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Time-varying associations between COVID-19 case incidence and community-level sociodemographic, occupational, environmental, and mobility risk factors in Massachusetts

BACKGROUND: Associations between community-level risk factors and COVID-19 incidence have been used to identify vulnerable subpopulations and target interventions, but the variability of these associations over time remains largely unknown. We evaluated variability in the associations between commun...

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Autores principales: Tieskens, Koen F., Patil, Prasad, Levy, Jonathan I., Brochu, Paige, Lane, Kevin J., Fabian, M. Patricia, Carnes, Fei, Haley, Beth M., Spangler, Keith R., Leibler, Jessica H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283097/
https://www.ncbi.nlm.nih.gov/pubmed/34271870
http://dx.doi.org/10.1186/s12879-021-06389-w
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author Tieskens, Koen F.
Patil, Prasad
Levy, Jonathan I.
Brochu, Paige
Lane, Kevin J.
Fabian, M. Patricia
Carnes, Fei
Haley, Beth M.
Spangler, Keith R.
Leibler, Jessica H.
author_facet Tieskens, Koen F.
Patil, Prasad
Levy, Jonathan I.
Brochu, Paige
Lane, Kevin J.
Fabian, M. Patricia
Carnes, Fei
Haley, Beth M.
Spangler, Keith R.
Leibler, Jessica H.
author_sort Tieskens, Koen F.
collection PubMed
description BACKGROUND: Associations between community-level risk factors and COVID-19 incidence have been used to identify vulnerable subpopulations and target interventions, but the variability of these associations over time remains largely unknown. We evaluated variability in the associations between community-level predictors and COVID-19 case incidence in 351 cities and towns in Massachusetts from March to October 2020. METHODS: Using publicly available sociodemographic, occupational, environmental, and mobility datasets, we developed mixed-effect, adjusted Poisson regression models to depict associations between these variables and town-level COVID-19 case incidence data across five distinct time periods from March to October 2020. We examined town-level demographic variables, including population proportions by race, ethnicity, and age, as well as factors related to occupation, housing density, economic vulnerability, air pollution (PM(2.5)), and institutional facilities. We calculated incidence rate ratios (IRR) associated with these predictors and compared these values across the multiple time periods to assess variability in the observed associations over time. RESULTS: Associations between key predictor variables and town-level incidence varied across the five time periods. We observed reductions over time in the association with percentage of Black residents (IRR = 1.12 [95%CI: 1.12–1.13]) in early spring, IRR = 1.01 [95%CI: 1.00–1.01] in early fall) and COVID-19 incidence. The association with number of long-term care facility beds per capita also decreased over time (IRR = 1.28 [95%CI: 1.26–1.31] in spring, IRR = 1.07 [95%CI: 1.05–1.09] in fall). Controlling for other factors, towns with higher percentages of essential workers experienced elevated incidences of COVID-19 throughout the pandemic (e.g., IRR = 1.30 [95%CI: 1.27–1.33] in spring, IRR = 1.20 [95%CI: 1.17–1.22] in fall). Towns with higher proportions of Latinx residents also had sustained elevated incidence over time (IRR = 1.19 [95%CI: 1.18–1.21] in spring, IRR = 1.14 [95%CI: 1.13–1.15] in fall). CONCLUSIONS: Town-level COVID-19 risk factors varied with time in this study. In Massachusetts, racial (but not ethnic) disparities in COVID-19 incidence may have decreased across the first 8 months of the pandemic, perhaps indicating greater success in risk mitigation in selected communities. Our approach can be used to evaluate effectiveness of public health interventions and target specific mitigation efforts on the community level.
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spelling pubmed-82830972021-07-19 Time-varying associations between COVID-19 case incidence and community-level sociodemographic, occupational, environmental, and mobility risk factors in Massachusetts Tieskens, Koen F. Patil, Prasad Levy, Jonathan I. Brochu, Paige Lane, Kevin J. Fabian, M. Patricia Carnes, Fei Haley, Beth M. Spangler, Keith R. Leibler, Jessica H. BMC Infect Dis Research BACKGROUND: Associations between community-level risk factors and COVID-19 incidence have been used to identify vulnerable subpopulations and target interventions, but the variability of these associations over time remains largely unknown. We evaluated variability in the associations between community-level predictors and COVID-19 case incidence in 351 cities and towns in Massachusetts from March to October 2020. METHODS: Using publicly available sociodemographic, occupational, environmental, and mobility datasets, we developed mixed-effect, adjusted Poisson regression models to depict associations between these variables and town-level COVID-19 case incidence data across five distinct time periods from March to October 2020. We examined town-level demographic variables, including population proportions by race, ethnicity, and age, as well as factors related to occupation, housing density, economic vulnerability, air pollution (PM(2.5)), and institutional facilities. We calculated incidence rate ratios (IRR) associated with these predictors and compared these values across the multiple time periods to assess variability in the observed associations over time. RESULTS: Associations between key predictor variables and town-level incidence varied across the five time periods. We observed reductions over time in the association with percentage of Black residents (IRR = 1.12 [95%CI: 1.12–1.13]) in early spring, IRR = 1.01 [95%CI: 1.00–1.01] in early fall) and COVID-19 incidence. The association with number of long-term care facility beds per capita also decreased over time (IRR = 1.28 [95%CI: 1.26–1.31] in spring, IRR = 1.07 [95%CI: 1.05–1.09] in fall). Controlling for other factors, towns with higher percentages of essential workers experienced elevated incidences of COVID-19 throughout the pandemic (e.g., IRR = 1.30 [95%CI: 1.27–1.33] in spring, IRR = 1.20 [95%CI: 1.17–1.22] in fall). Towns with higher proportions of Latinx residents also had sustained elevated incidence over time (IRR = 1.19 [95%CI: 1.18–1.21] in spring, IRR = 1.14 [95%CI: 1.13–1.15] in fall). CONCLUSIONS: Town-level COVID-19 risk factors varied with time in this study. In Massachusetts, racial (but not ethnic) disparities in COVID-19 incidence may have decreased across the first 8 months of the pandemic, perhaps indicating greater success in risk mitigation in selected communities. Our approach can be used to evaluate effectiveness of public health interventions and target specific mitigation efforts on the community level. BioMed Central 2021-07-16 /pmc/articles/PMC8283097/ /pubmed/34271870 http://dx.doi.org/10.1186/s12879-021-06389-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Tieskens, Koen F.
Patil, Prasad
Levy, Jonathan I.
Brochu, Paige
Lane, Kevin J.
Fabian, M. Patricia
Carnes, Fei
Haley, Beth M.
Spangler, Keith R.
Leibler, Jessica H.
Time-varying associations between COVID-19 case incidence and community-level sociodemographic, occupational, environmental, and mobility risk factors in Massachusetts
title Time-varying associations between COVID-19 case incidence and community-level sociodemographic, occupational, environmental, and mobility risk factors in Massachusetts
title_full Time-varying associations between COVID-19 case incidence and community-level sociodemographic, occupational, environmental, and mobility risk factors in Massachusetts
title_fullStr Time-varying associations between COVID-19 case incidence and community-level sociodemographic, occupational, environmental, and mobility risk factors in Massachusetts
title_full_unstemmed Time-varying associations between COVID-19 case incidence and community-level sociodemographic, occupational, environmental, and mobility risk factors in Massachusetts
title_short Time-varying associations between COVID-19 case incidence and community-level sociodemographic, occupational, environmental, and mobility risk factors in Massachusetts
title_sort time-varying associations between covid-19 case incidence and community-level sociodemographic, occupational, environmental, and mobility risk factors in massachusetts
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283097/
https://www.ncbi.nlm.nih.gov/pubmed/34271870
http://dx.doi.org/10.1186/s12879-021-06389-w
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