The interaction of ethnicity and deprivation on COVID-19 mortality risk: A retrospective ecological study

Black, Asian and Minority Ethnic (BAME) populations are at an increased risk of developing COVID-19 and consequentially more severe outcomes compared to White populations. The aim of this study was to quantify how much of the disproportionate disease burden can be attributed to deprivation. An ecological study was conducted using data derived from the Office for National Statistics data at a Local Authority District (LAD) level in England between 1st March-17th April 2020. The primary analysis was to examine how age adjusted Covid-19 mortality depends on the interaction between deprivation and ethnicity using linear regression. The secondary analysis using spatial regression methods allowed for the quantification of the extent of LAD spillover effect of Covid-19 mortality. We find that in LADs with the highest deprivation quartile, where there is a 1% increase in "Black-African (regression coefficient 2.86; 95% CI 1.08 – 4.64)", "Black-Caribbean (9.66: 95% CI 5.25 – 14.06)" and "Bangladeshi (1.95: 95% CI 1.14 – 2.76)" communities there is a significantly higher age-adjusted Covid-19 mortality compared to respective control populations. In addition, the spatial regression results indicated positive significant correlation between the age-adjusted mortality in one LAD and the age-adjusted mortality in a neighbouring LAD.