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Associations Between Structural and Social Determinants of Health With COVID Infection Rates at a Safety Net Hospital

Background: The reported disproportionate impact of COVID-19 infections on minority populations may be due to living in disinvested communities with a high level of poverty, pollution, inadequate unsafe employment, and overcrowded housing. Objective: To determine the association of county, city, and...

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Autores principales: Ogunyemi, Dotun, Mantilla, Rolando, Markus, Abhinav, Reeves, Aubrey, Win, Suyee, Barrientos, Devin R, Lim, Dandrich, Lanum, David, Raval, Niren
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8457892/
https://www.ncbi.nlm.nih.gov/pubmed/34584806
http://dx.doi.org/10.7759/cureus.17397
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author Ogunyemi, Dotun
Mantilla, Rolando
Markus, Abhinav
Reeves, Aubrey
Win, Suyee
Barrientos, Devin R
Lim, Dandrich
Lanum, David
Raval, Niren
author_facet Ogunyemi, Dotun
Mantilla, Rolando
Markus, Abhinav
Reeves, Aubrey
Win, Suyee
Barrientos, Devin R
Lim, Dandrich
Lanum, David
Raval, Niren
author_sort Ogunyemi, Dotun
collection PubMed
description Background: The reported disproportionate impact of COVID-19 infections on minority populations may be due to living in disinvested communities with a high level of poverty, pollution, inadequate unsafe employment, and overcrowded housing. Objective: To determine the association of county, city, and individual risk factors with COVID-19 infection rates. Methods: Retrospective chart review on COVID-19 tests performed from March through July 2020 at Arrowhead Regional Medical Center (ARMC), Colton, California. Results: A total of 7104 tests were performed with 69% in the drive-through testing center. The mean duration of test-to-results time was 2.36 (+0.02) days. COVID-19 positive tests occurred in 1095 (15.4%). At least one symptom occurred in 414 (33%) with a sensitivity of 37.8, specificity of 86.02, a positive predictive value of 33.01, and a negative predictive value of 72.76. Individual factors significantly associated with testing positive for COVID-19 were diabetes, Hispanic ethnicity, and male gender. Younger age was significantly associated with testing COVID positive with the highest risk in children <10 years. COVID-19 positive persons significantly resided in cities with higher population density, household members, poverty, non-English speaking homes, disability, lower median household income, lack of health insurance and decreased access to a computer and Wi-Fi services. County health rankings showed a significant positive association between testing positive for COVID-19 with increased smoking, air pollution, violent crimes, physical inactivity, decreased education, and access to exercise.  Conclusion: Adverse county health rankings, socially and economically disadvantaged cities are associated with an increased risk of testing positive for COVD-19. This information can be used in strategic planning and invention mitigation.
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spelling pubmed-84578922021-09-27 Associations Between Structural and Social Determinants of Health With COVID Infection Rates at a Safety Net Hospital Ogunyemi, Dotun Mantilla, Rolando Markus, Abhinav Reeves, Aubrey Win, Suyee Barrientos, Devin R Lim, Dandrich Lanum, David Raval, Niren Cureus Family/General Practice Background: The reported disproportionate impact of COVID-19 infections on minority populations may be due to living in disinvested communities with a high level of poverty, pollution, inadequate unsafe employment, and overcrowded housing. Objective: To determine the association of county, city, and individual risk factors with COVID-19 infection rates. Methods: Retrospective chart review on COVID-19 tests performed from March through July 2020 at Arrowhead Regional Medical Center (ARMC), Colton, California. Results: A total of 7104 tests were performed with 69% in the drive-through testing center. The mean duration of test-to-results time was 2.36 (+0.02) days. COVID-19 positive tests occurred in 1095 (15.4%). At least one symptom occurred in 414 (33%) with a sensitivity of 37.8, specificity of 86.02, a positive predictive value of 33.01, and a negative predictive value of 72.76. Individual factors significantly associated with testing positive for COVID-19 were diabetes, Hispanic ethnicity, and male gender. Younger age was significantly associated with testing COVID positive with the highest risk in children <10 years. COVID-19 positive persons significantly resided in cities with higher population density, household members, poverty, non-English speaking homes, disability, lower median household income, lack of health insurance and decreased access to a computer and Wi-Fi services. County health rankings showed a significant positive association between testing positive for COVID-19 with increased smoking, air pollution, violent crimes, physical inactivity, decreased education, and access to exercise.  Conclusion: Adverse county health rankings, socially and economically disadvantaged cities are associated with an increased risk of testing positive for COVD-19. This information can be used in strategic planning and invention mitigation. Cureus 2021-08-23 /pmc/articles/PMC8457892/ /pubmed/34584806 http://dx.doi.org/10.7759/cureus.17397 Text en Copyright © 2021, Ogunyemi et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Family/General Practice
Ogunyemi, Dotun
Mantilla, Rolando
Markus, Abhinav
Reeves, Aubrey
Win, Suyee
Barrientos, Devin R
Lim, Dandrich
Lanum, David
Raval, Niren
Associations Between Structural and Social Determinants of Health With COVID Infection Rates at a Safety Net Hospital
title Associations Between Structural and Social Determinants of Health With COVID Infection Rates at a Safety Net Hospital
title_full Associations Between Structural and Social Determinants of Health With COVID Infection Rates at a Safety Net Hospital
title_fullStr Associations Between Structural and Social Determinants of Health With COVID Infection Rates at a Safety Net Hospital
title_full_unstemmed Associations Between Structural and Social Determinants of Health With COVID Infection Rates at a Safety Net Hospital
title_short Associations Between Structural and Social Determinants of Health With COVID Infection Rates at a Safety Net Hospital
title_sort associations between structural and social determinants of health with covid infection rates at a safety net hospital
topic Family/General Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8457892/
https://www.ncbi.nlm.nih.gov/pubmed/34584806
http://dx.doi.org/10.7759/cureus.17397
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