Association between median household income, state Medicaid expansion status, and COVID-19 outcomes across US counties.

Autor: Apenyo T; Division of Biology and Medicine, The Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island, United States of America., Vera-Urbina AE; Department of Biology, The University of Puerto Rico, San Juan, Puerto Rico, United States of America., Ahmad K; Division of Biology and Medicine, The Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island, United States of America.; Department of Internal Medicine, The Providence Veterans Affairs Medical Center, Providence, Rhode Island, United States of America.; Department of Internal Medicine, Lifespan Hospitals, Providence, Rhode Island, United States of America., Taveira TH; Division of Biology and Medicine, The Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island, United States of America.; Department of Internal Medicine, The Providence Veterans Affairs Medical Center, Providence, Rhode Island, United States of America.; College of Pharmacy, The University of Rhode Island, Kingston, Rhode Island, United States of America., Wu WC; Division of Biology and Medicine, The Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island, United States of America.; Department of Internal Medicine, The Providence Veterans Affairs Medical Center, Providence, Rhode Island, United States of America.; Department of Internal Medicine, Lifespan Hospitals, Providence, Rhode Island, United States of America.; College of Pharmacy, The University of Rhode Island, Kingston, Rhode Island, United States of America.; Department of Epidemiology, The School of Public Health at Brown University, Providence, Rhode Island, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Aug 11; Vol. 17 (8), pp. e0272497. Date of Electronic Publication: 2022 Aug 11 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0272497
Abstrakt: Objective: To study the relationship between county-level COVID-19 outcomes (incidence and mortality) and county-level median household income and status of Medicaid expansion of US counties.
Methods: Retrospective analysis of 3142 US counties was conducted to study the relationship between County-level median-household-income and COVID-19 incidence and mortality per 100,000 people in US counties, January-20th-2021 through December-6th-2021. County median-household-income was log-transformed and stratified by quartiles. Multilevel-mixed-effects-generalized-linear-modeling adjusted for county socio-demographic and comorbidities and tested for Medicaid-expansion-times-income-quartile interaction on COVID-19 outcomes.
Results: There was no significant difference in COVID-19 incidence-rate across counties by income quartiles or by Medicaid expansion status. Conversely, for non-Medicaid-expansion states, counties in the lowest income quartile had a 41% increase in COVID-19 mortality-rate compared to counties in the highest income quartile. Mortality-rate was not related to income in counties from Medicaid-expansion states.
Conclusions: Median-household-income was not related to COVID-19 incidence-rate but negatively related to COVID-19 mortality-rate in US counties of states without Medicaid-expansion.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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