Association Between Income Inequality and County-Level COVID-19 Cases and Deaths in the US
| Autor: | Lorene M. Nelson, Annabel X. Tan, Michelle C. Odden, Jessica A Hinman, Hoda S. Abdel Magid |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Social Determinants of Health Economic inequality Income distribution Interquartile range Ethnicity Medicine Humans Risk factor Healthcare Disparities Mortality Original Investigation Gini coefficient Poverty business.industry SARS-CoV-2 Research COVID-19 General Medicine Health Status Disparities Middle Aged United States Online Only Socioeconomic Factors Relative risk Communicable Disease Control Income Social Marginalization Female Public Health business Needs Assessment Demography Cohort study |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | Key Points Question How does the association between county-level income inequality, measured by the Gini coefficient, and COVID-19 cases and deaths change over time? Findings This ecological cohort study found that there was a positive correlation between Gini coefficients and county-level COVID-19 cases and deaths during the study period. The association between income inequality and COVID-19 cases and deaths varied over time and was strongest in the summer months of 2020. Meaning The findings suggest that, during the COVID-19 pandemic, areas of higher income inequality may serve as effective targets for interventions to mitigate the spread of SARS-CoV-2. Importance Socioeconomically marginalized communities have been disproportionately affected by the COVID-19 pandemic. Income inequality may be a risk factor for SARS-CoV-2 infection and death from COVID-19. Objective To evaluate the association between county-level income inequality and COVID-19 cases and deaths from March 2020 through February 2021 in bimonthly time epochs. Design, Setting, and Participants This ecological cohort study used longitudinal data on county-level COVID-19 cases and deaths from March 1, 2020, through February 28, 2021, in 3220 counties from all 50 states, Puerto Rico, and the District of Columbia. Main Outcomes and Measures County-level daily COVID-19 case and death data from March 1, 2020, through February 28, 2021, were extracted from the COVID-19 Data Repository by the Center for Systems Science and Engineering at Johns Hopkins University in Baltimore, Maryland. Exposure The Gini coefficient, a measure of unequal income distribution (presented as a value between 0 and 1, where 0 represents a perfectly equal geographical region where all income is equally shared and 1 represents a perfectly unequal society where all income is earned by 1 individual), and other county-level data were obtained primarily from the 2014 to 2018 American Community Survey 5-year estimates. Covariates included median proportions of poverty, age, race/ethnicity, crowding given by occupancy per room, urbanicity and rurality, educational level, number of physicians per 100 000 individuals, state, and mask use at the county level. Results As of February 28, 2021, on average, each county recorded a median of 8891 cases of COVID-19 per 100 000 individuals (interquartile range, 6935-10 666 cases per 100 000 individuals) and 156 deaths per 100 000 individuals (interquartile range, 94-228 deaths per 100 000 individuals). The median county-level Gini coefficient was 0.44 (interquartile range, 0.42-0.47). There was a positive correlation between Gini coefficients and county-level COVID-19 cases (Spearman ρ = 0.052; P This cohort study evaluates the association between county-level income inequality and COVID-19 cases and deaths from March 2020 through February 2021 in bimonthly time epochs. |
| Databáze: | OpenAIRE |
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