Disparities in COVID-19 Incidence, Hospitalizations, and Testing, by Area-Level Deprivation - Utah, March 3-July 9,...

Area of Science:

• Public Health
• Epidemiology
• Social Determinants of Health

Background:

• Coronavirus disease 2019 (COVID-19) disproportionately affected minority populations and essential workers in the U.S.
• The role of geographic social and economic inequities, termed deprivation, in these disparities was previously unexamined.
• Utah reported 27,356 confirmed COVID-19 cases by July 9, 2020.

Purpose of the Study:

• To investigate how area-level deprivation reinforces ethnic, racial, and workplace-based COVID-19 inequities in Utah.
• To analyze the relationship between COVID-19 infection, hospitalization, and testing rates with geographic deprivation.

Main Methods:

• Analysis of confirmed SARS-CoV-2 cases, hospitalizations, and testing rates in Utah.
• Deprivation measured using Utah's Health Improvement Index (HII).
• Calculation of age-weighted odds ratios for four age groups, standardized to the 2000 U.S. Census population.

Main Results:

• Odds of COVID-19 infection significantly increased with higher levels of area-level deprivation.
• Infection odds were two times greater in high-deprivation areas (weighted OR=2.08) and three times greater in very high-deprivation areas (weighted OR=3.11) compared to very low-deprivation areas.
• Odds of hospitalization and testing also increased with deprivation, though to a lesser extent than infection.

Conclusions:

• Area-level deprivation is a significant factor reinforcing COVID-19 disparities.
• Public health strategies should incorporate deprivation measures and social determinants of health.
• Targeted interventions, including increased testing accessibility and prevention guidance, are crucial for high-deprivation areas.