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2020 ; 36
(3
): 446-456
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Community Susceptibility and Resiliency to COVID-19 Across the Rural-Urban
Continuum in the United States
#MMPMID32543751
Peters DJ
J Rural Health
2020[Jun]; 36
(3
): 446-456
PMID32543751
show ga
PURPOSE: This study creates a COVID-19 susceptibility scale at the county level,
describes its components, and then assesses the health and socioeconomic
resiliency of susceptible places across the rural-urban continuum. METHODS:
Factor analysis grouped 11 indicators into 7 distinct susceptibility factors for
3,079 counties in the conterminous United States. Unconditional mean differences
are assessed using a multivariate general linear model. Data from 2018 are
primarily taken from the US Census Bureau and CDC. RESULTS: About 33% of rural
counties are highly susceptible to COVID-19, driven by older and
health-compromised populations, and care facilities for the elderly. Major
vulnerabilities in rural counties include fewer physicians, lack of mental health
services, higher disability, and more uninsured. Poor Internet access limits
telemedicine. Lack of social capital and social services may hinder local
pandemic recovery. Meat processing facilities drive risk in micropolitan
counties. Although metropolitan counties are less susceptible due to healthier
and younger populations, about 6% are at risk due to community spread from dense
populations. Metropolitan vulnerabilities include minorities at higher health and
diabetes risk, language barriers, being a transportation hub that helps spread
infection, and acute housing distress. CONCLUSIONS: There is an immediate need to
know specific types of susceptibilities and vulnerabilities ahead of time to
allow local and state health officials to plan and allocate resources
accordingly. In rural areas it is essential to shelter-in-place vulnerable
populations, whereas in large metropolitan areas general closure orders are
needed to stop community spread. Pandemic response plans should address
vulnerabilities.
|Age Factors
[MESH]
|Betacoronavirus
[MESH]
|COVID-19
[MESH]
|Coronavirus Infections/*epidemiology
[MESH]
|Health Services Accessibility/statistics & numerical data
[MESH]
|Health Status
[MESH]
|Humans
[MESH]
|Mental Health
[MESH]
|Pandemics
[MESH]
|Pneumonia, Viral/*epidemiology
[MESH]
|Rural Population/*statistics & numerical data
[MESH]