Renuka Tipirneni, MD, MSc, FACP Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine, Divisions of General Medicine and Hospital Medicine, and Institute for Healthcare Policy & Innovation Ann Arbor, MI

COVID-19: Social Disadvantage Strongly Linked to Incidence and Deaths

MedicalResearch.com Interview with:

Renuka Tipirneni, MD, MSc, FACP Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine, Divisions of General Medicine and Hospital Medicine, and Institute for Healthcare Policy & Innovation Ann Arbor, MI

Dr. Tipirneni

Renuka Tipirneni, MD, MSc, FACP
Assistant Professor
Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024
University of Michigan Department of Internal Medicine, Divisions of General Medicine and Hospital Medicine,
and Institute for Healthcare Policy & Innovation
Ann Arbor, MI

MedicalResearch.com: What is the background for this study?

Response: As there have been significant racial/ethnic disparities in US COVID-19 infections and health outcomes including death, we investigated county-level social factors that may explain these inequities. Specifically, we examined the association between the Centers for Disease Control and Prevention’s Social Vulnerability Index (a composite measure of social disadvantage) and COVID-19 incidence and mortality rates. We found that with just a one-point increase in the ten-point scale, there was a 14% increase in incidence rate and 14% increase in mortality rate. This equated to approximately 87 excess COVID-19 infections and 3 deaths per 100,000 population.

MedicalResearch.com: What are the main findings?

Response: When we looked at individual social factors, crowded housing, limited English proficiency, and single-parent households had the strongest association with COVID-19 cases and deaths.

MedicalResearch.com: What should readers take away from your report?

Response: These findings highlight that underlying inequality and social disadvantage, and its role in promoting the spread of the coronavirus, is a problem that affects all of us, no matter where we live. This evidence contradicts the perception that COVID-19 mostly affects just one set of people in one kind of area. While the first surge was mainly in urban areas with high percentages of Black and Latinx residents, as time went on some of highest rates of cases and deaths were in rural counties with predominantly white populations. But across the board, we find the areas hardest-hit by the disease were linked by higher rates of social disadvantage.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research in this area should consider even smaller geographic areas than counties. This would help target specific high-risk communities for outreach, such as enhanced COVID-19 testing, vaccine distribution, or targeted social services such as housing assistance.

No disclosures

Citation:

Karmakar M, Lantz PM, Tipirneni R. Association of Social and Demographic Factors With COVID-19 Incidence and Death Rates in the US. JAMA Netw Open. 2021;4(1):e2036462. doi:10.1001/jamanetworkopen.2020.36462

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Jan 29, 2021 @ 7:22 pm

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