Missing data and missed infections: Investigating racial and ethnic disparities in SARS-CoV-2 testing and infection rates in Holyoke, Massachusetts
Missing data and missed infections: Investigating racial and ethnic disparities in SARS-CoV-2 testing and infection rates in Holyoke, Massachusetts
Abstract Routinely collected testing data has been a vital resource for public health response during the COVID-19 pandemic and has revealed the extent to which Black and Hispanic persons have borne a disproportionate burden of SARS-CoV-2 infections and hospitalizations in the United States. However, missing race and ethnicity data and missed infections due to testing disparities limit the interpretation of testing data and obscure the true toll of the pandemic. We investigated potential bias arising from these two types of missing data through a case study in Holyoke, Massachusetts during the pre-vaccination phase of the pandemic. First, we estimated SARS-CoV-2 testing and case rates by race/ethnicity, imputing missing data using a joint modelling approach. We then investigated disparities in SARS-CoV-2 reported case rates and missed infections by comparing case rate estimates to estimates derived from a COVID-19 seroprevalence survey. Compared to the non-Hispanic white population, we found that the Hispanic population had similar testing rates (476 vs. 480 tested per 1,000) but twice the case rate (8.1% vs. 3.7%). We found evidence of inequitable testing, with a higher rate of missed infections in the Hispanic population compared to the non-Hispanic white population (77 vs. 58 infections missed per 1,000).
Zhu Jack、Franke Molly、Paxton Ryan、Ivers Louise C.、Sauer Sara M.、Fulcher Isabel R.、Matias Wilfredo R.、Gonsalves Sean、Elnaiem Ahmed、Guillaume Yodeline
Center for Global Health, Massachusetts General HospitalDepartment of Global Health and Social Medicine, Harvard Medical SchoolHolyoke Board of HealthDepartment of Global Health and Social Medicine, Harvard Medical School||Division of Infectious Diseases, Massachusetts General Hospital||Center for Global Health, Massachusetts General Hospital||Harvard Global Health InstituteDepartment of Global Health and Social Medicine, Harvard Medical SchoolDepartment of Global Health and Social Medicine, Harvard Medical School||Harvard Data Science InitiativeDivision of Infectious Diseases, Massachusetts General Hospital||Center for Global Health, Massachusetts General Hospital||Division of Global Health Equity, Brigham and Women?ˉs HospitalHolyoke Board of HealthDivision of Global Health Equity, Brigham and Women?ˉs HospitalCenter for Global Health, Massachusetts General Hospital
医学研究方法预防医学医药卫生理论
COVID-19missing datamultiple imputationbiashealth disparities
Zhu Jack,Franke Molly,Paxton Ryan,Ivers Louise C.,Sauer Sara M.,Fulcher Isabel R.,Matias Wilfredo R.,Gonsalves Sean,Elnaiem Ahmed,Guillaume Yodeline.Missing data and missed infections: Investigating racial and ethnic disparities in SARS-CoV-2 testing and infection rates in Holyoke, Massachusetts[EB/OL].(2025-03-28)[2025-06-08].https://www.medrxiv.org/content/10.1101/2023.05.24.23290470.点此复制
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