By Ruolz Ariste
Since spring 2020, the media has routinely reported statistics on COVID-19 cases and deaths for different countries, states, regions or communities. Most of the time, only absolute or crude numbers are presented. For a valid comparison, absolute numbers should be ideally adjusted for demographic factors such as population size and age. Adjusting for population size is basic and will be the focus of this article.
According to data from John Hopkins, as of January 26, the top 10 countries with absolute numbers of cumulative cases were: USA, India, Brazil, Russia, United Kingdom, France, Spain, Italy, Turkey, and Germany with a range from 25.3 to 2.2 million. However, the ranking changed significantly for some countries when considering cases per 100,000 inhabitants, which is the population adjustment, also called “cases on a per capita basis” (See Figure 1).
The US was the country that was hit the hardest both in absolute and population adjusted terms — at 7,707 per 100,000, or six times higher than the world rate.
For the benefits of the readers of The Haitian Times, we also report and compare numbers for Canada, the Dominican Republic (DR) and Haïti. Numbers of cumulative cases per 100,000 were about the same for Canada and the Dominican Republic (2,016 and 1,910 respectively or about 1.5 times higher than the world rate) while that was only 99 for Haïti — more than 12 times lower than the world rate.
A second indicator of interest is the number of cumulative deaths due to COVID-19. By order of importance, the top 10 countries in absolute terms are: the U.S., Brazil, India, Mexico, United Kingdom, Italy, France, Russia, Iran, and Spain, with a range from 421,129 to 56,208. However, the ranking again changed for some countries when considering deaths per 100,000 inhabitants (see Figure 2).
The UK became the country that was hit the hardest in terms of deaths per 100,000 (147 or 5.3 times higher than the world rate). Note that the worldwide number of cumulative deaths was 2.2 million or 28 per 100,000. The U.S. ranked better and got the third position when adjusted for population (128 or 4.6 times higher than the world rate).
The number of cumulative cases per 100,000 was about the same in Canada and the DR, number of death rate was about twice higher in Canada than in the DR — 50 and 24, respectively. This rate was only 2 for Haïti, or 14 times lower than the world rate.
Diaspora feels brunt of COVID-19
While people living in Haiti fare relatively well compared to the western countries, the Haitian diaspora in North America didn’t. As of June 13, 2020, an IC/ES study revealed that people from Haiti living in Ontario (Canada) had the highest measured cumulative incidence of COVID-19 (1,200 per 100,000 which was 12 times higher compared to Canadian-born and long-time residents and four times higher compared to all immigrants and refugees).
More generally, COVID-19 death rates were double in Canadian neighbourhoods where more than 25% of the people are members of visible minorities compared to neighbourhoods where minorities are less than one per cent of the people. In the case of the U.S., Black individuals were the most overrepresented among COVID-19 deaths, accounting for 9.9% greater than their share of the US Census population, whereas White individuals were underrepresented at −8.1%.
Even more puzzling, in US counties where the population was substantially non-white with a median income defined as $60,240, the COVID-19 death rate was more than nine times higher when compared to counties that are substantially white with the same median income.
This shows that income is not the only source of health inequities. From a North-American perspective, future research is needed to better understand the other determinants of health inequities. Data on household crowding, the proportion of essential workers, language barriers, the number of people taking public transportation, access to health care and testing needs to be scrutinized.
From an Haitian perspective, research is needed to better understand the weight of the factors assumed to curb the infection rate in this country: younger age of the population, limited exposure to external visitors (peyi lock), lifestyle of the population (long period of active time outside and exposed to vitamin D), use of natural medicine and other factors.
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