Predicting Health Disparities in Regions at Risk of Severe Illness to Inform Health Care Resource Allocation During Pandemics: Observational Study

BACKGROUND: Pandemics including COVID-19 have disproportionately affected socioeconomically vulnerable populations. OBJECTIVE: Our objective was to create a repeatable modeling process to identify regional population centers with pandemic vulnerability. METHODS: Using readily available COVID-19 and socioeconomic variable data sets, we used stepwise linear regression techniques to build predictive models during the early days of the COVID-19 pandemic. The models were validated later in the pandemic timeline using actual COVID-19 mortality rates in high population density states. The mean sample size was 43 and ranged from 8 (Connecticut) to 82 (Michigan). RESULTS: The New York, New Jersey, Connecticut, Massachusetts, Louisiana, Michigan, and Pennsylvania models provided the strongest predictions of top counties in densely populated states with a high likelihood of disproportionate COVID-19 mortality rates. For all of these models, P values were less than .05. CONCLUSIONS: The models have been shared with the Department of Health Commissioners of each of these states with strong model predictions as input into a much needed “pandemic playbook” for local health care agencies in allocating medical testing and treatment resources. We have also confirmed the utility of our models with pharmaceutical companies for use in decisions pertaining to vaccine trial and distribution locations.