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socioeconomic lines.59 The CDC has found that racial and ethnic minorities are at increased risk <br />for infection, hospitalization, and death from COVID-19, with Hispanic or Latino and Native <br />American or Alaska Native patients at highest risk.60 <br />Similarly, low-income and socially vulnerable communities have seen the most severe <br />health impacts. For example, counties with high poverty rates also have the highest rates of <br />infections and deaths, with 308 deaths per 100,000 compared to the U.S. average of 238 deaths <br />per 100,000, as of December 2021.61 Counties with high social vulnerability, as measured by <br />factors such as poverty and educational attainment, have also fared more poorly than the national <br />average, with 325 deaths per 100,000 as of December 2021.62 Over the course of the pandemic, <br />Native Americans have experienced more than one and a half times the rate of COVID-19 <br />infections, more than triple the rate of hospitalizations, and more than double the death rate <br />compared to White Americans.63 Low-income and minority communities also exhibit higher <br />rates of pre-existing conditions that may contribute to an increased risk of COVID-19 <br />59 Office of the White House, National Strategy for the COVID-19 Response and Pandemic Preparedness (Jan. 21, <br />2021), https://www.whitehouse.gov/wp-content/uploads/2021 /01/National-Strategy-for-the-COVID-19-Response- <br />and-Pandemic-Preparedness.pdf. <br />6o In a study of 13 states from October to December 2020, the CDC found that Hispanic or Latino and Native <br />American or Alaska Native individuals were 1.7 times more likely to visit an emergency room for COVID-19 than <br />White individuals, and Black individuals were 1.4 times more likely to do so than White individuals. See Sebastian <br />D. Romano et al., Trends in Racial and Ethnic Disparities in COVID-19 Hospitalizations, by Region United <br />States, March— December 2020, MMWR Morb Mortal Wkly Rep 2021, 70:560-565 (Apr. 16, 2021), https:// <br />www.cdc.gov/mmwr/volumes/70/wr/ mm7015e2.htm?s_cid=mm7015e2_w. <br />61 Centers for Disease Control and Prevention, COVID Data Tracker: Trends in COVID-19 Cases and Deaths in the <br />United States, by County -level Population Factors, https://covid.cdc.gov/covid-data-tracker/#pop-factors_totaldeaths <br />(last visited December 7, 2021). <br />62 The CDC's Social Vulnerability Index includes fifteen variables measuring social vulnerability, including <br />unemployment, poverty, education levels, single -parent households, disability status, non-English speaking <br />households, crowded housing, and transportation access. <br />Centers for Disease Control and Prevention, COVID Data Tracker: Trends in COVID-19 Cases and Deaths in the <br />United States, by Social Vulnerability Index, https://covid.cdc.gov/covid-data-tracker/#pop-factors_totaldeaths (last <br />visited December 7, 2021). <br />63 Centers for Disease Control and Prevention, Risk for COVID-19 Infection, Hospitalization, and Death By <br />Race/Ethnicity, https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization- <br />death-by-race-ethnicity.html (last visited December 7, 2021). <br />52 <br />