Minnesota. The foreign-born population includes a higher proportion of younger and working age individuals, while the U.S.-born population includes a higher proportion of older adults.
Studies have shown that COVID-19 is more likely to have serious health consequences for older individuals, as well as for men.
- After adjustments for population-level differences in age and gender, immigrants experienced a COVID-19 mortality rate twice that of U.S.-born Minnesotans: 261.4 vs 129.7 deaths per 100,000.
- Adjusted mortality rates were also higher among immigrants within racial categories, with foreign-born Black, White, Latino, and Asian populations suffering higher age-specific COVID-19 mortality rates than U.S.-born populations from the same racial groups.
- There are substantial differences in the gendered impact of COVID-19 among U.S.- and foreign-born Minnesotans. Foreign-born men and women died from COVID-19 at younger ages than their U.S.-born counterparts, and within subgroups, a higher proportion of young men died than women.
- Foreign-born men saw the heaviest COVID-19 mortality burden. Their age-adjusted mortality rate was 1.5 times higher than foreign-born women, and 2.2 times higher than U.S.-born men.
- The age-adjusted COVID-19 mortality rate for foreign-born women in Minnesota was 1.8 times higher than U.S.-born women.
The analysis suggests that efforts to achieve equity in health care, health protection, and vaccine access by public health officials and policymakers have fallen far short.
The higher mortality rates among foreign-born Minnesotans, and foreign-born men especially, demonstrate the need for a better understanding of the intersection of policy with economic and social characteristics that put immigrant communities more at risk.
While COVID-19 is an acute health crisis, disparities in health care are deeply rooted in this nation’s history. Addressing this reality will require sustained commitment from researchers and policymakers over the long term.
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