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Determinants of COVID-19 Case Fatality Rate in the United States: Spatial Analysis Over One Year of the Pandemic

Background: The United States continues to account for the highest proportion of the global Coronavirus Disease-2019 (COVID-19) cases and deaths. Currently, it is important to contextualize COVID-19 fatality to guide mitigation efforts. Objectives: The objective of this study was to assess the ecolo...

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Autores principales: Kathe, Niranjan J., Wani, Rajvi J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Columbia Data Analytics, LLC 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8112906/
https://www.ncbi.nlm.nih.gov/pubmed/34017883
http://dx.doi.org/10.36469/jheor.2021.22978
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author Kathe, Niranjan J.
Wani, Rajvi J.
author_facet Kathe, Niranjan J.
Wani, Rajvi J.
author_sort Kathe, Niranjan J.
collection PubMed
description Background: The United States continues to account for the highest proportion of the global Coronavirus Disease-2019 (COVID-19) cases and deaths. Currently, it is important to contextualize COVID-19 fatality to guide mitigation efforts. Objectives: The objective of this study was to assess the ecological factors (policy, health behaviors, socio-economic, physical environment, and clinical care) associated with COVID-19 case fatality rate (CFR) in the United States. Methods: Data from the New York Times’ COVID-19 repository and the Centers for Disease Control and Prevention Data (01/21/2020 - 02/27/2021) were used. County-level CFR was modeled using the Spatial Durbin model (SDM). The SDM estimates were decomposed into direct and indirect impacts. Results: The study found percent positive for COVID-19 (0.057% point), stringency index (0.014% point), percent diabetic (0.011% point), long-term care beds (log) (0.010% point), premature age-adjusted mortality (log) (0.702 % point), income inequality ratio (0.078% point), social association rate (log) (0.014% point), percent 65 years old and over (0.055% point), and percent African Americans (0.016% point) in a given county were positively associated with its COVID-19 CFR. The study also found food insecurity, long-term beds (log), mental health-care provider (log), workforce in construction, social association rate (log), and percent diabetic of a given county as well as neighboring county were associated with given county’s COVID-19 CFR, indicating significant externalities. Conclusion: The spatial models identified percent positive for COVID-19, stringency index, elderly, college education, race/ethnicity, residential segregation, premature mortality, income inequality, workforce composition, and rurality as important ecological determinants of the geographic disparities in COVID-19 CFR.
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spelling pubmed-81129062021-05-19 Determinants of COVID-19 Case Fatality Rate in the United States: Spatial Analysis Over One Year of the Pandemic Kathe, Niranjan J. Wani, Rajvi J. J Health Econ Outcomes Res Infectious Diseases Background: The United States continues to account for the highest proportion of the global Coronavirus Disease-2019 (COVID-19) cases and deaths. Currently, it is important to contextualize COVID-19 fatality to guide mitigation efforts. Objectives: The objective of this study was to assess the ecological factors (policy, health behaviors, socio-economic, physical environment, and clinical care) associated with COVID-19 case fatality rate (CFR) in the United States. Methods: Data from the New York Times’ COVID-19 repository and the Centers for Disease Control and Prevention Data (01/21/2020 - 02/27/2021) were used. County-level CFR was modeled using the Spatial Durbin model (SDM). The SDM estimates were decomposed into direct and indirect impacts. Results: The study found percent positive for COVID-19 (0.057% point), stringency index (0.014% point), percent diabetic (0.011% point), long-term care beds (log) (0.010% point), premature age-adjusted mortality (log) (0.702 % point), income inequality ratio (0.078% point), social association rate (log) (0.014% point), percent 65 years old and over (0.055% point), and percent African Americans (0.016% point) in a given county were positively associated with its COVID-19 CFR. The study also found food insecurity, long-term beds (log), mental health-care provider (log), workforce in construction, social association rate (log), and percent diabetic of a given county as well as neighboring county were associated with given county’s COVID-19 CFR, indicating significant externalities. Conclusion: The spatial models identified percent positive for COVID-19, stringency index, elderly, college education, race/ethnicity, residential segregation, premature mortality, income inequality, workforce composition, and rurality as important ecological determinants of the geographic disparities in COVID-19 CFR. Columbia Data Analytics, LLC 2021-05-11 /pmc/articles/PMC8112906/ /pubmed/34017883 http://dx.doi.org/10.36469/jheor.2021.22978 Text en https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (4.0) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Infectious Diseases
Kathe, Niranjan J.
Wani, Rajvi J.
Determinants of COVID-19 Case Fatality Rate in the United States: Spatial Analysis Over One Year of the Pandemic
title Determinants of COVID-19 Case Fatality Rate in the United States: Spatial Analysis Over One Year of the Pandemic
title_full Determinants of COVID-19 Case Fatality Rate in the United States: Spatial Analysis Over One Year of the Pandemic
title_fullStr Determinants of COVID-19 Case Fatality Rate in the United States: Spatial Analysis Over One Year of the Pandemic
title_full_unstemmed Determinants of COVID-19 Case Fatality Rate in the United States: Spatial Analysis Over One Year of the Pandemic
title_short Determinants of COVID-19 Case Fatality Rate in the United States: Spatial Analysis Over One Year of the Pandemic
title_sort determinants of covid-19 case fatality rate in the united states: spatial analysis over one year of the pandemic
topic Infectious Diseases
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8112906/
https://www.ncbi.nlm.nih.gov/pubmed/34017883
http://dx.doi.org/10.36469/jheor.2021.22978
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