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COVID deaths vary by race, community, social factors
Filed Under:
COVID-19
Mary Van Beusekom | News Writer | CIDRAP News
| Mar 07, 2022
Social determinants of health (SDOH) tied to COVID-19 death rates varied by race and community type in the first year of the pandemic, suggests an observational spatial analysis involving 3,142 counties in all 50 US states and Washington, DC.
The study was published late last week in JAMA Network Open.
SDOH are nonmedical factors, such as where people live and work, that influence health outcomes such as COVID-19 infection and death.
"Racial disparities in health largely emanate from the inequitable access to social, economic, and physical or built environmental conditions resulting from racism in the US," the researchers wrote. "Specifically, racism interacts with and exists within societal structures and systems to shape the major SDOH."
Limited Internet access tied to more deaths
University of Chicago researchers analyzed Centers for Disease Control and Prevention (CDC) COVID-19 data from Jan 22, 2020, to Feb 28, 2021, identifying counties with high proportions of residents of a single race (Black, Hispanic, or White) and high coronavirus-related death rates as "concentrated longitudinal-impact counties."
Among 3,142 total counties, 531 were classified as concentrated longitudinal-impact counties, with 11.0% having a large Black population relative to other counties, 6.3% having a large Hispanic population, and 1.1% having a large share of White residents.
Overall, 489,254 people in the included counties died. All concentrated longitudinal-impact counties had significantly higher COVID-19 death rates than other counties. Median deaths per 100,000 residents were 231.4 in such counties with a large Black population, 218.8 in such counties with a large proportion of Hispanic residents, and 251.8 in such counties with a large White population. In contrast, the median death rate in other counties was 128.6 per 100,000.
While the 33 concentrated longitudinal-impact counties with a large proportion of White residents had a higher death rate per 100,000 residents, many more such counties had higher Black and Hispanic concentrations, which the researchers said indicates that the latter counties had a higher COVID-19 death toll than all White concentrated longitudinal-impact counties (deaths, 138,315 and 195,852 vs 2,586).
Across all types of communities, those with limited Internet access—particularly in urban areas—had higher death rates. "Adopting an asset-based approach, we believe this finding suggests that more awareness is needed about the essential asset of technological access to reliable information, remote work, schooling opportunities, resource purchasing, and/or social community," the study authors wrote. "Populations with limited internet access remain understudied and are often excluded in pandemic research."
Income inequality and preventable hospitalizations
Many concentrated longitudinal-impact counties with the largest percentages of Black (67.1%) and Hispanic residents (55.6%) had a higher proportion of working-age people than the national median. And 78.8% of counties with a large White population had a higher percentage of people 65 years and older than the national median.
Of concentrated longitudinal-impact counties with a large White population, 69.7% were in rural areas, while 57.6% of counties with a large Hispanic population were located in urban areas, and those with a large Black population were in rural, suburban, and urban areas.
Most concentrated longitudinal-impact counties with a relatively large Black population had disadvantages, such as greater income inequality (85.6%) and more preventable hospital stays (81.0%). Among counties with a large proportion of Hispanic residents, 65.7% had high percentages of residents with no health insurance.
Among concentrated longitudinal-impact counties with large proportions of White residents, 78.8% had a large population of older adults, and 72.7% had limited access to quality healthcare.
Future research is needed to identify dimensions and regional patterns of SDOH to address health disparities and guide policies and programs, the authors noted. "A more complex model that uses geospatial and temporal patterns to reflect spatial effects and dynamic community aspects (eg, changes in policies, unemployment), in addition to existing SDOH measures and human behaviors, is needed for future analysis," they wrote.
COVID deaths vary by race, community, social factors
Filed Under:
COVID-19
Mary Van Beusekom | News Writer | CIDRAP News
| Mar 07, 2022
Social determinants of health (SDOH) tied to COVID-19 death rates varied by race and community type in the first year of the pandemic, suggests an observational spatial analysis involving 3,142 counties in all 50 US states and Washington, DC.
The study was published late last week in JAMA Network Open.
SDOH are nonmedical factors, such as where people live and work, that influence health outcomes such as COVID-19 infection and death.
"Racial disparities in health largely emanate from the inequitable access to social, economic, and physical or built environmental conditions resulting from racism in the US," the researchers wrote. "Specifically, racism interacts with and exists within societal structures and systems to shape the major SDOH."
Limited Internet access tied to more deaths
University of Chicago researchers analyzed Centers for Disease Control and Prevention (CDC) COVID-19 data from Jan 22, 2020, to Feb 28, 2021, identifying counties with high proportions of residents of a single race (Black, Hispanic, or White) and high coronavirus-related death rates as "concentrated longitudinal-impact counties."
Among 3,142 total counties, 531 were classified as concentrated longitudinal-impact counties, with 11.0% having a large Black population relative to other counties, 6.3% having a large Hispanic population, and 1.1% having a large share of White residents.
Overall, 489,254 people in the included counties died. All concentrated longitudinal-impact counties had significantly higher COVID-19 death rates than other counties. Median deaths per 100,000 residents were 231.4 in such counties with a large Black population, 218.8 in such counties with a large proportion of Hispanic residents, and 251.8 in such counties with a large White population. In contrast, the median death rate in other counties was 128.6 per 100,000.
While the 33 concentrated longitudinal-impact counties with a large proportion of White residents had a higher death rate per 100,000 residents, many more such counties had higher Black and Hispanic concentrations, which the researchers said indicates that the latter counties had a higher COVID-19 death toll than all White concentrated longitudinal-impact counties (deaths, 138,315 and 195,852 vs 2,586).
Across all types of communities, those with limited Internet access—particularly in urban areas—had higher death rates. "Adopting an asset-based approach, we believe this finding suggests that more awareness is needed about the essential asset of technological access to reliable information, remote work, schooling opportunities, resource purchasing, and/or social community," the study authors wrote. "Populations with limited internet access remain understudied and are often excluded in pandemic research."
Income inequality and preventable hospitalizations
Many concentrated longitudinal-impact counties with the largest percentages of Black (67.1%) and Hispanic residents (55.6%) had a higher proportion of working-age people than the national median. And 78.8% of counties with a large White population had a higher percentage of people 65 years and older than the national median.
Of concentrated longitudinal-impact counties with a large White population, 69.7% were in rural areas, while 57.6% of counties with a large Hispanic population were located in urban areas, and those with a large Black population were in rural, suburban, and urban areas.
Most concentrated longitudinal-impact counties with a relatively large Black population had disadvantages, such as greater income inequality (85.6%) and more preventable hospital stays (81.0%). Among counties with a large proportion of Hispanic residents, 65.7% had high percentages of residents with no health insurance.
Among concentrated longitudinal-impact counties with large proportions of White residents, 78.8% had a large population of older adults, and 72.7% had limited access to quality healthcare.
Future research is needed to identify dimensions and regional patterns of SDOH to address health disparities and guide policies and programs, the authors noted. "A more complex model that uses geospatial and temporal patterns to reflect spatial effects and dynamic community aspects (eg, changes in policies, unemployment), in addition to existing SDOH measures and human behaviors, is needed for future analysis," they wrote.
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