Mapping community-level determinants of COVID-19 transmission in nursing homes: A multi-scale approach
| Autor: | Trent J. Spaulding, Stella R. Harden, Sandi J. Lane, Margaret M. Sugg, Jennifer D. Runkle, Lakshmi S. Iyer, Adam Hege |
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| Rok vydání: | 2020 |
| Předmět: |
Research design
Multivariate analysis Environmental Engineering 010504 meteorology & atmospheric sciences Cross-sectional study Population Pneumonia Viral Staffing Nursing homes 010501 environmental sciences Medicare 01 natural sciences Article American Community Survey Betacoronavirus Risk Factors Environmental health Environmental Chemistry Humans education Waste Management and Disposal Pandemics 0105 earth and related environmental sciences Aged Population Density education.field_of_study Multilevel models SARS-CoV-2 Spatial analysis COVID-19 Pollution United States Geography Cross-Sectional Studies Workforce Income Coronavirus Infections Medicaid |
| Zdroj: | The Science of the Total Environment Science of The Total Environment |
| ISSN: | 1879-1026 |
| Popis: | Deaths from the COVID-19 pandemic have disproportionately affected older adults and residents in nursing homes. Although emerging research has identified place-based risk factors for the general population, little research has been conducted for nursing home populations. This GIS-based spatial modeling study aimed to determine the association between nursing home-level metrics and county-level, place-based variables with COVID-19 confirmed cases in nursing homes across the United States. A cross-sectional research design linked data from Centers for Medicare & Medicaid Services, American Community Survey, the 2010 Census, and COVID-19 cases among the general population and nursing homes. Spatial cluster analysis identified specific regions with statistically higher COVID-19 cases and deaths among residents. Multivariate analysis identified risk factors at the nursing home level including, total count of fines, total staffing levels, and LPN staffing levels. County-level or place-based factors like per-capita income, average household size, population density, and minority composition were significant predictors of COVID-19 cases in the nursing home. These results provide a framework for examining further COVID-19 cases in nursing homes and highlight the need to include other community-level variables when considering risk of COVID-19 transmission and outbreaks in nursing homes. Graphical abstract Unlabelled Image Highlights • Nursing home COVID-19 cases are clustered in the Northeast and Southeast US. • Community-level factors had the strongest association with nursing home cases. • Nursing home quality did not predict COVID-19 cases. |
| Databáze: | OpenAIRE |
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