COVID-19 Deaths and Minority Health Social Vulnerability, in the U.S., January 1, 2020 through June 24, 2023.

IF 3.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-11 DOI:10.1007/s40615-024-02192-w

Hope King, Makhabele Nolana Woolfork, Andrea Yunyou, Yuwa Edomwande, Erik Euler, Olivia Almendares, Suresh Nath Neupane, Melissa Briggs Hagen

{"title":"COVID-19 Deaths and Minority Health Social Vulnerability, in the U.S., January 1, 2020 through June 24, 2023.","authors":"Hope King, Makhabele Nolana Woolfork, Andrea Yunyou, Yuwa Edomwande, Erik Euler, Olivia Almendares, Suresh Nath Neupane, Melissa Briggs Hagen","doi":"10.1007/s40615-024-02192-w","DOIUrl":null,"url":null,"abstract":"Background: Health disparities, leading to worse health outcomes such as elevated COVID-19 mortality rates, are rooted in social and structural factors. These disparities notably impact individuals from lower socioeconomic backgrounds and more socially vulnerable areas. We analyzed the relationship between COVID-19 deaths and social vulnerability using the Minority Health Social Vulnerability Index (MHSVI).Methods: COVID-19 death data in the U.S. was obtained from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, where COVID-19 deaths were defined using the ICD-10 code U07.1. MHSVI composite scores were calculated for 3089 U.S. counties and categorized into social vulnerability quartiles, where values ranged from 0 (lowest vulnerability) to 1 (highest vulnerability). Negative binomial regression was employed to determine death rate ratios for each quartile within each theme. Finally, a multivariate negative binomial regression including all MHSVI sub-themes, excluding the overall index ranking, was used to assess the association between each theme and COVID-19 death rates independently.Results: There were 1,134,272 COVID-19 deaths from January 1, 2020 through June 24, 2023. Adjusted rate ratios for COVID-19 deaths in the overall index ranking were 1.06 (95% CI 0.99-1.13), 1.14 (95% CI 1.06-1.22), and 1.41 (95% CI 1.31-1.52) for the second, third and fourth quartiles, respectively. Sub-themes of socioeconomic status (SES), household characteristics (HC), racial and ethnic minority status (REMS), housing type and transportation (HTT), and medical vulnerability (MV) revealed increasing death rates in higher vulnerability quartiles. The healthcare infrastructure and access (HIA) theme had decreasing death rate ratios of 0.74 (95% CI 0.71-0.78), 0.59 (95% CI 0.56-0.62), and 0.42 (95% CI 0.39-0.44) for the second, third, and fourth quartiles, respectively. Finally, the multivariate analysis showed that the HC, HTT, HIA, and MV themes were associated with COVID-19 deaths (P < 0.05).Conclusion: Counties that were identified as more socially vulnerable experienced higher death rates from COVID-19. These areas may need additional public health and social support during future pandemics.","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Racial and Ethnic Health Disparities","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40615-024-02192-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Health disparities, leading to worse health outcomes such as elevated COVID-19 mortality rates, are rooted in social and structural factors. These disparities notably impact individuals from lower socioeconomic backgrounds and more socially vulnerable areas. We analyzed the relationship between COVID-19 deaths and social vulnerability using the Minority Health Social Vulnerability Index (MHSVI).

Methods: COVID-19 death data in the U.S. was obtained from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, where COVID-19 deaths were defined using the ICD-10 code U07.1. MHSVI composite scores were calculated for 3089 U.S. counties and categorized into social vulnerability quartiles, where values ranged from 0 (lowest vulnerability) to 1 (highest vulnerability). Negative binomial regression was employed to determine death rate ratios for each quartile within each theme. Finally, a multivariate negative binomial regression including all MHSVI sub-themes, excluding the overall index ranking, was used to assess the association between each theme and COVID-19 death rates independently.

Results: There were 1,134,272 COVID-19 deaths from January 1, 2020 through June 24, 2023. Adjusted rate ratios for COVID-19 deaths in the overall index ranking were 1.06 (95% CI 0.99-1.13), 1.14 (95% CI 1.06-1.22), and 1.41 (95% CI 1.31-1.52) for the second, third and fourth quartiles, respectively. Sub-themes of socioeconomic status (SES), household characteristics (HC), racial and ethnic minority status (REMS), housing type and transportation (HTT), and medical vulnerability (MV) revealed increasing death rates in higher vulnerability quartiles. The healthcare infrastructure and access (HIA) theme had decreasing death rate ratios of 0.74 (95% CI 0.71-0.78), 0.59 (95% CI 0.56-0.62), and 0.42 (95% CI 0.39-0.44) for the second, third, and fourth quartiles, respectively. Finally, the multivariate analysis showed that the HC, HTT, HIA, and MV themes were associated with COVID-19 deaths (P < 0.05).

Conclusion: Counties that were identified as more socially vulnerable experienced higher death rates from COVID-19. These areas may need additional public health and social support during future pandemics.

查看原文本刊更多论文

COVID-19 2020 年 1 月 1 日至 2023 年 6 月 24 日美国的死亡人数和少数民族健康社会脆弱性。

背景：健康差异会导致更糟糕的健康结果，如 COVID-19 死亡率升高，其根源在于社会和结构性因素。这些差异对社会经济背景较差和社会弱势地区的人影响显著。我们使用少数民族健康社会脆弱性指数（MHSVI）分析了 COVID-19 死亡与社会脆弱性之间的关系：美国 COVID-19 死亡数据来自美国疾病控制和预防中心 (CDC) 国家卫生统计中心，其中 COVID-19 死亡使用 ICD-10 代码 U07.1 进行定义。计算了美国 3089 个县的 MHSVI 综合得分，并将其划分为社会脆弱性四分位数，数值从 0（最低脆弱性）到 1（最高脆弱性）不等。采用负二叉回归法确定每个主题中每个四分位数的死亡率比率。最后，使用包括所有 MHSVI 子主题（不包括总指数排名）的多变量负二项回归来独立评估每个主题与 COVID-19 死亡率之间的关联：从 2020 年 1 月 1 日到 2023 年 6 月 24 日，共有 1,134,272 例 COVID-19 死亡。在总指数排名中，第二、第三和第四四分位数的 COVID-19 死亡调整率比分别为 1.06（95% CI 0.99-1.13）、1.14（95% CI 1.06-1.22）和 1.41（95% CI 1.31-1.52）。社会经济状况（SES）、家庭特征（HC）、少数种族和少数民族状况（REMS）、住房类型和交通（HTT）以及医疗脆弱性（MV）等子主题显示，在较高的脆弱性四分位数中，死亡率不断上升。医疗基础设施和获取（HIA）主题在第二、第三和第四四分位数的死亡率比率分别为 0.74（95% CI 0.71-0.78）、0.59（95% CI 0.56-0.62）和 0.42（95% CI 0.39-0.44）。最后，多变量分析表明，HC、HTT、HIA 和 MV 主题与 COVID-19 死亡相关（P 结论）：被确定为社会脆弱性较高的县的 COVID-19 死亡率较高。在未来的大流行病期间，这些地区可能需要更多的公共卫生和社会支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.