Demographic shift: White Californians accounted for more COVID-19 deaths in 2021

Last year, as the vaccines against COVID-19 rolled out to the public, a startling demographic shift went completely unnoticed in California, according to new research from Stanford University and the University of California: The respiratory disease began killing more middle-aged white Californians than any other racial group.

"The dominant narrative in the media at the time was about how much success vaccination was having with creating large declines in overall mortality, but this research shows that it's also important to pay close attention to proportional changes within racial and ethnic groups," said Alicia Riley, an assistant professor of sociology at UC Santa Cruz and one of the leaders of the research.

By July 2021, 36% of COVID-19 deaths in California were among middle-aged whites, Riley said, a figure virtually equal to the percentage of whites in the state population.

One of the greatest racial equity gaps of the pandemic had closed, Riley said, but no one had noticed. Middle-aged Latinos had borne the brunt of COVID-19 deaths until then — 66% of them in mid-March — although they represented 38.9% of the state's population, she said.

By July 2021, Hispanic millennials, Gen Xers and baby boomers saw their share of COVID-19 deaths in California drop to 30%, Riley said.

"What this study reminds us is that we can't just assume that COVID-19 is a disease that impacts those communities over there or those people over there and then just get comfortable," Riley said. "Even though, for much of the pandemic, Latino Californians were those who were hardest hit and were experiencing disproportionate deaths due to COVID, that shifted."

Until then, she said, middle-aged whites represented 36.6% of California's population but 17% of COVID-19 deaths.

Like white Californians, middle-age African Americans in the state also experienced an astounding jump in their share of overall COVID-19 deaths, rising to 21% from 6%, the researchers said. African Americans make up about 7% of the state population.

"We don't know exactly why it shifted, but we see that it shifted," Riley said, "and by the end of July, it's white people who are dying at disproportionate rates and it's black people who are dying at disproportionate rates. You can't just assume that this is someone else's problem and let your guard down."

Riley stressed that the July 2021 snapshot may not be the same as what's going on now in terms of the proportion of deaths among racial and ethnic groups. The joint team of researchers at UCSC, Stanford and UC San Francisco decided to study this period because COVID-19 were declining, she said, and they wanted to know how that decline in deaths was affecting racial disparities that the disease had laid bare.

Those who have studied these racial equity gaps have said that Latinos were more likely to work in jobs where the risk of exposure was high and protections against infection few. In addition, researchers have said, access to testing and medical care were barriers to beating the disease.

So, why did things change for Latinos from March to July 2021? The UC-Stanford scientists cannot conclusively say, but they do have theories.

"The 2020 winter COVID-19 surge hit Latino communities especially hard, resulting in a lot of deaths but also likely some natural immunity, which vaccination then built upon," Riley explained. "There were also widespread efforts, from the state to the local level, taking place over this time period to try to reduce these disparities by reaching people with testing and vaccination, and that's likely playing a role in some of this too."

Although an estimated 41% of middle-class white Californians were vaccinated by early May, the UC-Stanford researchers said, they may have experienced an increase in the share of their deaths because of a combination of where they live and vaccine hesitancy in some rural and conservative predominantly-white communities.

COVID-19 spread more rapidly in coastal cities and urban centers, Riley said, but these numbers indicate that, since stay-at-home orders have lifted and people have begun to move about, rural whites will not be spared as they were from earlier exposure, infection and death.

Vaccination rates were 26% among Black Californians, the researchers said, and the explosion in their share of deaths also may be related to avoiding exposure to the disease early in the pandemic.

"There's a lot to be learned about vaccine rollout in different racial and ethnic groups in different areas," said Mathew Kiang, an assistant professor of epidemiology and population health at Stanford University, who co-led the study with Riley. "Vaccination campaigns are often implemented as one-size-fits-all, but we clearly see racially patterned uptake and room for improvement."