Overall and temporal associations between race/ethnicity and COVID-19 incidence and death per capita In order to further investigate the association of minority status with worse COVID-19 outcomes, we compared the rate of infections and death per capita according to the proportion of white, Hispanic and black residents within each county, based on county-level **data** from 2015 to Open access 2019 from the US Census Bureau ACS database. 4 Proportionately more black residents reside in southern USA and Hispanics in southwestern states. Cumulatively for the full year analysis, county-level increase in proportion of black residents (adjusted IRR per 10% increase: 0.99, 95% CI 0.98 to 1.00, p=0.01) was associated with lower, while increase in proportion of Hispanic residents (adjusted IRR per 10% increase: 1.07, 95% CI 1.05 to 1.08, p<0.001) was associated with higher COVID-19 incidence after adjusting for comorbidities using the HCC score and environmental factors (table 3). While county-level increase in proportion of black residents (adjusted IRR per 10% increase: 1.00, 95% CI 0.99 to 1.02, p=0.85) was not associated with COVID-19 death per capita, countylevel increase in Hispanic residents (adjusted RR per 10% increase: 1.07, 95% CI 1.05 to 1.08, p<0.001) was independently associated with higher COVID-19 death per capita (table 3).