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Socio-economic status and COVID-19–related cases and fatalities
OBJECTIVES: The United States has the highest number of coronavirus disease 2019 (COVID-19) in the world, with high variability in cases and mortality between communities. We aimed to quantify the associations between socio-economic status and COVID-19–related cases and mortality in the U.S. STUDY D...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Royal Society for Public Health. Published by Elsevier Ltd.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568122/ https://www.ncbi.nlm.nih.gov/pubmed/33227595 http://dx.doi.org/10.1016/j.puhe.2020.09.016 |
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author | Hawkins, R.B. Charles, E.J. Mehaffey, J.H. |
author_facet | Hawkins, R.B. Charles, E.J. Mehaffey, J.H. |
author_sort | Hawkins, R.B. |
collection | PubMed |
description | OBJECTIVES: The United States has the highest number of coronavirus disease 2019 (COVID-19) in the world, with high variability in cases and mortality between communities. We aimed to quantify the associations between socio-economic status and COVID-19–related cases and mortality in the U.S. STUDY DESIGN: The study design includes nationwide COVID-19 data at the county level that were paired with the Distressed Communities Index (DCI) and its component metrics of socio-economic status. METHODS: Severely distressed communities were classified by DCI>75 for univariate analyses. Adjusted rate ratios were calculated for cases and fatalities per 100,000 persons using hierarchical linear mixed models. RESULTS: This cohort included 1,089,999 cases and 62,298 deaths in 3127 counties for a case fatality rate of 5.7%. Severely distressed counties had significantly fewer deaths from COVID-19 but higher number of deaths per 100,000 persons. In risk-adjusted analysis, the two socio-economic determinants of health with the strongest association with both higher cases per 100,000 persons and higher fatalities per 100,000 persons were the percentage of adults without a high school degree (cases: RR 1.10; fatalities: RR 1.08) and proportion of black residents (cases and fatalities: Relative risk(RR) 1.03). The percentage of the population aged older than 65 years was also highly predictive for fatalities per 100,000 persons (RR 1.07). CONCLUSION: Lower education levels and greater percentages of black residents are strongly associated with higher rates of both COVID-19 cases and fatalities. Socio-economic factors should be considered when implementing public health interventions to ameliorate the disparities in the impact of COVID-19 on distressed communities. |
format | Online Article Text |
id | pubmed-7568122 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The Royal Society for Public Health. Published by Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75681222020-10-19 Socio-economic status and COVID-19–related cases and fatalities Hawkins, R.B. Charles, E.J. Mehaffey, J.H. Public Health Original Research OBJECTIVES: The United States has the highest number of coronavirus disease 2019 (COVID-19) in the world, with high variability in cases and mortality between communities. We aimed to quantify the associations between socio-economic status and COVID-19–related cases and mortality in the U.S. STUDY DESIGN: The study design includes nationwide COVID-19 data at the county level that were paired with the Distressed Communities Index (DCI) and its component metrics of socio-economic status. METHODS: Severely distressed communities were classified by DCI>75 for univariate analyses. Adjusted rate ratios were calculated for cases and fatalities per 100,000 persons using hierarchical linear mixed models. RESULTS: This cohort included 1,089,999 cases and 62,298 deaths in 3127 counties for a case fatality rate of 5.7%. Severely distressed counties had significantly fewer deaths from COVID-19 but higher number of deaths per 100,000 persons. In risk-adjusted analysis, the two socio-economic determinants of health with the strongest association with both higher cases per 100,000 persons and higher fatalities per 100,000 persons were the percentage of adults without a high school degree (cases: RR 1.10; fatalities: RR 1.08) and proportion of black residents (cases and fatalities: Relative risk(RR) 1.03). The percentage of the population aged older than 65 years was also highly predictive for fatalities per 100,000 persons (RR 1.07). CONCLUSION: Lower education levels and greater percentages of black residents are strongly associated with higher rates of both COVID-19 cases and fatalities. Socio-economic factors should be considered when implementing public health interventions to ameliorate the disparities in the impact of COVID-19 on distressed communities. The Royal Society for Public Health. Published by Elsevier Ltd. 2020-12 2020-10-17 /pmc/articles/PMC7568122/ /pubmed/33227595 http://dx.doi.org/10.1016/j.puhe.2020.09.016 Text en © 2020 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Research Hawkins, R.B. Charles, E.J. Mehaffey, J.H. Socio-economic status and COVID-19–related cases and fatalities |
title | Socio-economic status and COVID-19–related cases and fatalities |
title_full | Socio-economic status and COVID-19–related cases and fatalities |
title_fullStr | Socio-economic status and COVID-19–related cases and fatalities |
title_full_unstemmed | Socio-economic status and COVID-19–related cases and fatalities |
title_short | Socio-economic status and COVID-19–related cases and fatalities |
title_sort | socio-economic status and covid-19–related cases and fatalities |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568122/ https://www.ncbi.nlm.nih.gov/pubmed/33227595 http://dx.doi.org/10.1016/j.puhe.2020.09.016 |
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