Assessing Socioeconomic Vulnerabilities Related to COVID-19 Risk in India: A State-Level Analysis

OBJECTIVE: There is a paucity of scientific analysis that has examined spatial heterogeneities in the socioeconomic vulnerabilities related to coronavirus disease 2019 (COVID-19) risk and potential mitigation strategies at the sub-national level in India. The present study examined the demographic, socioeconomic, and health system-related vulnerabilities shaping COVID-19 risk across 36 states and union territories in India. METHODS: Using secondary data from the Ministry of Health and Family Welfare (MoHFW), Government of India; Census of India, 2011; National Family Health Survey, 2015-16; and various rounds of the National Sample Survey, we examined socioeconomic vulnerabilities associated with COVID-19 risk at the sub-national level in India from March 16, 2020, to May 3, 2020. Descriptive statistics, principal component analysis, and the negative binomial regression model were used to examine the predictors of COVID-19 risk in India. RESULTS: There persist substantial heterogeneities in the COVID-19 risk across states and union territories in India. The underlying demographic, socioeconomic, and health infrastructure characteristics drive the vulnerabilities related to COVID-19 in India. CONCLUSIONS: This study emphasizes that concerted socially inclusive policy action and sustained livelihood/economic support for the most vulnerable population groups is critical to mitigate the impact of the COVID-19 pandemic in India.