Background: Age-adjusted COVID-19 mortality estimates have exposed a previously hidden excess mortality burden for the US Hispanic population. Multiple explanations have been put forth, including unequal quality/access to health care, higher proportion of pre-existing health conditions, multigenerational household composition, and disproportionate representation in telecommute-unfriendly occupations. However, these hypotheses have been rarely tested.

Objective: We examine age-stratified patterns of Hispanic COVID-19 mortality vis-à-vis patterns of exposure to evaluate the multiple posited hypotheses.

Methods: We use a combination of public and restricted data from the Centers of Disease Control and Prevention and leverage national and subnational race- and age-stratified COVID-19 mortality and case burdens/advantages to evaluate the workplace vulnerability hypothesis. We also use individual-level information on prior health conditions and mortality from the case data to assess whether observed patterns are consistent with the other hypotheses.

Results: Our results indicate that the disproportionate burdens for both COVID-19 case and mortality for the Hispanic population are largest among the working-age groups, supporting the hypothesis that workplace exposure plays a critical role in heightening vulnerability to COVID-19 mortality. We find little evidence to support the hypotheses regarding multigenerational household composition, pre-existing health conditions, or unequal quality/access to health care.

Conclusions: Our findings point to the key roles played by age structure and differential exposure in contributing to the disproportionately severe impact of COVID-19 on the Hispanic population.

Contribution: We contribute evidence to explain the driving factors in the observed excess COVID-19 mortality burden among Hispanics. Our findings underscore the importance of focusing on more robust workplace protections, particularly for working-age minority populations.