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Community Susceptibility and Resiliency to COVID‐19 Across the Rural‐Urban Continuum in the United States

PURPOSE: This study creates a COVID‐19 susceptibility scale at the county level, describes its components, and then assesses the health and socioeconomic resiliency of susceptible places across the rural‐urban continuum. METHODS: Factor analysis grouped 11 indicators into 7 distinct susceptibility f...

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Autor principal: Peters, David J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323251/
https://www.ncbi.nlm.nih.gov/pubmed/32543751
http://dx.doi.org/10.1111/jrh.12477
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author Peters, David J.
author_facet Peters, David J.
author_sort Peters, David J.
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description PURPOSE: This study creates a COVID‐19 susceptibility scale at the county level, describes its components, and then assesses the health and socioeconomic resiliency of susceptible places across the rural‐urban continuum. METHODS: Factor analysis grouped 11 indicators into 7 distinct susceptibility factors for 3,079 counties in the conterminous United States. Unconditional mean differences are assessed using a multivariate general linear model. Data from 2018 are primarily taken from the US Census Bureau and CDC. RESULTS: About 33% of rural counties are highly susceptible to COVID‐19, driven by older and health‐compromised populations, and care facilities for the elderly. Major vulnerabilities in rural counties include fewer physicians, lack of mental health services, higher disability, and more uninsured. Poor Internet access limits telemedicine. Lack of social capital and social services may hinder local pandemic recovery. Meat processing facilities drive risk in micropolitan counties. Although metropolitan counties are less susceptible due to healthier and younger populations, about 6% are at risk due to community spread from dense populations. Metropolitan vulnerabilities include minorities at higher health and diabetes risk, language barriers, being a transportation hub that helps spread infection, and acute housing distress. CONCLUSIONS: There is an immediate need to know specific types of susceptibilities and vulnerabilities ahead of time to allow local and state health officials to plan and allocate resources accordingly. In rural areas it is essential to shelter‐in‐place vulnerable populations, whereas in large metropolitan areas general closure orders are needed to stop community spread. Pandemic response plans should address vulnerabilities.
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spelling pubmed-73232512020-06-29 Community Susceptibility and Resiliency to COVID‐19 Across the Rural‐Urban Continuum in the United States Peters, David J. J Rural Health Original Articles PURPOSE: This study creates a COVID‐19 susceptibility scale at the county level, describes its components, and then assesses the health and socioeconomic resiliency of susceptible places across the rural‐urban continuum. METHODS: Factor analysis grouped 11 indicators into 7 distinct susceptibility factors for 3,079 counties in the conterminous United States. Unconditional mean differences are assessed using a multivariate general linear model. Data from 2018 are primarily taken from the US Census Bureau and CDC. RESULTS: About 33% of rural counties are highly susceptible to COVID‐19, driven by older and health‐compromised populations, and care facilities for the elderly. Major vulnerabilities in rural counties include fewer physicians, lack of mental health services, higher disability, and more uninsured. Poor Internet access limits telemedicine. Lack of social capital and social services may hinder local pandemic recovery. Meat processing facilities drive risk in micropolitan counties. Although metropolitan counties are less susceptible due to healthier and younger populations, about 6% are at risk due to community spread from dense populations. Metropolitan vulnerabilities include minorities at higher health and diabetes risk, language barriers, being a transportation hub that helps spread infection, and acute housing distress. CONCLUSIONS: There is an immediate need to know specific types of susceptibilities and vulnerabilities ahead of time to allow local and state health officials to plan and allocate resources accordingly. In rural areas it is essential to shelter‐in‐place vulnerable populations, whereas in large metropolitan areas general closure orders are needed to stop community spread. Pandemic response plans should address vulnerabilities. John Wiley and Sons Inc. 2020-06-16 2020 /pmc/articles/PMC7323251/ /pubmed/32543751 http://dx.doi.org/10.1111/jrh.12477 Text en © 2020 The Authors. The Journal of Rural Health published by Wiley Periodicals LLC on behalf of National Rural Health Association. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Peters, David J.
Community Susceptibility and Resiliency to COVID‐19 Across the Rural‐Urban Continuum in the United States
title Community Susceptibility and Resiliency to COVID‐19 Across the Rural‐Urban Continuum in the United States
title_full Community Susceptibility and Resiliency to COVID‐19 Across the Rural‐Urban Continuum in the United States
title_fullStr Community Susceptibility and Resiliency to COVID‐19 Across the Rural‐Urban Continuum in the United States
title_full_unstemmed Community Susceptibility and Resiliency to COVID‐19 Across the Rural‐Urban Continuum in the United States
title_short Community Susceptibility and Resiliency to COVID‐19 Across the Rural‐Urban Continuum in the United States
title_sort community susceptibility and resiliency to covid‐19 across the rural‐urban continuum in the united states
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323251/
https://www.ncbi.nlm.nih.gov/pubmed/32543751
http://dx.doi.org/10.1111/jrh.12477
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