Disparities in demand for COVID‐19 hospital care in the United States: Insights from a longitudinal hierarchical study

Background and aims This study examined disparities in hospitalization for COVID‐19 within the U.S. by racial and ethnic groups, health insurance status, and social support structure. Methods Using publicly available ecological case and contextual data from July 2020 to April 2021, a longitudinal hierarchical model for the 51 U.S. states was constructed. Results Racial/ethnic disparities were observed, such as that hospitalization rates were higher in states with a higher percentage of Black (β = .002, P = .009) and American Indian or Alaska Native persons (β = .003, P = .03). Conversely, lack of health insurance was related to a lower hospitalization rate (β = −.005, P = .002), and so was a stronger social support system (β = −.015, P = .05). Conclusion These differences suggest disparities in COVID‐19 incidence, symptom severity, and demand for hospital care. Understanding how they contribute to geographic differences in hospitalization can help guide public health decisions and resource allocation to address COVID‐19‐related health inequalities.