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2020 ; 36
(3
): 433-445
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English Wikipedia
Spatial Disparities in Coronavirus Incidence and Mortality in the United States:
An Ecological Analysis as of May 2020
#MMPMID32543763
Zhang CH
; Schwartz GG
J Rural Health
2020[Jun]; 36
(3
): 433-445
PMID32543763
show ga
PURPOSE: This ecological analysis investigates the spatial patterns of the
COVID-19 epidemic in the United States in relation to socioeconomic variables
that characterize US counties. METHODS: Data on confirmed cases and deaths from
COVID-19 for 2,814 US counties were obtained from Johns Hopkins University. We
used Geographic Information Systems (GIS) to map the spatial aspects of this
pandemic and investigate the disparities between metropolitan and nonmetropolitan
communities. Multiple regression models were used to explore the contextual risk
factors of infections and death across US counties. We included population
density, percent of population aged 65+, percent population in poverty, percent
minority population, and percent of the uninsured as independent variables. A
state-level measure of the percent of the population that has been tested for
COVID-19 was used to control for the impact of testing. FINDINGS: The impact of
COVID-19 in the United States has been extremely uneven. Although densely
populated large cities and their surrounding metropolitan areas are hotspots of
the pandemic, it is counterintuitive that incidence and mortality rates in some
small cities and nonmetropolitan counties approximate those in epicenters such as
New York City. Regression analyses support the hypotheses of positive
correlations between COVID-19 incidence and mortality rates and socioeconomic
factors including population density, proportions of elderly residents, poverty,
and percent population tested. CONCLUSIONS: Knowledge about the spatial aspects
of the COVID-19 epidemic and its socioeconomic correlates can inform first
responders and government efforts. Directives for social distancing and to
"shelter-in-place" should continue to stem the spread of COVID-19.