Abstract：
OBJECTIVE: Multiple studies have shown that racially minoritized groups had disproportionate COVID-19 mortality relative to non-Hispanic White individuals. However, there is little known regarding mortality by immigrant status nationally in the United States, despite being another vulnerable population.
METHODS: This was an observational cross-sectional study using mortality vital statistics system data to calculate proportionate mortality ratios (PMRs) and mortality rates due to COVID-19 as the underlying cause.
METHODS: Rates were compared by decedents\' identified race, ethnicity (Hispanic vs non-Hispanic), and immigrant (immigrants vs US born) status. Asian race was further disaggregated into \"Asian Indian,\" \"Chinese,\" \"Filipino,\" \"Japanese,\" \"Korean,\" and \"Vietnamese.\"
RESULTS: Of the over 3.4 million people who died in 2020, 10.4% of all deaths were attributed to COVID-19 as the underlying cause (n = 351,530). More than double (18.9%, n = 81,815) the percentage of immigrants who died of COVID-19 compared with US-born decedents (9.1%, n = 269,715). PMRs due to COVID-19 were higher among immigrants compared with US-born individuals for non-Hispanic White, non-Hispanic Black, Hispanic, and most disaggregated Asian groups. Among disaggregated Asian immigrants, age- and sex-adjusted PMR due to COVID-19 ranged from 1.58 times greater mortality among Filipino immigrants (95% confidence interval [CI]: 1.53, 1.64) to 0.77 times greater mortality among Japanese immigrants (95% CI: 0.68, 0.86). Age-adjusted mortality rates were also higher among immigrant individuals compared with US-born people.
CONCLUSIONS: Immigrant individuals experienced greater mortality due to COVID-19 compared with their US-born counterparts. As COVID-19 becomes more endemic, greater clinical and public health efforts are needed to reduce disparities in mortality among immigrants compared with their US-born counterparts.
METHODS: This was an observational cross-sectional study using mortality vital statistics system data to calculate proportionate mortality ratios (PMRs) and mortality rates due to COVID-19 as the underlying cause.
METHODS: Rates were compared by decedents\' identified race, ethnicity (Hispanic vs non-Hispanic), and immigrant (immigrants vs US born) status. Asian race was further disaggregated into \"Asian Indian,\" \"Chinese,\" \"Filipino,\" \"Japanese,\" \"Korean,\" and \"Vietnamese.\"
RESULTS: Of the over 3.4 million people who died in 2020, 10.4% of all deaths were attributed to COVID-19 as the underlying cause (n = 351,530). More than double (18.9%, n = 81,815) the percentage of immigrants who died of COVID-19 compared with US-born decedents (9.1%, n = 269,715). PMRs due to COVID-19 were higher among immigrants compared with US-born individuals for non-Hispanic White, non-Hispanic Black, Hispanic, and most disaggregated Asian groups. Among disaggregated Asian immigrants, age- and sex-adjusted PMR due to COVID-19 ranged from 1.58 times greater mortality among Filipino immigrants (95% confidence interval [CI]: 1.53, 1.64) to 0.77 times greater mortality among Japanese immigrants (95% CI: 0.68, 0.86). Age-adjusted mortality rates were also higher among immigrant individuals compared with US-born people.
CONCLUSIONS: Immigrant individuals experienced greater mortality due to COVID-19 compared with their US-born counterparts. As COVID-19 becomes more endemic, greater clinical and public health efforts are needed to reduce disparities in mortality among immigrants compared with their US-born counterparts.
摘要：
目的：多项研究表明，相对于非西班牙裔白人，种族少数群体的COVID-19死亡率不成比例。然而,在美国全国范围内，关于移民身份的死亡率知之甚少，尽管是另一个弱势群体。
方法：这是一项观察性横断面研究，使用死亡率重要统计系统数据来计算因COVID-19为根本原因导致的死亡率比例（PMR）和死亡率。
方法：按死者确定的种族，种族（西班牙裔与非西班牙裔），和移民（移民vs美国出生）身份。亚洲种族被进一步分解为“亚洲印第安人”，\"\"中文,\"\"菲律宾人,\"\"日本人,\"\"韩语,“和”越南人。\"
结果：在2020年死亡的340多万人中，所有死亡的10.4%归因于COVID-19作为根本原因(n=351,530)。两倍以上（18.9%，n=81,815)与美国出生的死者相比，死于COVID-19的移民比例(9.1%，n=269,715)。与美国出生的非西班牙裔白人相比，由于COVID-19导致的PMR在移民中更高，非西班牙裔黑人,西班牙裔,和最分类的亚洲群体。在分类的亚洲移民中，因COVID-19引起的年龄和性别调整后的PMR范围从菲律宾移民死亡率高1.58倍(95%置信区间[CI]:1.53,1.64)到日本移民死亡率高0.77倍(95%CI:0.68,0.86)。与美国出生的人相比，移民人群的年龄调整死亡率也更高。
结论：与美国出生的同龄人相比，移民个体因COVID-19的死亡率更高。随着COVID-19变得更加地方性，与美国出生的移民相比,需要加大临床和公共卫生工作,以减少移民死亡率的差异.
方法：这是一项观察性横断面研究，使用死亡率重要统计系统数据来计算因COVID-19为根本原因导致的死亡率比例（PMR）和死亡率。
方法：按死者确定的种族，种族（西班牙裔与非西班牙裔），和移民（移民vs美国出生）身份。亚洲种族被进一步分解为“亚洲印第安人”，\"\"中文,\"\"菲律宾人,\"\"日本人,\"\"韩语,“和”越南人。\"
结果：在2020年死亡的340多万人中，所有死亡的10.4%归因于COVID-19作为根本原因(n=351,530)。两倍以上（18.9%，n=81,815)与美国出生的死者相比，死于COVID-19的移民比例(9.1%，n=269,715)。与美国出生的非西班牙裔白人相比，由于COVID-19导致的PMR在移民中更高，非西班牙裔黑人,西班牙裔,和最分类的亚洲群体。在分类的亚洲移民中，因COVID-19引起的年龄和性别调整后的PMR范围从菲律宾移民死亡率高1.58倍(95%置信区间[CI]:1.53,1.64)到日本移民死亡率高0.77倍(95%CI:0.68,0.86)。与美国出生的人相比，移民人群的年龄调整死亡率也更高。
结论：与美国出生的同龄人相比，移民个体因COVID-19的死亡率更高。随着COVID-19变得更加地方性，与美国出生的移民相比,需要加大临床和公共卫生工作,以减少移民死亡率的差异.
