ORCID

https://orcid.org/0009-0009-1698-516X

Date of Award

2025

Document Type

Thesis

Degree Name

MA in Psychology

Department

Psychology

First Advisor

Elizabeth Brondolo

Second Advisor

William Chaplin

Abstract

The COVID-19 pandemic exposed racial and ethnic health disparities in the U.S., with Hispanic populations experiencing higher infection and population-mortality rates than non-Hispanic Whites (NHW). Case fatality rates are closely tied to medical comorbidities such as hypertension, diabetes, and chronic kidney disease, which are more prevalent among Hispanic individuals. Case-fatality rates showed mixed results. Some studies found no differences, while others reported better outcomes for Hispanics, aligning with the Hispanic Paradox, which suggests that despite socioeconomic disadvantages, Hispanics experience equal or better health outcomes. These effects may be tied to the immigrant health advantage, which suggests immigrants tend to be healthier than the general population. One factor which has led to better health outcomes for Hispanic patients and sometimes for Non-Hispanic White patients is Hispanic Ethnic Density (HED), the proportion of Hispanic residents in a neighborhood. Some studies linked HED to COVID-19 mortality. However, less is known about how HED relates to comorbidities, which increase fatality risk in COVID-19. This study examined the relationships between race/ethnicity, HED, comorbidities, and case-fatality in a sample of patients treated early in the pandemic, before vaccines were available. This study analyzed electronic medical records from 1,870 COVID-19 patients from New York-Presbyterian Queens Hospital (March–December 2020), using geocoded address data linked to the American Community Survey. The sample included 1,228 Hispanic and 642 NHW patients. Hispanic patients were younger by 16 years on average, had higher BMI, and were more likely male. Despite socioeconomic disadvantages, their crude mortality rate (16.11%) was lower than NHWs (23.83%). This difference disappeared after adjusting for age, gender, and BMI. Comorbidity patterns varied: NHWs had higher hypertension, cardiovascular, and lung disease rates, whereas Hispanics had more diabetes and alcohol use. Age, male gender, and renal disease were the strongest mortality predictors. Higher Hispanic density was associated with lower odds of diabetes and pulmonary disease among Hispanics. However, HED was not linked to lower mortality rates. Neighborhood-level protective mechanisms, such as HED and foreign-born density, mitigate health risks for Hispanic patients, underscoring the importance of social and environmental factors in health outcomes during the pandemic.

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