The dynamic impact of community social vulnerability on COVID-19 outcomes: A census tract-level analysis of Fulton County, GA.

IF 8.2 1区医学 Q1 IMMUNOLOGY

Clinical Infectious Diseases Pub Date : 2025-04-03 DOI:10.1093/cid/ciaf177

Kamini Doraivelu, Steve Williams, Mallory Hazell, Sasha Smith, Allison T Chamberlain, Neel R Gandhi, N Sarita Shah, Shivani A Patel

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引用次数: 0

Abstract

Background: COVID-19 case and death rates have been variable across geography and time; an understanding of community social vulnerability and variation in COVID-19 outcomes is needed to better respond to acute public health needs and prioritize post-pandemic recovery.

Methods: We analyzed records of confirmed COVID-19 cases (N = 106,037) and deaths (N = 2,107) in Fulton County, Georgia, from 3/4/2020 to 11/11/2021. We developed the Social Vulnerability Index-Plus (SVI+) as a composite measure of 19 census tract-level social and health indicators summarizing community vulnerability. Ecological analyses included linear regression estimates of differences in weekly COVID-19 case and death rates per 100,000 population by SVI + across 201 census tracts. Multilevel analyses included log-binomial regression estimates of relative risk of individual-level death among confirmed cases according to the SVI+. Calendar periods included Pre-Vaccine (03/2020-12/15/2020), Post-Vaccine/Pre-Delta variant surge (12/16/20-06/30/21), and Post-Vaccine/Delta variant surge (7/1/21-11/21).

Results: We observed a positive association between SVI + and both COVID-19 census tract-level case and death rates. Analyses by calendar period indicated that the strongest association between SVI + and both case rates, and death rates was in the Post-Vaccine/Delta variant surge period. Analyses of individual-level death among cases showed a positive association between SVI + and COVID-19 death after accounting for age, race, and sex. SVI + and individual-level death were positively associated in all calendar periods.

Conclusion: Even after vaccine availability, communities with higher social vulnerability experienced worse COVID-19 outcomes. The findings reiterate the importance of addressing social determinants by increasing public health efforts in vulnerable communities to mitigate health disparities in future pandemics.

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来源期刊

Clinical Infectious Diseases 医学-传染病学

CiteScore

25.00

自引率

2.50%

发文量

900

审稿时长

3 months

期刊介绍： Clinical Infectious Diseases (CID) is dedicated to publishing original research, reviews, guidelines, and perspectives with the potential to reshape clinical practice, providing clinicians with valuable insights for patient care. CID comprehensively addresses the clinical presentation, diagnosis, treatment, and prevention of a wide spectrum of infectious diseases. The journal places a high priority on the assessment of current and innovative treatments, microbiology, immunology, and policies, ensuring relevance to patient care in its commitment to advancing the field of infectious diseases.