Research article Special Issues

Assessing the association between area deprivation index on COVID-19 prevalence: a contrast between rural and urban U.S. jurisdictions

Running title: COVID-19 prevalence, ADI and county type
  • Received: 21 May 2021 Accepted: 15 July 2021 Published: 22 July 2021
  • 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.

    Citation: Christopher Kitchen, Elham Hatef, Hsien Yen Chang, Jonathan P Weiner, Hadi Kharrazi. Assessing the association between area deprivation index on COVID-19 prevalence: a contrast between rural and urban U.S. jurisdictions[J]. AIMS Public Health, 2021, 8(3): 519-530. doi: 10.3934/publichealth.2021042

    Related Papers:

  • 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.



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    Acknowledgments



    We thank our colleagues at the JHU Center for Systems Science and Engineering for managing a world class resource on COVID-19 data and the reviewers for their timely feedback on this manuscript during a time of public health crisis.

    Conflict of interest



    The authors declare no conflict of interest.

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