Open AccessAssessing the association between area deprivation index on COVID-19 prevalence: a contrast between rural and urban U.S. jurisdictions
Author(s) -
Christopher Kitchen,
Elham Hatef,
Hsien Yen Chang,
Jonathan P. Weiner,
Hadi Kharrazi
Publication year - 2021
Publication title -
aims public health
Language(s) - English
Resource type - Journals
ISSN - 2327-8994
DOI - 10.3934/publichealth.2021042
Subject(s) - metropolitan area , context (archaeology) , rural area , covid-19 , pandemic , geography , index (typography) , demography , poisson regression , social deprivation , socioeconomics , environmental health , medicine , economic growth , population , sociology , economics , disease , archaeology , pathology , infectious disease (medical specialty) , world wide web , computer science
Background The COVID-19 pandemic has impacted communities differentially, with poorer and minority populations being more adversely affected. Prior rural health research suggests such disparities may be exacerbated during the pandemic and in remote parts of the U.S. Objectives To understand the spread and impact of COVID-19 across the U.S., county level data for confirmed cases of COVID-19 were examined by Area Deprivation Index (ADI) and Metropolitan vs. Nonmetropolitan designations from the National Center for Health Statistics (NCHS). These designations were the basis for making comparisons between Urban and Rural jurisdictions. Method Kendall's Tau-B was used to compare effect sizes between jurisdictions on select ADI composites and well researched social determinants of health (SDH). Spearman coefficients and stratified Poisson modeling was used to explore the association between ADI and COVID-19 prevalence in the context of county designation. Results Results show that the relationship between area deprivation and COVID-19 prevalence was positive and higher for rural counties, when compared to urban ones. Family income, property value and educational attainment were among the ADI component measures most correlated with prevalence, but this too differed between county type. Conclusions Though most Americans live in Metropolitan Areas, rural communities were found to be associated with a stronger relationship between deprivation and COVID-19 prevalence. Models predicting COVID-19 prevalence by ADI and county type reinforced this observation and may inform health policy decisions.