1
|
Fortunato F, Lillini R, Martinelli D, Iannelli G, Ascatigno L, Casanova G, Lopalco PL, Prato R. Association of socio-economic deprivation with COVID-19 incidence and fatality during the first wave of the pandemic in Italy: lessons learned from a local register-based study. Int J Health Geogr 2023; 22:10. [PMID: 37143110 PMCID: PMC10157567 DOI: 10.1186/s12942-023-00332-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/26/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND COVID-19 has been characterised by its global and rapid spread, with high infection, hospitalisation, and mortality rates worldwide. However, the course of the pandemic showed differences in chronology and intensity in different geographical areas and countries, probably due to a multitude of factors. Among these, socio-economic deprivation has been supposed to play a substantial role, although available evidence is not fully in agreement. Our study aimed to assess incidence and fatality rates of COVID-19 across the levels of socio-economic deprivation during the first epidemic wave (March-May 2020) in the Italian Province of Foggia, Apulia Region. METHODS Based on the data of the regional active surveillance platform, we performed a retrospective epidemiological study among all COVID-19 confirmed cases that occurred in the Apulian District of Foggia, Italy, from March 1st to May 5th, 2020. Geocoded addresses were linked to the individual Census Tract (CT) of residence. Effects of socio-economic condition were calculated by means of the Socio-Economic and Health-related Deprivation Index (SEHDI) on COVID-19 incidence and fatality. RESULTS Of the 1054 confirmed COVID-19 cases, 537 (50.9%) were men, 682 (64.7%) were 0-64 years old, and 338 (32.1%) had pre-existing comorbidities. COVID-19 incidence was higher in the less deprived areas (p < 0.05), independently on age. The level of socio-economic deprivation did not show a significant impact on the vital status, while a higher fatality was observed in male cases (p < 0.001), cases > 65 years (p < 0.001), cases having a connection with a nursing home (p < 0.05) or having at least 1 comorbidity (p < 0.001). On the other hand, a significant protection for healthcare workers was apparent (p < 0.001). CONCLUSIONS Our findings show that deprivation alone does not affect COVID-19 incidence and fatality burden, suggesting that the burden of disease is driven by a complexity of factors not yet fully understood. Better knowledge is needed to identify subgroups at higher risk and implement effective preventive strategies.
Collapse
Affiliation(s)
- Francesca Fortunato
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Roberto Lillini
- Analytical Epidemiology & Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Domenico Martinelli
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giuseppina Iannelli
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Leonardo Ascatigno
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Georgia Casanova
- IRCCS-INRCA National Institute of Health & Science on Ageing, Centre for Socio-Economic Research on Ageing, Ancona, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Rosa Prato
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| |
Collapse
|
2
|
Maged A, Ahmed A, Haridy S, Baker AW, Xie M. SEIR Model to address the impact of face masks amid COVID-19 pandemic. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023; 43:129-143. [PMID: 35704273 PMCID: PMC9349537 DOI: 10.1111/risa.13958] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Early in the pandemic of coronavirus disease 2019 (COVID-19), face masks were used extensively by the general public in several Asian countries. The lower transmission rate of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Asian countries compared with Western countries suggested that the wider community use of face masks has the potential to decrease transmission of SARS-CoV-2. A risk assessment model named Susceptible, Exposed, Infectious, Recovered (SEIR) model is used to quantitatively evaluate the potential impact of community face masks on SARS-CoV-2 reproduction number (R0 ) and peak number of infectious persons. For a simulated population of one million, the model showed a reduction in R0 of 49% and 50% when 60% and 80% of the population wore masks, respectively. Moreover, we present a modified model that considers the effect of mask-wearing after community vaccination. Interestingly mask-wearing still provided a considerable benefit in lowering the number of infectious individuals. The results of this research are expected to help public health officials in making prompt decisions involving resource allocation and crafting legislation.
Collapse
Affiliation(s)
- Ahmed Maged
- Department of Advanced Design and Systems EngineeringCity University of Hong KongHong Kong
- Department of Mechanical EngineeringBenha UniversityBanhaEgypt
| | - Abdullah Ahmed
- Department of Mechanical EngineeringBenha UniversityBanhaEgypt
- Department of Systems Innovation, Graduate School of Engineering ScienceOsaka UniversitySuitaJapan
| | - Salah Haridy
- Department of Mechanical EngineeringBenha UniversityBanhaEgypt
- Department of Industrial Engineering and Engineering ManagementUniversity of SharjahSharjahUnited Arab Emirates
| | - Arthur W. Baker
- Duke University School of Medicine, Division of Infectious DiseasesDurhamNorth CarolinaUSA
- Duke Center for Antimicrobial Stewardship and Infection PreventionDurhamNorth CarolinaUSA
| | - Min Xie
- Department of Advanced Design and Systems EngineeringCity University of Hong KongHong Kong
- Center for Intelligent Multidimensional Data Analysis, Hong Kong Science ParkShatinHong Kong
| |
Collapse
|
3
|
Dragano N, Hoebel J, Wachtler B, Diercke M, Lunau T, Wahrendorf M. [Social inequalities in the regional spread of SARS-CoV-2 infections]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:1116-1124. [PMID: 34297163 PMCID: PMC8298974 DOI: 10.1007/s00103-021-03387-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/29/2021] [Indexed: 12/11/2022]
Abstract
Hintergrund und Ziel Ob sozioökonomische Faktoren die Ausbreitung von SARS-CoV‑2 beeinflussen, ist nicht ausreichend beantwortet, da frühere Studien in der Regel kumulative Inzidenzen betrachtet und die zeitliche Entwicklung der Ausbreitung außer Acht gelassen haben. Dieser Beitrag konzentriert sich daher auf die Entwicklung von regionalen Neuinfektionen in Zusammenhang mit sozioökonomischen Faktoren. Ausgehend vom internationalen Forschungsstand präsentieren wir eigene Analysen von Meldedaten aus Deutschland. Methoden Diese Studie untersucht regionale Daten gemeldeter COVID-19-Fälle für die 401 Landkreise und kreisfreien Städte (Kreisebene) in Deutschland und vergleicht den zeitlichen Verlauf entlang sozioökonomischer Merkmale der Kreise. Betrachtet werden altersstandardisierte wöchentliche Inzidenzen für den Zeitraum 03.02.2020–28.03.2021. Sozial- und Wirtschaftsindikatoren auf Kreisebene stammen aus der INKAR(Indikatoren und Karten zur Raum- und Stadtentwicklung)-Datenbank (z. B. Einkommen, Beschäftigtenquote, Wohnfläche). Ergebnisse Während in der ersten und zu Beginn der zweiten Welle der Pandemie Kreise mit höherem mittleren Haushaltseinkommen höhere Inzidenzen hatten, stiegen sie in Kreisen mit niedrigem Einkommen ab Dezember 2020 deutlich an. Kreise mit einem hohen Anteil an Beschäftigten allgemein und speziell solchen im Produktionssektor hatten gerade in der zweiten und dritten Welle hohe Inzidenzen. Kreise mit einer geringen Wohnfläche je Einwohner hatten ab November 2020 ausgeprägt höhere Inzidenzen. Schlussfolgerung Der regionale Verlauf der Pandemie unterscheidet sich nach Sozial- und Wirtschaftsindikatoren. Eine differenzierte Betrachtung dieser Unterschiede könnte Hinweise auf zielgruppenspezifische Schutz- und Teststrategien geben und helfen, soziale Faktoren zu identifizieren, die Infektionen begünstigen. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00103-021-03387-w) enthalten.
Collapse
Affiliation(s)
- Nico Dragano
- Institut für Medizinische Soziologie, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - Jens Hoebel
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
| | - Benjamin Wachtler
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
| | - Michaela Diercke
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Deutschland
| | - Thorsten Lunau
- Institut für Medizinische Soziologie, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - Morten Wahrendorf
- Institut für Medizinische Soziologie, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| |
Collapse
|
4
|
Hagan KK, Javed Z, Cainzos-Achirica M, Sostman D, Vahidy FS, Valero-Elizondo J, Acquah I, Yahya T, Kash B, Andrieni JD, Dubey P, Hyder AA, Nasir K. Social Determinants of Adherence to COVID-19 Risk Mitigation Measures Among Adults With Cardiovascular Disease. Circ Cardiovasc Qual Outcomes 2021; 14:e008118. [PMID: 33955228 PMCID: PMC8204764 DOI: 10.1161/circoutcomes.121.008118] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Supplemental Digital Content is available in the text. Social determinants of health (SDOH) may limit the practice of coronavirus disease 2019 (COVID-19) risk mitigation guidelines with health implications for individuals with underlying cardiovascular disease (CVD). Population-based evidence of the association between SDOH and practicing such mitigation strategies in adults with CVD is lacking. We used the National Opinion Research Center’s COVID-19 Household Impact Survey conducted between April and June 2020 to evaluate sociodemographic disparities in adherence to COVID-19 risk mitigation measures in a sample of respondents with underlying CVD representing 18 geographic areas of the United States.
Collapse
Affiliation(s)
- Kobina K Hagan
- Center for Outcomes Research, Houston Methodist, Houston, TX (K.K.H., Z.J., M.C.-A., F.S.V., I.A., B.K., K.N.)
| | - Zulqarnain Javed
- Center for Outcomes Research, Houston Methodist, Houston, TX (K.K.H., Z.J., M.C.-A., F.S.V., I.A., B.K., K.N.)
| | - Miguel Cainzos-Achirica
- Center for Outcomes Research, Houston Methodist, Houston, TX (K.K.H., Z.J., M.C.-A., F.S.V., I.A., B.K., K.N.).,Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist De-Bakey Heart and Vascular Center, TX (M.C.-A., J.V.-E., T.Y, K.N.)
| | - Dirk Sostman
- Academic Institute, Houston Methodist, Houston, TX (D.S.).,Research Institute, Houston Methodist, Houston, TX (D.S.).,Department of Radiology, Weill Cornell Medicine, New York, NY (D.S.).,Weill Cornell Medicine, New York, NY (D.S., B.K.)
| | - Farhaan S Vahidy
- Center for Outcomes Research, Houston Methodist, Houston, TX (K.K.H., Z.J., M.C.-A., F.S.V., I.A., B.K., K.N.).,Neurological Institute, Houston Methodist, Houston, TX (F.S.V.)
| | - Javier Valero-Elizondo
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist De-Bakey Heart and Vascular Center, TX (M.C.-A., J.V.-E., T.Y, K.N.)
| | - Isaac Acquah
- Center for Outcomes Research, Houston Methodist, Houston, TX (K.K.H., Z.J., M.C.-A., F.S.V., I.A., B.K., K.N.)
| | - Tamer Yahya
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist De-Bakey Heart and Vascular Center, TX (M.C.-A., J.V.-E., T.Y, K.N.)
| | - Bita Kash
- Center for Outcomes Research, Houston Methodist, Houston, TX (K.K.H., Z.J., M.C.-A., F.S.V., I.A., B.K., K.N.).,Weill Cornell Medicine, New York, NY (D.S., B.K.).,Texas A&M University School of Public Health, College Station, TX (B.K.)
| | - Julia D Andrieni
- Department of Medicine, Houston Methodist, Houston, TX (J.D.A).,Department of Medicine, Weill Cornell Medicine, New York, NY (J.D.A.)
| | - Prachi Dubey
- Department of Radiology (P.D.), Houston Methodist Hospital, TX
| | - Adnan A Hyder
- Center on Commercial Determinants of Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, (A.A.H.)
| | - Khurram Nasir
- Center for Outcomes Research, Houston Methodist, Houston, TX (K.K.H., Z.J., M.C.-A., F.S.V., I.A., B.K., K.N.).,Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist De-Bakey Heart and Vascular Center, TX (M.C.-A., J.V.-E., T.Y, K.N.).,Department of Cardiology, DeBakey Heart and Vascular Center (K.N.), Houston Methodist Hospital, TX
| |
Collapse
|
5
|
Willeit P, Krause R, Lamprecht B, Berghold A, Hanson B, Stelzl E, Stoiber H, Zuber J, Heinen R, Köhler A, Bernhard D, Borena W, Doppler C, von Laer D, Schmidt H, Pröll J, Steinmetz I, Wagner M. Prevalence of RT-qPCR-detected SARS-CoV-2 infection at schools: First results from the Austrian School-SARS-CoV-2 prospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2021; 5:100086. [PMID: 34396360 PMCID: PMC8350968 DOI: 10.1016/j.lanepe.2021.100086] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The role of schools in the SARS-CoV-2 pandemic is much debated. We aimed to quantify reliably the prevalence of SARS-CoV-2 infections at schools detected with reverse-transcription quantitative polymerase-chain-reaction (RT-qPCR). METHODS This nationwide prospective cohort study monitors a representative sample of pupils (grade 1-8) and teachers at Austrian schools throughout the school year 2020/2021. We repeatedly test participants for SARS-CoV-2 infection using a gargling solution and RT-qPCR. We herein report on the first two rounds of examinations. We used mixed-effects logistic regression to estimate odds ratios and robust 95% confidence intervals (95% CI). FINDINGS We analysed data on 10,734 participants from 245 schools (9465 pupils, 1269 teachers). Prevalence of SARS-CoV-2 infection increased from 0·39% at round 1 (95% CI 028-0·55%, 28 September-22 October 2020) to 1·39% at round 2 (95% CI 1·04-1·85%, 10-16 November). Odds ratios for SARS-CoV-2 infection were 2·26 (95% CI 1·25-4·12, P = 0·007) in regions with >500 vs. ≤500 inhabitants/km2, 1·67 (95% CI 1·42-1·97, P<0·001) per two-fold higher regional 7-day community incidence, and 2·78 (95% CI 1·73-4·48, P<0·001) in pupils at schools with high/very high vs. low/moderate social deprivation. Associations of regional community incidence and social deprivation persisted in a multivariable adjusted model. Prevalence did not differ by average number of pupils per class nor between age groups, sexes, pupils vs. teachers, or primary (grade 1-4) vs. secondary schools (grade 5-8). INTERPRETATION This monitoring study in Austrian schools revealed SARS-CoV-2 infection in 0·39%-1·39% of participants and identified associations of regional community incidence and social deprivation with higher prevalence. FUNDING BMBWF Austria.
Collapse
Affiliation(s)
- Peter Willeit
- Clinical Epidemiology Team, Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria,Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,Corresponding author at: Clinical Epidemiology Team, Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria and BioTechMed-Graz, Graz, Austria
| | - Bernd Lamprecht
- Department of Pulmonology, Faculty of Medicine, Kepler-University-Hospital, Johannes Kepler University Linz, Linz, Austria
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Buck Hanson
- Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria,Vienna Covid-19 Detection Initiative, Vienna, Austria
| | - Evelyn Stelzl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Heribert Stoiber
- Institute of Virology, Medical University Innsbruck, Innsbruck, Austria
| | - Johannes Zuber
- Vienna Covid-19 Detection Initiative, Vienna, Austria,IMP - Research Institute of Molecular Pathology, Vienna, Austria
| | - Robert Heinen
- Vienna Covid-19 Detection Initiative, Vienna, Austria,Gregor Mendel Institute of Molecular Plant Biology, Austrian Academy of Sciences, Vienna, Austria
| | - Alwin Köhler
- Vienna Covid-19 Detection Initiative, Vienna, Austria,Max Perutz Labs, University of Vienna, Vienna, Austria
| | - David Bernhard
- Center for Medical Research, Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria,Division of Pathophysiology, Institute of Physiology and Pathophysiology, Johannes Kepler University Linz, Linz, Austria
| | - Wegene Borena
- Institute of Virology, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Doppler
- Center for Medical Research, Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria,Division of Pathophysiology, Institute of Physiology and Pathophysiology, Johannes Kepler University Linz, Linz, Austria
| | - Dorothee von Laer
- Institute of Virology, Medical University Innsbruck, Innsbruck, Austria
| | - Hannes Schmidt
- Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria,Vienna Covid-19 Detection Initiative, Vienna, Austria
| | - Johannes Pröll
- Center for Medical Research, Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Michael Wagner
- Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria,Vienna Covid-19 Detection Initiative, Vienna, Austria,Center for Microbial Communities, Department of Chemistry and Bioscience, Aalborg University, Aalborg, Denmark,Corresponding author at: Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria.
| |
Collapse
|
6
|
Wang S, Green HC, Wilder ML, Du Q, Kmush BL, Collins MB, Larsen DA, Zeng T. High-throughput wastewater analysis for substance use assessment in central New York during the COVID-19 pandemic. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2020; 22:2147-2161. [PMID: 33104143 DOI: 10.1039/d0em00377h] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Wastewater entering sewer networks represents a unique source of pooled epidemiological information. In this study, we coupled online solid-phase extraction with liquid chromatography-high resolution mass spectrometry to achieve high-throughput analysis of health and lifestyle-related substances in untreated municipal wastewater during the coronavirus disease 2019 (COVID-19) pandemic. Twenty-six substances were identified and quantified in influent samples collected from six wastewater treatment plants during the COVID-19 pandemic in central New York. Over a 12 week sampling period, the mean summed consumption rate of six major substance groups (i.e., antidepressants, antiepileptics, antihistamines, antihypertensives, synthetic opioids, and central nervous system stimulants) correlated with disparities in household income, marital status, and age of the contributing populations as well as the detection frequency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater and the COVID-19 test positivity in the studied sewersheds. Nontarget screening revealed the covariation of piperine, a nontarget substance, with SARS-CoV-2 RNA in wastewater collected from one of the sewersheds. Overall, this proof-of-the-concept study demonstrated the utility of high-throughput wastewater analysis for assessing the population-level substance use patterns during a public health crisis such as COVID-19.
Collapse
Affiliation(s)
- Shiru Wang
- Department of Civil and Environmental Engineering, Syracuse University, Syracuse, NY 13244, USA.
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Richmond HL, Tome J, Rochani H, Fung ICH, Shah GH, Schwind JS. The Use of Penalized Regression Analysis to Identify County-Level Demographic and Socioeconomic Variables Predictive of Increased COVID-19 Cumulative Case Rates in the State of Georgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8036. [PMID: 33142755 PMCID: PMC7663274 DOI: 10.3390/ijerph17218036] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/22/2020] [Accepted: 10/25/2020] [Indexed: 02/07/2023]
Abstract
Systemic inequity concerning the social determinants of health has been known to affect morbidity and mortality for decades. Significant attention has focused on the individual-level demographic and co-morbid factors associated with rates and mortality of COVID-19. However, less attention has been given to the county-level social determinants of health that are the main drivers of health inequities. To identify the degree to which social determinants of health predict COVID-19 cumulative case rates at the county-level in Georgia, we performed a sequential, cross-sectional ecologic analysis using a diverse set of socioeconomic and demographic variables. Lasso regression was used to identify variables from collinear groups. Twelve variables correlated to cumulative case rates (for cases reported by 1 August 2020) with an adjusted r squared of 0.4525. As time progressed in the pandemic, correlation of demographic and socioeconomic factors to cumulative case rates increased, as did number of variables selected. Findings indicate the social determinants of health and demographic factors continue to predict case rates of COVID-19 at the county-level as the pandemic evolves. This research contributes to the growing body of evidence that health disparities continue to widen, disproportionality affecting vulnerable populations.
Collapse
Affiliation(s)
- Holly L. Richmond
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Joana Tome
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Haresh Rochani
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Isaac Chun-Hai Fung
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Gulzar H. Shah
- Jiann-Ping Hsu College of Public Health, Department of Health Policy and Community Health, Georgia Southern University, Statesboro, GA 30458, USA;
| | - Jessica S. Schwind
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| |
Collapse
|