Objective: This thesis aims to: 1) conduct a formative evaluation of the next of kin (NOK) interview data collected during the Michigan COVID-19 Death Investigation (MiCOVDI);2) investigate the prevalence of proxy-reported health care discrimination experienced by those that died from COVID-19 in Michigan during March 3-July 26, 2020. Methods: Decedents were eligible for inclusion in the mortality review if COVID-19 was listed as an underlying or related cause of death on the death certificate. A stratified random sample of deaths was taken and NOK interviews were conducted via telephone. The completeness of the dataset was assessed to evaluate feasibility and validity. NOK-reported discrimination in decedent's COVID-19 testing and care was described and compared by attributes of the decedent and NOK using univariate statistics. Qualitative interview responses were used to elaborate on the NOK's understanding of the decedent's experience. Results: The overall prevalence of NOK-reported health care discrimination experienced by the decedent was 28% with no strong associations with decedent or NOK attributes. The majority of reported discrimination was age- (20%) or comorbidity-based (27%). The prevalence estimates of situation-specific discrimination were: doctor's office (2%), urgent care (12%), COVID-19 testing (13%), being hospitalized (14%), and at an emergency room (18%). The overall completeness of the MiCOVDI survey was 59%. Completeness did not differ by race. Conclusion: Mortality reviews shed light on systematic issues experienced by those that passed away from COVID-19 and may inform targets that improve health equity. Examining the completeness of these data can provide insight to improve future endeavors.
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