A spatial analysis of the association between social vulnerability and the cumulative number of confirmed deaths from COVID-19 in United States counties through November 14, 2020

OBJECTIVES: Coronavirus disease 2019 (COVID-19) is classified as a natural hazard, and social vulnerability describes the susceptibility of social groups to potential damages from natural hazards. Therefore, the objective of this study was to examine the association between social vulnerability and the cumulative number of confirmed COVID-19 deaths (per 100,000) in 3,141 United States counties. METHODS: The cumulative number of COVID-19 deaths was obtained from USA Facts. Variables related to social vulnerability were obtained from the Centers for Disease Control and Prevention Social Vulnerability Index and the 2018 5-Year American Community Survey. Data were analyzed using spatial autoregression models. RESULTS: Lowest income and educational level, as well as high proportions of single parent households, mobile home residents, and people without health insurance were positively associated with a high cumulative number of COVID-19 deaths. CONCLUSION: In conclusion, there are regional differences in the cumulative number of COVID-19 deaths in United States counties, which are affected by various social vulnerabilities. Hence, these findings underscore the need to take social vulnerability into account when planning interventions to reduce COVID-19 deaths.