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This study aims to examine the spatially varying relationships between social vulnerability factors and COVID-19 cases and deaths in the contiguous United States. County-level COVID-19 data and the Centers for Disease Control and Prevention social vulnerability index (SVI) dataset were analyzed using local Spearman’s rank correlation coefficient. Results suggested that SVI and four social vulnerability themes have spatially varying relationships with COVID-19 cases and deaths, which means spatial heterogeneity is an essential factor that influences the relationship, and the strength of association varies significantly across counties. County hot spots that were subject to all four social vulnerability themes during the pandemic were also identified. Local communities and health authorities should pay immediate attention to the most influential social vulnerability factors that are dominant in their region and incorporate measures tailored to the specific groups of people who are under the greatest risk of being affected during the COVID-19 pandemic.

The spatial association of social vulnerability with COVID-19 prevalence in the contiguous United States