Asian Americans Have Higher COVID-19 Case-Fatality Rates in Many States, Localities

July 13, 2020

The higher case-fatality rate could be because of low resting rates, a greater number of deaths, or both,

The COVID-19 case-fatality rate of among Asian Americans is much higher than the overall population, according to research results reported today in an Health Affairs blog post.

In San Francisco, Asian Americans have experienced a case-fatality rate of 5.2% compared with 1.3% for the overall population, report a research team at the University of California, San Francisco, that includes Tung Nguyen, M.D., director of the Asian American Research Center on Health, which is in San Francisco.

Other areas of the country also have a higher case-fatality rate among Asian Americans. Here are some of the numbers reported by Nguyen and his colleagues:

StateOverall case-fatality rateAsian case-fatality rate
California2.6%8.4%
New Jersey7.7%13.9%
Washington3.9%7.8%
Nevada2.5%7.3%
Massachusetts7.4%9.2%

The case-fatality rates is the ratio of fatalities to cases, so a high case-fatality rate could be the result of a low testing rate (a smaller denominator) as well as greater number of deaths (a larger numerator). Nguyen and his colleagues note that data from Los Angeles County and Illionois suggest that Asian Americans may be receiving disproportionately low rates of testing.

Socioeconomic factors may play a role. The researchers note that almost 60% of Asian Americans are born outside the U.S. so factors such as health literacy and English proficiency may affect access to care, quality of care, and seeking care later in the illness.

The researchers say that policy makers could help address the Asian American disparity by mandating standardized case and fatality reporting and directing public health agencies to investigate the reasons that particular populations, including Asian Americans, face a seemingly heightened risk of death from COVID-19.

“Importantly, there is no evidence that Asian Americans face a higher case fatality due to ethnicity itself,” the researchers wrote in the blog post. “In comparison, the CFR (case-fatality rate) in Asian countries are substantially lower than those observed among Asian Americans in many US states and counties.”