Temporal trends in the association of social vulnerability and race/ethnicity with county-level COVID-19 incidence and outcomes in the USA: an ecological analysis
| Autor: | Tené T. Lewis, Katherine Dieppa, Yingtian Hu, Shivani A. Patel, Arshed A. Quyyumi, Aditi Nayak, Abhinav Goyal, Yi-An Ko, Zakaria Almuwaqqat, Samaah Sullivan, Shabatun J. Islam, Anurag Mehta, Viola Vaccarino, Alanna A. Morris |
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| Rok vydání: | 2021 |
| Předmět: |
Percentile
medicine.medical_specialty Epidemiology Population Rate ratio social medicine 03 medical and health sciences 0302 clinical medicine Social medicine Per capita Medicine 030212 general & internal medicine education education.field_of_study 030505 public health business.industry Incidence (epidemiology) public health COVID-19 General Medicine 0305 other medical science business Social vulnerability Demography |
| Zdroj: | BMJ Open, Vol 11, Iss 7 (2021) BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | BackgroundThe COVID-19 pandemic adversely affected the socially vulnerable and minority communities in the USA initially, but the temporal trends during the year-long pandemic remain unknown.ObjectiveWe examined the temporal association of county-level Social Vulnerability Index (SVI), a percentile-based measure of social vulnerability to disasters, its subcomponents and race/ethnic composition with COVID-19 incidence and mortality in the USA in the year starting in March 2020.MethodsCounties (n=3091) with ≥50 COVID-19 cases by 6 March 2021 were included in the study. Associations between SVI (and its subcomponents) and county-level racial composition with incidence and death per capita were assessed by fitting a negative-binomial mixed-effects model. This model was also used to examine potential time-varying associations between weekly number of cases/deaths and SVI or racial composition. Data were adjusted for percentage of population aged ≥65 years, state-level testing rate, comorbidities using the average Hierarchical Condition Category score, and environmental factors including average fine particulate matter of diameter ≥2.5 μm, temperature and precipitation.ResultsHigher SVI, indicative of greater social vulnerability, was independently associated with higher COVID-19 incidence (adjusted incidence rate ratio per 10 percentile increase: 1.02, 95% CI 1.02 to 1.03, pConclusionExcept for the winter ‘third wave’, when majority of the white communities had the highest incidence of cases, counties with greater social vulnerability and proportionately higher minority populations experienced worse COVID-19 outcomes. |
| Databáze: | OpenAIRE |
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