Declining COVID-19 mortality risk ratios must be interpreted with caution

In their recent letter in J Epidemiol Community Health, Schultes et al1 examined patterns of declining race/ethnic disparities in COVID-19 mortality in Connecticut from March 2020 to December 2021. This work is a helpful contribution to the expanding literature on race/ethnic disparities in SARS-CoV-2 mortality, and due to its attention to the differential toll of SARS-CoV-2 in congregate versus non-congregate settings by race/ethnicity is particularly important.

However, motivated by our shared concern about the inequities highlighted by Schultes et al, we feel compelled to address the authors’ contention that their ‘findings suggest that attenuation of racial and ethnic disparities is an achievable public health goal’. We believe that this statement reflects a broadly held misapprehension about the meaningfulness of declining mortality rate ratios (MRRs) as evidence of progress against inequity in pandemic-related mortality.

While changes in the MRR for non-whites as compared with whites—the main indicator of disparity used in…

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