Examining the geographic distribution of six chronic disease risk factors for severe COVID-19: Veteran–nonveteran differences

OBJECTIVES: We aimed to better understand where the prevalence of risk factors for severe COVID-19 occur, especially among veterans and nonveterans – populations that are given the opportunity to seek healthcare from separate entities. METHODS: In this cross-sectional study, we use data from the SMART Behavioral Risk Factor Surveillance System to estimate the prevalence (i.e., survey-weighted %) of six risk factors for severe COVID-19 (i.e., chronic obstructive pulmonary disorder [COPD], asthma, diabetes, obesity, cardiovascular disease, and kidney disease) for veterans and nonveterans at the national level, in 155 metropolitan/micropolitan statistical areas, and in Veteran Integrated Service Networks (veterans only). We examine differences in these outcomes among veterans and between geographic areas using chi-square analysis or multivariable logistic regression. RESULTS: In the national aggregate, veterans exhibited higher prevalence rates of COPD, diabetes, cardiovascular disease, and kidney disease than nonveterans, but not asthma and obesity. However, we show significant variation in the prevalence of risk factors for severe COVID-19 among veterans by geographic location. DISCUSSION: This study provides a dataset that can be used by healthcare providers in order to prioritize prevention programming for veterans who may be at higher risk for COVID-19 due to their increased risk for certain chronic diseases.