Assessing the Impact of Neighborhood Socioeconomic Characteristics on COVID-19 Prevalence Across Seven States in the United States

Introduction: The spread of Coronavirus Disease 2019 (COVID-19) across the United States has highlighted the long-standing nationwide health inequalities with socioeconomically challenged communities experiencing a higher burden of the disease. We assessed the impact of neighborhood socioeconomic characteristics on the COVID-19 prevalence across seven selected states (i.e., Arizona, Florida, Illinois, Maryland, North Carolina, South Carolina, and Virginia). Methods: We obtained cumulative COVID-19 cases reported at the neighborhood aggregation level by Departments of Health in selected states on two dates (May 3rd, 2020, and May 30th, 2020) and assessed the correlation between the COVID-19 prevalence and neighborhood characteristics. We developed Area Deprivation Index (ADI), a composite measure to rank neighborhoods by their socioeconomic characteristics, using the 2018 US Census American Community Survey. The higher ADI rank represented more disadvantaged neighborhoods. Results: After controlling for age, gender, and the square mileage of each community we identified Zip-codes with higher ADI (more disadvantaged neighborhoods) in Illinois and Maryland had higher COVID-19 prevalence comparing to zip-codes across the country and in the same state with lower ADI (less disadvantaged neighborhoods) using data on May 3rd. We detected the same pattern across all states except for Florida and Virginia using data on May 30th, 2020. Conclusion: Our study provides evidence that not all Americans are at equal risk for COVID-19. Socioeconomic characteristics of communities appear to be associated with their COVID-19 susceptibility, at least among those study states with high rates of disease.