We measure inequities from the COVID-19 pandemic on mortality and hospitalizations in theUnited States during the early months of the outbreak. We discuss challenges in measuring healthoutcomes and health inequality, some of which are specific to COVID-19 and others thatcomplicate attribution during most large health shocks. As in past epidemics, pre-existingbiological and social vulnerabilities profoundly influenced the distribution of disease. In additionto the elderly, Hispanic, Black and Native American communities were disproportionatelyaffected by the virus, particularly when assessed using the years of potential life lost metric. Forexample, Hispanic and Black Americans in 2020 saw 39.5 and 25 percent increases in excessmortality relative to trend, compared to a less than 15 percent increase for Whites; we find lossesin potential years of life three to four times larger among Hispanic and Black compared to WhiteAmericans. Individual-level data from a commercially insured population show that otherwisesimilar Black and Hispanic enrollees were hospitalized due to COVID-19 at a higher rate thanWhite enrollees. We provide a conceptual framework and initial empirical analysis which seek toshed light on contributors to pandemic-related health inequality, and suggest areas for futureresearch.