Racial disparities in excess mortality in Minnesota in 2020 are worse than previously reported

Excess mortality — defined as deaths above what would be expected based on prior years — was worse in Minnesota in 2020 than expected, largely due to the COVID-19 pandemic, according to new research from the University of Minnesota. 

On the surface, Minnesota seems to have had a relatively equal COVID-19 pandemic compared to other states. For example, white Minnesotans are about 80% of the population and made up 86% of the COVID-19 deaths through December 16, 2020. According to a study published in the journal Socius: Sociological Research for a Dynamic World, this appearance is misleading. 

Researchers state this seeming equality stems from two factors:

• Minnesota's white population is much older than all its populations of color, on average. Additionally, COVID-19 cases have been the worst in long-term care facilities whose residents are overwhelmingly white. Once age is adjusted for, Minnesotans of color show markedly greater risk than white Minnesotans. 
• Disparities are greater in overall excess mortality than confirmed COVID-19 mortality. Confirmed COVID-19 mortality accounts for most of the excess mortality among white Minnesotans, but far less among most other racial groups. As a result, the state's official COVID-19 statistics understate the pandemic's toll for Minnesotans of color.

"To understand the pandemic's toll, we need to look at deaths holistically,” said study lead Elizabeth Wrigley-Field, an assistant professor in the Department of Sociology in the College of Liberal Arts. “Focusing only on official, confirmed COVID-19 deaths understates what has happened to Minnesota's communities of color in particular." 

The researchers estimated death rates using a complete set of Minnesota death certificates from January 1, 2017, through October 31, 2020. Death certificates from 2017 to 2019 formed a baseline for estimating excess mortality in 2020. The mortality analyzed in the study is from March 1 - October 31, 2020. 

The study found:

• Age-adjusted excess mortality rates were highest for Black, Latino, and Native Minnesotans. In the case of Black Minnesotans, mortality rates were more than 5 times higher than whites. 
• Official COVID-19 statistics reflect excess mortality unequally for different racial groups. Eighty-four percent of cumulative excess mortality (not adjusted for age) through October 2020 is accounted for by COVID-19 deaths in the white population. However, it accounts for only 67%, 71%, and 53% in the Black, Latino, and Native populations, respectively. The rate among the Asian American and Pacific Islander populations is similar to that among the white population, at 83%.

“Each racial group has a distinctive pattern of risk, so lifesaving efforts should be based on understanding excess mortality patterns in detail,” said Wrigley-Field. “They should not be based solely on confirmed COVID-19 rates.”

The researchers are conducting several more studies of the pandemic's ongoing death toll in Minnesota.

The study was supported by a Sustainable Development Goals Rapid Response Grant at the University of Minnesota, the Division of Health Policy and Management at the University of Minnesota School of Public Health, the University of Minnesota’s Fesler-Lampert Chair in Aging Studies, and the Minnesota Population Center, which is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

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