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10.2196/29205

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34081608!8354426!34081608
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suck abstract from ncbi


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pmid34081608      JMIR+Public+Health+Surveill 2021 ; 7 (8): e29205
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  • Census Tract Patterns and Contextual Social Determinants of Health Associated With COVID-19 in a Hispanic Population From South Texas: A Spatiotemporal Perspective #MMPMID34081608
  • Bauer C; Zhang K; Lee M; Fisher-Hoch S; Guajardo E; McCormick J; de la Cerda I; Fernandez ME; Reininger B
  • JMIR Public Health Surveill 2021[Aug]; 7 (8): e29205 PMID34081608show ga
  • BACKGROUND: Previous studies have shown that various social determinants of health (SDOH) may have contributed to the disparities in COVID-19 incidence and mortality among minorities and underserved populations at the county or zip code level. OBJECTIVE: This analysis was carried out at a granular spatial resolution of census tracts to explore the spatial patterns and contextual SDOH associated with COVID-19 incidence from a Hispanic population mostly consisting of a Mexican American population living in Cameron County, Texas on the border of the United States and Mexico. We performed age-stratified analysis to identify different contributing SDOH and quantify their effects by age groups. METHODS: We included all reported COVID-19-positive cases confirmed by reverse transcription-polymerase chain reaction testing between March 18 (first case reported) and December 16, 2020, in Cameron County, Texas. Confirmed COVID-19 cases were aggregated to weekly counts by census tracts. We adopted a Bayesian spatiotemporal negative binomial model to investigate the COVID-19 incidence rate in relation to census tract demographics and SDOH obtained from the American Community Survey. Moreover, we investigated the impact of local mitigation policy on COVID-19 by creating the binary variable "shelter-in-place." The analysis was performed on all COVID-19-confirmed cases and age-stratified subgroups. RESULTS: Our analysis revealed that the relative incidence risk (RR) of COVID-19 was higher among census tracts with a higher percentage of single-parent households (RR=1.016, 95% posterior credible intervals [CIs] 1.005, 1.027) and a higher percentage of the population with limited English proficiency (RR=1.015, 95% CI 1.003, 1.028). Lower RR was associated with lower income (RR=0.972, 95% CI 0.953, 0.993) and the percentage of the population younger than 18 years (RR=0.976, 95% CI 0.959, 0.993). The most significant association was related to the "shelter-in-place" variable, where the incidence risk of COVID-19 was reduced by over 50%, comparing the time periods when the policy was present versus absent (RR=0.506, 95% CI 0.454, 0.563). Moreover, age-stratified analyses identified different significant contributing factors and a varying magnitude of the "shelter-in-place" effect. CONCLUSIONS: In our study, SDOH including social environment and local emergency measures were identified in relation to COVID-19 incidence risk at the census tract level in a highly disadvantaged population with limited health care access and a high prevalence of chronic conditions. Results from our analysis provide key knowledge to design efficient testing strategies and assist local public health departments in COVID-19 control, mitigation, and implementation of vaccine strategies.
  • |*Hispanic or Latino[MESH]
  • |*Social Determinants of Health[MESH]
  • |Adolescent[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |COVID-19/*epidemiology[MESH]
  • |Censuses[MESH]
  • |Female[MESH]
  • |Health Equity[MESH]
  • |Humans[MESH]
  • |Incidence[MESH]
  • |Male[MESH]
  • |Mexico/ethnology[MESH]
  • |Middle Aged[MESH]
  • |Minority Groups[MESH]
  • |Physical Distancing[MESH]
  • |SARS-CoV-2[MESH]
  • |Socioeconomic Factors[MESH]
  • |Spatial Analysis[MESH]
  • |Texas/epidemiology[MESH]
  • |United States[MESH]
  • |Vulnerable Populations[MESH]


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