Data Brief: Widened Racial Inequities in Underutilized Medicare Beneficiary COVID-19 Claims Files Illustrate Lifelong Structural Racism Exposure

Covid Inequities in Older Adults Cover

Policy Brief

Data Brief: Widened Racial Inequities in Underutilized Medicare Beneficiary COVID-19 Claims Files Illustrate Lifelong Structural Racism Exposure

COVID-19 inequities among Black, Indigenous and other Populations of Color (BIPOC) in the US continue to be studied. However, one data source important for showing the magnitude of how lifelong systemic racism and adverse social risk manifests in the context COVID remains underutilized: Medicare Beneficiary COVID-19 Claims Data.

In this Duke-Margolis data brief, we analyze these publicly-available data, representing race- and ethnicity-stratified COVID-19 cases and hospitalizations at 14 timepoints from May 2020-November 2021. For almost all BIPOC Medicare beneficiaries, caseload and hospitalization rates were higher than non-Hispanic, White beneficiaries, remaining essentially unchanged since December 2020.

Notably, disparities in hospitalization ratios were much wider than disparities in case ratios. These ratios would be the same if the body’s ability to fight off COVID infection and quality of health care were the same by race and ethnicity. We connect these findings to upstream causes in the context of COVID in a conceptual model guided by literature review.

Many policymakers stood up programs during the pandemic to address social needs. This data brief can be used by policymakers—in tandem with our companion issue brief, published in Health Affairs on March 10, 2022, on lessons from pandemic health policies to address social needs—to help design and sustain whole-person efforts.

Duke-Margolis Authors

William K. Bleser - Margolis headhot

William K. Bleser, PhD, MSPH

Assistant Research Director, Health Care Transformation for Population Health, Social Needs, and Health Equity
Senior Team Member
Anti-Racism and Equity Committee Member

Andrea Thoumi

Andrea Thoumi, MPP, MSc

Health Equity Policy Fellow
Faculty Director of Health Equity Educational Programming
Senior Team Member
Anti-Racism and Equity Committee Member
Core Faculty Member
Adjunct Assistant Professor
2020 Intern Mentor

Picture of Rushina Cholera

Rushina Cholera, MD

Medical Instructor in the Department of Pediatrics
2020 Intern Mentor
Anti-Racism and Equity Committee Member
Margolis Core Faculty

Robert Saunders

Robert Saunders, PhD

Senior Research Director, Health Care Transformation
Adjunct Associate Professor
Senior Team Member
Margolis Core Faculty

Rebecca Whitaker Headshot

Rebecca Whitaker, PhD, MSPH

Research Director, North Carolina Health Care Transformation
Senior Team Member
Anti-Racism and Equity Committee Member

Mark McClellan

Mark McClellan, MD, PhD

Director of Margolis Center
Robert J. Margolis, MD, Professor of Business, Medicine and Policy
Margolis Executive Core Faculty

Additional Authors include:

Jay Pearson, PhD, MPH  Associate Professor of Public Policy and Global Health at Duke University's Sanford School of Public Policy

Hannah Crook, PhD student at Vanderbilt University