Sex disparities in COVID-19 outcomes in the United States: Quantifying and contextualizing variation

Ann Caroline Danielsen; Katharine Mn Lee; Marion Boulicault; Tamara Rushovich; Annika Gompers; Amelia Tarrant; Meredith Reiches; Heather Shattuck-Heidorn; Luke W Miratrix; Sarah S Richardson

doi:10.1016/j.socscimed.2022.114716

Sex disparities in COVID-19 outcomes in the United States: Quantifying and contextualizing variation

Soc Sci Med. 2022 Feb:294:114716. doi: 10.1016/j.socscimed.2022.114716. Epub 2022 Jan 10.

Affiliations

¹ Harvard GenderSci Lab, Boylston Hall G-34, Cambridge, MA, 02138, USA. Electronic address: [email protected].
² Division of Public Health Sciences, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave, Campus Box 8100, St. Louis, MO, 63110, USA.
³ Department of Linguistics and Philosophy, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA; Department of Philosophy, University of Adelaide, 259 North Terrace, Adelaide, SA, 5000, Australia.
⁴ Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
⁵ Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA.
⁶ Department of Human Evolutionary Biology, Harvard University, 11 Divinity Avenue, Cambridge, MA, 02138, USA.
⁷ Department of Anthropology, University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA, 02125, USA.
⁸ Women and Gender Studies, University of Southern Maine, 94 Bedford Street, Portland, ME, 04102, USA.
⁹ Harvard Graduate School of Education, 13 Appian Way, Cambridge, MA, 02138, USA.
¹⁰ Department of the History of Science, Harvard University, 1 Oxford St, Cambridge, MA, 02138, USA; Committee on Degrees in Studies of Women, Gender, and Sexuality, Harvard University, Boylston Hall, Cambridge, MA, 02138, USA.

Abstract

This paper presents the first longitudinal study of sex disparities in COVID-19 cases and mortalities across U.S. states, derived from the unique 13-month dataset of the U.S. Gender/Sex COVID-19 Data Tracker. To analyze sex disparities, weekly case and mortality rates by sex and mortality rate ratios were computed for each U.S. state, and a multilevel crossed-effects conditional logistic binomial regression model was fitted to estimate the variation of the sex disparity in mortality over time and across states. Results demonstrate considerable variation in the sex disparity in COVID-19 cases and mortalities over time and between states. These data suggest that the sex disparity, when present, is modest, and likely varies in relation to context-sensitive variables, which may include health behaviors, preexisting health status, occupation, race/ethnicity, and other markers of social experience.

Keywords: Biological essentialism; COVID-19; Gender; Sex disparities.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Ethnicity
Health Status Disparities
Humans
Longitudinal Studies
SARS-CoV-2
United States / epidemiology

Grants and funding

T32 CA190194/CA/NCI NIH HHS/United States