Research: Black, Hispanic and Asian Minnesotans under 65 more likely to be vaccinated against COVID-19 — and more likely to die of it

At the height of the COVID-19 pandemic, health care providers saw the disproportionate impact the virus had on populations of color. 

Minnesota’s populations of color were hospitalized at higher rates and also died at higher rates than white Minnesotans.

“We were seeing large populations of people of color in our ICUs (Intensive Care Units), having the harder time with COVID,” said Nneka Sederstrom, the chief health equity officer for Hennepin Healthcare.

In fact, new research finds that despite higher levels of vaccination during the delta and omicron waves of the pandemic, Minnesotans of color under age 65 were more likely to die of the virus than white Minnesotans in the same age group. The findings underscore underlying inequalities that impact Minnesota’s populations of color.

Health care response

Black and Hispanic Minnesotans were hospitalized for COVID-19 at rates that exceeded their share of the population, a University of Minnesota study found using data from the beginning months of the pandemic. 

From April 30 to June 24, 2020, Black people accounted for 25% of COVID-19 hospitalizations in Minnesota but 7% of the state’s population, while Hispanic people made up 16% of hospitalizations but 6% of the population, according to the study. 

Hospitals were seeing an influx of people of color. So when vaccines eventually rolled out, leaders of health systems, like Sederstrom, knew which communities were in need.

“When we did a press conference trying to push the vaccine, I said really clearly that it’s not old people that are dying in our ICUs at the time, it was young people who thought they were healthy, got COVID and ended up in our units and, and they were people of color,” Sederstrom said. “That was our reality.” 

Hennepin Healthcare partnered with community organizations, like Comunidades Latinas Unidas En Servicio to connect with Hispanic populations, and Black churches, bringing vaccines and staff to those locations. Over the three months between February and May of 2021, they reached more than  9,000 people.

Zeke McKinney, a doctor at HealthPartners, recognized the need during the first summer of the pandemic when he walked into Wilson’s Image, a North Minneapolis barbershop, and noticed that he was the only person with a mask. 

 McKinney was aware of racial disparities through his work as a physician and recognized that for much of the Black population, there is hesitancy to participate in clinical research due to medical mistrust that traces back to the Tuskegee Syphilis study, he said. From 1932 to 1972, the study aimed to “observe the natural history of untreated syphilis” in Black populations, but the subjects of the study were unaware of the study’s goal and instead were told they were receiving treatment for bad blood, despite them receiving no treatment at all. 

 McKinney said he almost turned around when he was the only person in the barber shop wearing a mask. “But then I thought to myself, ‘If I really want to try to engage people, talk about how serious COVID is and why we need to do things to protect ourselves, I should stay here and just do that,’” McKinney said. 

 So he did. He says he kept getting his haircut there, and eventually, after the vaccines became available, his barber asked him where he could get vaccinated. 

With some funding from MDH, McKinney and the barbershop started hosting vaccination clinics. His goal was to have the clinic consistently be at the shop so that if people changed their minds about being vaccinated, they would know where to come back to, he said. 

McKinney said most of its success is because the clinic was in a Black space.

“For people of color, even me as a Black man and a doctor, it’s not my favorite thing to go to the doctor. So if it’s bad for me, how bad is it for somebody who’s not this educated with this privilege and this dialed into the system” he said. “This clinic was designed to be at a safe, comfortable place, a barbershop, which is a generally a safe space in the Black community.”

High vaccination rates, yet higher death rates

All those efforts to reach people of color with vaccines helped: the study’s authors found Black, Hispanic and Asian people under age 65 were more highly vaccinated than white Minnesotans the same age for most of the delta variant surge and during waves of omicron.

But while COVID-19 vaccines were effective in preventing hospitalizations and deaths overall, they couldn’t fix  the underlying health disparities that made communities of color more vulnerable to COVID-19: Minnesotans of color, for example, are more likely to have diabetes, asthma and heart disease — all COVID-19 comorbidities — because of factors like poverty and access to health care.

 “We vaccinated as many as we could to try and curb. Although the numbers were great with how many vaccines were given, we still know that the disparities, systemic racism, and environmental racism, issues that underpin health care in general, are the reason why people are still dying,” Sederstrom said. 

Despite the higher vaccination rates, death rates for people of color under age 65 were higher than white people in the same age group in Minnesota.

The findings also suggest some of the messaging at the beginning of the pandemic that focused on older populations as the most vulnerable didn’t capture the breadth of who was most at-risk.

“If you just assumed that this was a vaccine just for the elderly to protect them, then that was a false assumption,” said Elizabeth Wrigley-Field, a University of Minnesota researcher and one of the study’s authors. “We show in this paper that people of color aged 55 to 64 are at more risk of dying of COVID than white people who are 10 years older. That’s a really big difference,” she said.  

 Systematic factors are behind that age gap. 

“It shows us what we already know to be true. Black and Brown and Indigenous populations are way more at risk for poor health outcomes because of social determinants of health, things like lack of access to healthcare, lack of access to health insurance, unstable finances, unstable housing, not having access to food, not having access to safe environments,” McKinney said. 

 The researchers looked at death certificate data, which includes information like race, ethnicity, age, gender and location of death. They didn’t, however, have access to previous health issues or comorbidities, Wrigley-Field said. 

Further research could look further into the reasons behind the racial disparities, but pinning those down was not the goal of this study, she said.

Providers hope that this research opens people’s eyes to racism – and the ways it affects people’s lives.

“I hope that it helps people have a better understanding of how racism impacts healthcare. I think we like to come up with another answer to the why. We don’t like accepting the reality that is racism because it seems like it’s too big of an issue to tackle. And we just don’t want to as a society face the reality that we haven’t come past this big huge blemish in our history,” Sederstrom said. “There will always be data to highlight that. So this is just another example of data highlighting that we still have a long way to go, but if we continue pretending like racism doesn’t exist, then we’ll continue having these outcomes.”