Differences in cumulative confirmed COVID-19 cases and deaths, by race and ethnicity

COVID-19 case data: The top chart shows the rate of confirmed COVID-19 cases reported to North Carolina by race or ethnicity for select counties in North Carolina. Rates are presented as cases per 100,000 people. Counties were selected based on data availability, as COVID-19 case data by race and ethnicity are suppressed for small groups. The bottom chart shows the rate of confirmed COVID-19 cases per 100,000 people by race or ethnicity for the state of North Carolina. The height of each bar presents the rate for that race or ethnicity. For all rates, we assumed the number of people in each race or ethnicity group remained the same throughout the time period (i.e., steady state). 

COVID-19 death data: The chart shows the rate of death from COVID-19 per 100,000 people by race or ethnicity for the state of North Carolina. Due to data availability and suppression for COVID-19 death data by race or ethnicity over time, this data is not presented for North Carolina counties. For all rates, we assumed the number of people in each race or ethnicity group stayed the same throughout the time period (i.e., steady state).

Collectively, these visualizations depict racial and ethnic disparities that persist in rates of becoming a case of confirmed COVID-19 cases and deaths from COVID-19 in select counties and North Carolina. 

It is important to note some limitations of this data. In this data, a case is defined as a COVID-19 positive test through PCR or antigen tests that are reported to NC DHHS. Thus, cases presented may not include positive tests from at-home testing kits. Additionally, some race and ethnicity groups have differential access to testing and healthcare which may impact case diagnoses or deaths counted. Further, misclassification of race or ethnicity is possible due to differences in reporting (e.g., self-reported vs provider reported). Misclassification of COVID-19 deaths is also possible.

The COVID-19 confirmed case and death data are from the publicly available NC DHHS COVID-19 dashboard. Statewide cases and deaths to date are reported on the NC DHHS COVID-19 dashboard. County level COVID-19 death data over time by race and ethnicity are often suppressed due to small counts or denominators. Specifically, for denominators with less than 500 people, case and death data are suppressed for that race or ethnicity group. For more information on data suppression rules, please visit the NC DHHS COVID-19 dashboard: Data behind the dashboards site. 

Statewide and county population data are from the 2019 U.S. Census population estimates for North Carolina.

The weekly rate of confirmed COVID-19 cases by race and ethnicity group was calculated by dividing the number of confirmed COVID-19 cases each week by the estimated number of people in that race or ethnic group. These numbers were multiplied by 100,000 to be converted to a rate of cases per 100,000 people. We present weekly rates by county and for North Carolina as a whole. We also present the rate of death from COVID-19 by race and ethnicity for North Carolina as a whole. We report the average death rate over the course of the pandemic (rather than weekly) to avoid issues with sparse data and data suppression. The death rate was calculated as the number of deaths due to COVID-19 in a specific group defined by race or ethnicity divided by the number of people in that racial or ethnic group, times 100,000. For all rates, we assumed the number of people in each race or ethnicity group remained the same throughout the time period (i.e., steady state).

We assumed missing data on race or ethnicity for confirmed cases were missing completely at random. Therefore, cases and deaths with missing race and ethnicity information were redistributed based on the observed race and ethnicity distribution of cases and deaths.

Note that the NC DHHS COVID-19 dashboard provides case and death counts by race and by ethnicity, but not by jointly defined categories based on both race and ethnicity, such that all race groups shown here may include both Hispanic and non-Hispanic individuals. Similarly, both ethnicity categories may include people in any of the White/Other, Black, American Indian/Alaskan Native, and Asian/Pacific Islander race categories. 

White and Other race categories were combined for the analyses shown here. When analyzed separately, the number of cases attributed to the “other” race category often surpassed the reported population in the “other” race category. We believe that some cases and deaths among people of Hispanic origin may have been attributed to the “other” race category rather than the appropriate White/Other, Black, American Indian/Alaskan Native, or Asian/Pacific Islander race category. Because most (but certainly not all) people of Hispanic origin likely appear in the White race category in census data, we combined the White and Other groups here to harmonize the numerators of cases/deaths with the denominators of population counts.

These charts were last updated in February 2022. The most current COVID-19 case and death data can be found on the NC DHHS COVID-19 dashboard.